抗生素英文课件精品Chemotherapeutic .pptVIP

Chemotherapeutic Agents Antibiotics Antifungals Antivirals Antiprotozoal Antihelmintics Anticancer drugs Antibiotics General Aspects: Principle: inhibit growth of bacteria without harming the host – Drug must penetrate body tissue to reach bacteria (exception: GI infection)(unique targets: cell wall, protein synthesis, metabolic pathways…) Bacteria targeted must be within the spectrum of the AB Drug can be bactericidal or bacteriostatic Different agents can be combined for synergistic effect (Note: not all combinations are useful, e.g. cell wall synthesis inhibitors loose effectiveness when combined with bacteriostatic drugs) Identification of the invasive microorganism necessary for optimal treatment General side effect: Alteration in normal body flora – GI tract harbors symbiotic bacteria which are killed by AB =resistant bacteria repopulate the niche = secondary or superinfection(most common: overgrowth of Clostridium difficile) Antibiotics Resistance: loss of efficacy of a given AB against a particular strain – Frequently: Staphylococcus aureus, pseudomonas aeruginosa, mycobacterium tuberculosii Acquisition: Spontaneous mutation Adaption: drug metabolism (b-lactamase); alternative metabolic pathways Gene transfer: plasmids (via conjugation and transduction); transposons Manifestation: Microbes may increase manufacture of drug-metabolizing enzymes (penicillins) Microbes may cease active uptake of certain drugs (tetracyclines) Changes in receptors which decrease antibiotic binding and action Microbes may synthesize compounds that antagonize drug actions Antibiotic use promotes the emergence of drug-resistant microbes (especially the use of broad-spectrum antibiotics) !!! The more ABs are used, the greater the chance of resistance !!! Antibiotics Resistance avoided/delayed by: Using AB only when absolutely needed and indicated: AB often abused for viral infections (diarrhea, flu-symptoms, etc.) Starting with narrow-spectrum drugs Limiting use