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All (Introduction To Anti-Mic

This document provides an overview of antimicrobial drugs including their classification, mechanisms of action, and factors considered in their selection and dosing. It discusses how antimicrobials are classified based on their activity (bacteriostatic vs bactericidal), spectrum (narrow, extended, broad), and mechanism of action (inhibiting cell wall synthesis, protein synthesis, etc.). Selection depends on microbial and patient factors like infection site, immune status, age, and organ function. Dosing frequency is based on pharmacodynamics like time-dependent bactericidal effects. Rational dosing considers pharmacokinetics and achieving optimal drug concentrations at the site of infection.

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54 views3 pages

All (Introduction To Anti-Mic

This document provides an overview of antimicrobial drugs including their classification, mechanisms of action, and factors considered in their selection and dosing. It discusses how antimicrobials are classified based on their activity (bacteriostatic vs bactericidal), spectrum (narrow, extended, broad), and mechanism of action (inhibiting cell wall synthesis, protein synthesis, etc.). Selection depends on microbial and patient factors like infection site, immune status, age, and organ function. Dosing frequency is based on pharmacodynamics like time-dependent bactericidal effects. Rational dosing considers pharmacokinetics and achieving optimal drug concentrations at the site of infection.

Uploaded by

Miki Abera
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© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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All ( Introduction to anti-microbial drugs) lecture examples:

Antibiotics: penicillin G, tetracycline


Antibacterial agents: fluoroquinolone, sulfonamides

Characteristics of Antimicrobial agents


Penicillin, cephalosporine act on( microbial cell wall)

Classification of Antimicrobial agents according to activity

Bacteriostatic: Chloramphenicol, Tetracyclines, Sulfadiazine, Erythromycin


Bactericidal: Aminoglycosides, penicillin, cephalosporine, Fluoroquinolones

Classification of Antimicrobial agents according to spectrum activity

Narrow spectrum: benzyl penicillin (Gt), Aztreonam (G-), Isoniazid (M. TB)
Extended spectrum: Ampicillin, Amoxicillin
Broad Spectrum: tetracycline, Chloramphenicol

Classification of Antimicrobial agents according to their mechanism of action


1. Inhibitors of cell wall synthesis: B-lactams; Penicillin, cephalosporins, Carbapenems, Vancomycin
2. of protein synthesis: Aminoglycosides, Erythromycin, Tetracyclines, Chloramphenicol
3. of bacterial nucleic acid synthesis: Quinolones, Metronidazole, Rifampin
4. Disruption of bacterial cell membrane: Polymyxin B, Colistin
5. Blocking of metabolic pathway essential for MO. : Sulfonamide, Trimethoprim

Selection of antimicrobial agents depend on

1. Microbial factor: Empiric therapy;


> combination of Gentamicin + Clindamycin
Empiric therapy choice is depending on (infection site, patient age, Clinical settings), Eg ;
Meningitis in neonates mostly caused by S. Agalactiae sensitive to penicillin G
but in 40 YOpatient mostly caused by S. Pneumoniae ---=-> resistant to penicillin G and high dosed 3rd
generation cephalosporines are given as treatment like: Ceftriaxone, Vancomycin.
2. Patient factors:
A. Immune system: they require bactericidal not bacteriostatic like (penicillin, cephalosporine,
fluoroquinolones)
B.
Renal function: Erythromycin, Doxycycline
C. Hepatic function: Amoxicillin, Meropenem
D.
Poor perfusion: Levofloxacin, Linezolid for diabetic foot infections
E. Age: Neonates;
Chloramphenicol: green baby syndrome
Sulfonamide: Jaundice, Kernicterus (both caused by bilirubin)
Young;
Tetracycline (teeth discoloration), Quinolones (cartilage deformity)
F. Pregnancy and lactation: Tetracycline is contra indicated during pregnancy bcz it cause teth and
bones dysplasia.

3. Site of infection:

Gentamycin: UTIs -> urinary tract infections


Cprofloxacin, Co-trimoxazole: prostatitis
Levofloxacin: Pneumonia
Ceftriaxone: Meningitis

4. Drug properties
Lipid solubility: Chloramphenicol, Metronidazole ,
Agent safety Penet"i'
Therapy cost

Rational dosing of antimicrobial agents based on

Pharmacodynamics Pharmacokinetics

Dosing frequency of AB depends on:

A. Time dependent bactericidal effects: penicillin, cephalosporins, vancomycin, macrolides, clindamycin,

C. Post-antibiotic effect
Penicillin:

-lactam bactericidal antibiotic, cell wall synthesis Inhibitor, narrow spectrum


Tetracyclines:
Bacteriostatic, Broad Spectrum, protein synthesis in og pregnancy and young

Cephalosporins (eg;Vancomycin) :
Bactericidal, cell wall synthesis Inhibitor

fluoroquinolone:
Bactericidal

Erythromycin:

c St , ro▇ ▇ ▇ ▇▇

Quinolones:

Bactericidal, bacterial nucleic acid synthesis inhibitor, contra indicated in youth

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