Antibacterials/

antibiotics
 ANTIBIOTICS- is from antibiosis, meaning against life.

- Substance derived from a microorganism or produced synthetically to kill or suppress

the growth of other microorganisms.

- ANTIBACTERIALS- any substance that kills or inhibits the bacteria, which can include

antibiotics

- 1st antibiotic discovered by Alexander Fleming is Penicillin in 1929

- Ideally, before the beginning of antibiotic therapy, the suspected areas of infection

should be cultured to identify the causative organism and potential antibiotic

 CULTURE AND SENSITIVITY TEST
CULTURE- identify the type of germs/ infection.
-

SENSITIVITY- identify the type of medication which needs to be given to treat or eradicate the
infection.
- searching for the correct medication.
 CULTURE AND SENSITIVITY TEST

SENSITIVITY- identify the type of medication which needs to be given to treat or eradicate the
infection.
- searching for the correct medication.
Most bacteria have a rigid cell wall. The structure of the cell wall determines the

shape of the bacteria:

Bacillus is a rod shaped organism, cocci are a spherical bacterium (when it

appeared in clusters it is called staphylococci; when the cocci divide into chains

it called streptococci

Sources of antibiotics: natural (mainly fungal sources); semi synthetic

( chemically altered natural compound); synthetic ( chemically designed in the

lab)
 INDICATIONS FOR ANTIBACTERIAL THERAPY
1. DEFINITIVE THERAPY- this is for proven infections
-attempts should be made to confirm the bacterial infection by
means of staining secretions, fluids,exudates, C/S and other test
2.Empirical therapy- restricted to critical cases, when time is
inadequate for identification and isolation of the bacteria and
have a strong doubt of bacterial infection exist
3. Prophylactic therapy- require the use of antibiotics for the
prevention rather than the treatment of infections
- Only narrow spectrum and specific drugs are used.
- The duration of prophylaxis is dictated by the duration of the
risk of infection.
 Factors to be considered before prescribing antibacterial agent
1. Site of Infection
2. Type of infection: localised or extensive;mild or
severe;superficial
3. Severity of infections
4. Isolate and sensitivity
5. Source of infection: community acquired/ hospital acquired
6. Patient factors: age of the patient; immune status;pregnancy
and lactation; associated conditions like renal failutre,
epilepsy
7. Drug factors: hypersensitivity; adverse reactions;cost;
interactions like with or without food
 CLASSIFICATION OF ANTIBIOTICS
Antibiotics are classified by several ways:
On the basis of mechanism of action
1. inhibition of cell wall synthesis
-bactericidal effect
- enzyme breakdown of the cell wall
penicillins, cephalosporins, vancomycin
2. Inhibition of functions of cellular membrane
-bacteriostatic or bactericidal effect
- membrane permeability is increased.
polymixins
3. Inhibition of protein synthesis
- bacteriostatic or bactericidal effect
- interferes with protein synthesis without affecting normal
cell.
Tetracyclines, aminoglycosides, macrolides
4. Inhibition of nucleic acid synthesis (RNA and DNA)
- inhibits synthesis of RNA and DNA in bacteria.
 CLASSIFICATION OF ANTIBIOTICS
Quinolones, rifampin
5. Inhibition of folic acid synthesis
-bacteriostatic effect
- interferes with steps of metabolism within the cell
sulfonamides and izoniazid (INH), trimethoprim

On the basis of spectrum activity

Antimicrobial Spectrum: the scope that a drug kills or suppresses
the growth of microorganism
Narrow spectrum- the drugs that only act on one kind or one
strain of bacteria ( Isoniazide)
Broad spectrum- the drugs that have a wide antimicrobial scope
( tetracycline and chloramphenicol)
On the basis of mode of action
 Misuse of antibiotics

Antibiotic misuse- sometimes called antibiotic abuse or

antibiotic overuse.

The misuse or overuse of antibiotics may produce serious effects

on health

It is a contributing factor to the creation of multidrug resistant

bacteria informally called “super bugs”

 Antibiotic resistance and cross resistances

Antibiotic resistance is the phenomenon that susceptibility of pathogenic microorganisms

to antibiotic becomes lower or even loses after the microorganisms contact with antibiotic

many times. When the bacteria show resistance to one antibiotic they are also resistant to

some other antibiotics or called the cross antibiotic resistances

Bacterial resistance may result naturally or ineherent occurs without previous exposure to

the antibacterial drugs while the acquired resistance is caused by prior exposure to
 Preventing antibiotic resistance

Patients can:

Take antibiotics exactly as doctor prescribed

Complete the prescribed course of treatment

Do not save the antibiotic for next illness

Only take antibiotics prescribed for you; do not share or use leftover antibiotics

Do not ask for antibiotic when your doctor thinks you do not need them
 Classes of antibiotics

Beta lactams ( penicillins, cephalosporins, carbapenems,

monobactams)

Macrolides

Aminoglyclosides

Fluoroquinolones

Tetracyclines, amphenicols
Penicillins
-the oldest class of antibiotics
Have a common chemical structure which they share with
the cephalosporins
-they are generally bactericidal inhibiting formation of the
cell wall. used to treat infections, dental infections, ear
infections, resp.tract infections, UTI and gonorrhea.
Types: Natural penicillins ( Pen G), penicillinase resistant
penicillins, aminopenicillins
Side effects: diarrhea, nausea, vomiting or upset stomach
Immediate and delayed allergic reactions (skin rashes,
fever and anaphylactic shock
Cephalosporins
- Have a mechanism of action same to penicillin
- They are bactericidal
- Commonly used for surgical prophylaxis
- Uised to treat pneumonia, strept throat, staph
infections, tonsillitis, bronchitis, otitis media
- Side effects: diarrhea, nausea, mild stomach upset
5%-10% of patients with allergic hypersensitivity to
penicillins will also have cross reactivity with
cephalosporins.

Carbapenems
- A class of B-lactam antibiotics with a broad spectrum of
anti bacterial activity
- Highly resistant to most b-lactamase
- Active against both gram positive and gram negative
Adverse effects: headache, rash, GI upset, phlebitis,
hypotension, seizures in patients with renal dysfunction

Monobactam
-they are B-lactam compounds
They work only against aerobic gram negative bacteria
( pseudomonas, neisseria)
Adverse effect: skin rash and occasional abnormal liver
function

Macrolides
- Are bacteriostatic, binding with bacterial ribosomes to
inhibit protein synthesis
- Used to treat resp.tract infections such as pharyngitis,
sinusitis and bronchitis
Macrolides
Aminoglyclosides
Fluoroquinolones
Tetracyclines
sulfonamide
 Complications of antibiotic therapy

Resistance due to inappropriate use of antibiotics

Hypersensitivity reaction

Direct toxicity

Super infections
Antimicrobial combination
results of combination therapy

Additive effect: the activity of two drugs in combination is equal to the sum opf their

independent activity

Synergistic effect: the activity of two drugs in combination is greater to the sum of

their independent activity

Antagonistic effect: the activity of two drugs in combination is less to the sum of their
HEALTH TEACHINGS
1. Finish the entire prescriptions of antibiotics
2. Some antibiotics makes oral contraceptives ineffective
3. Some antibiotics cause photosensitivity ( sensitivity to
sunlight and UV rays): wear sunscreen, avoid direct sun
exposure, protect skin and eyes with clothing and sunglasses
and hats
4. Most antibiotics caused abdominal upset like nausea,
vomiting and diarrhea so advised pt. to take daily probiotic
( eating yogurt and taking probiotic capsule.
Thank you for
your attention