Antibiotic Selection - Winston-SalemForsyth County Schools：抗生素的选择-温斯顿salemforsyth县学校.pptVIP

Antibiotics Disrupt Cell Wall Synthesis, Protein Synthesis, Nucleic Acid Synthesis and Metabolism Principles and Definitions Selectivity Selectivity vs toxicity Therapeutic index Toxic dose/ Effective dose Categories of antibiotics Bacteriostatic Reversibly inhibit growth Duration of treatment sufficient for host defenses to eradicate infection Bactericidal- Kill bacteria Usually antibiotic of choice for infections in sites such as endocardium or the meninges where host defenses are ineffective. Principles and Definitions Selectivity Therapeutic index Principles and Definitions Antibiotic susceptibility testing (in vitro) Bacteriostatic Antibiotics Minimum inhibitory concentration (MIC) Lowest concentration that results in inhibition of visible growth (colonies on a plate or turbidity of liquid culture) Bactericidal Antibiotics Minimum bactericidal concentration (MBC) Lowest concentration that kills 99.9% of the original inoculum Antibiotic Susceptibility Testing-MIC Principles and Definitions Combination therapy Prevent emergence of resistant strains Temporary treatment until diagnosis is made Take advantage of antibiotic synergism Penicillins and aminoglycosides inhibit cell wall synthesis and allow aminoglycosides to enter the bacterium and inhibit protein synthesis. CAUTION: Antibiotic antagonism Penicillins and bacteriostatic antibiotics. Cell wall synthesis is not occurring in cells that are not growing. Antibiotics vs chemotherapeutic agents vs antimicrobials Antibiotics-naturally occurring materials Chemotherapeutic-synthesized in the lab (most antibiotics are now synthesized and are therefore actually chemotherapeutic agents. Mechanisms of Antibiotics Mechanisms of Antibiotics Antimicrobial Drug ResistancePrinciples and Definitions Clinical resistance vs actual resistance Resistance can arise by new mutation or by gene transfer (e.g. acquisition of a plasmid) Resistance provides a selective advantage. Resistance can result from single or multiple ste