抗菌药（英文PPT）Antimicrobialsppt课件.pptVIP

β-Lactams : Carbapenems Tienam/ mepem ?Widest spectrum: 1) anaerobes, 2) most GPC (except Enterococcus faecium and ORSA) 3) most GNB (except: Stenotrophomonas maltophilia and Burkholderia cepacia ) Special stereochemical characteristics ? β-lactamase stable Hypersensitivity similar with PCNs Seizure attack with predisposing factors (e.g., advanced age, renal insufficiency, Hx. of seizure) ★ ★ ★ ★ ★ Amikacin (Amikin)/ Gentamicin/ Neomycin / Netromycin Aminoglycosides Amikacin (Amikin)/ Gentamicin/ Neomycin / Netromycin Bactericidal for numerous G(+) G(-) bacteria Not active in 1) oxygen-poor environment 2) low PH ? ineffective to anaerobes and abscesses Usually with β-Lactam antibiotics to GNB Synergy with PCNs to streptococcal, enterococcal endocarditis Interfering with protein synthesis during aerobic metabolism. Good potensy: concentration-dependent killing effect and time-dependent PAE on G(+) and G(-) organisms Potency depend on 1) susceptibility to aminoglycoside-inactivating enzyme 2) permeability to cell wall Aminoglycosides Freeze initiation Block peptide bond formation Misreading of mRNA Aminoglycosides Excreted rapidly by normally functioning kidney ?TBW-dependent distribution: ↑dose in pregnancy, burns, ascites, septic shock ? ↓dose in renal insufficiency Adverse effect: 1) Nephrotoxicity ?reversible but possible permanent renal failure ?monitor renal function during therapy 2) ototoxicity ? prolonged use (14 days) , renal insufficiency, concurrent use with other ototoxic agents. 常见心律失常心电图诊断的误区诺如病毒感染的防控知识介绍责任那些事浅谈用人单位承担的社会保险法律责任和案例分析现代农业示范工程设施红地球葡萄栽培培训材料 Antimicrobials Reporter: I1, Lin YH. Introduction Patients in the ICU are often infected with multiresistant organisms. Frequently exposed to broad-spectrum antibiotics and invasive procedures Judicious used of empiric antimicrobial therapy is needed to minimize emergence of