抗生素基本知识（英文PPT）TheABCs of .pptVIP

The ABC’s of Antibiotics Lourdes Irizarry, MD Associate Professor of Medicine Albuquerque VAMC UNM SOM Principles of Antimicrobial Therapy Site of action Individual patient Ecology of the institution Efficacy Toxicity Cost Classes of Antibiotics Beta lactams Monobactams Carbapenems Macrolides/Azalides/Lincosamides Aminoglycosides Fluoroquinolones Oxazolidinones Antibiotic brands 50 penicillins 71 cephalosporins 12 tetracyclines 8 aminoglycosides 1 monobactam 3 carbapenems 9 macrolides 2 streptogramins 3 dihydrofolate reductase inhibitors 1 oxazolidinone 5.5 quinolones Inhibition of Cell Cell Wall Synthesis Vancomycin, teicoplanin Beta-lactams Monobactams Carbapenems Inhibition of Protein Synthesis 50 S inhibitors macrolides chloramphenicol clindamycin 30 S inhibitors tetracycline aminoglycosides oxazolidinones Interference with basic cell functions quinolones DNA gyrase Folic acid metabolism trimethoprim sulfonamides Antibiotic Inactivation Destruction or modification Ex: Beta-lactamase production Alteration of the antibiotic target site(s) Ex: Abnormal PBPs Prevention of access to target Ex: Efflux pump Deletions of porins Antibiotic Essentials’ Antibiotic Essentials’ (2) Antibiotic Essentials’ (3) Antibiotic Essentials’ (4) Antibiotic Essentials’ (5) Antibiotic Essentials’ (6) Antibiotic Essentials: (7) Antibiotic Essentials’: (9) Macrolides Erythromycin and Clarithromycin have hepatic metabolism via cytochrome p-450 (Increase levels of theophylline, warfarin, triazolam, bromocriptine, carbamazepine and cyclosporin) Erythromycin iv from causes phlebitis, not Azithromycin, no IV Clarithromycin (too venous toxic) Classification of Fuoroquinolones First generation nalidixic acid Second generation norfloxacin ciprofloxacin* ofloxacin levofloxacin Third generation** gatifloxacin (sparfloxacin, grepafloxacin) Fourth generation*** moxifloxacin trovafloxacin, (clinafloxacin) Activity of Fluoroquinolones Against Gram Positive Bacteria Activity of Fluoroqu