药理学精品教学汕头大学introductiontoantimicrobialagents.ppt

Introduction to antimicrobial agents Antimicrobial drug Antimicrobial drugs either kill microbes (microbicidal) or prevent the growth of microbes (microbistatic). Antibacterial(抗菌药） Antiviral（抗病毒药） Antifungal（抗真菌药） Antimicrobial Chemotherapy Differential toxicity: based on the concept that the drug is more toxic to the infecting organism than to the host Majority of antibiotics are based on naturally occurring compounds ( antibiotics) or may be semi-synthetic or synthetic Definitions Spectrum of Activity（抗菌谱） Narrow spectrum - drug is effective against a limited number of species Broad spectrum - drug is effective against a wide variety of species Gram negative (G+) agentGram positive (G-) agentAnti-anaerobic activity Definitions Minimum Inhibitory Concentration (MIC)- minimum concentration of antibiotic required to inhibit the growth of the test organism Minimum Bactericidal Concentration (MBC)- minimum concentration of antibiotic required to kill the test organism Definitions Bacteriostatic（抑菌药） Bactericidal（杀菌药） Chemotherapeutic Index ( 化疗指数，CI ): LD50/ED50 or LD5/ED95 Definitions Post antibiotic effect (抗生素后效应，PAE) the continued suppression of antibacterial growth after the administration of antibiotic has ceased and serum concentrations have fallen below the MIC Unit: hour PAE is longer in vivo Clinical significance of PAE Design therapeutic regimen Increase dose: carbapenems (concentration dependent PAE) Determination of dosing interval： Antibiotics without PAE: serum concentration higher than MIC Antibiotics with PAE: serum concentration higher than MIC+PAE Evaluation of combined medication What is the ideal antibiotic Have the appropriate spectrum of activity for the clinical setting Have no toxicity to the host, be well tolerated Low propensity for development of resistance Not induce hypersensitivies in the host What is the ideal antibiotic Have rapid and extensive tissue distribution Have a relatively long half-life Be free of interaction