Antibiotics

• Penicillin - cidal, b-lactam
• -Amox - gas, gbs, coliforms, h.flu
• -ampicillin - enterococcus, gram neg, h. flu
• -piperacillin - some negative, pseudomonas
• -cloxacillin -staph aureus

• Carbapenems - broadest spectrum
• +/-/anaerobes
• -Extended spectrum B-lactamases (ESBLs)
• -B-lactam, cidal

• Aminoglycosides
• Bacteriostatic - inhibits 30S ribosome -> leaky cell
• -nephrotoxic, ototoxic
• -resistant GN, chlamydia, coliforms

• Tetracyclines - static - 30S ribosome
• GP (exc. enterococcus), mycoplasma, chlamydia, syphillis
• AE: stains teeth (children), pregnancy

• Macrolides - Static, Bind 50S
• -GI Intolerance
• -CAP - H.flu, GP/GN/Aerobes/Anaerobes/mycoplasma
• -Erythromycin - mycoplasma, legionella

• Lincosamides - binds 23S of 50S interrupts tRNA
• -anerobes, protozoa (malaria), acne, mrsa
• AE: C. DIFF!

• Sulfonamide - bactericide/bacteriostatic
• -anti-folic acid-> decreased dna synth
• -broad spectrum
• -pneumocystis, utis, gn aerobic bacili
• -inhibits cyp2c9 - glyburide -> increase insulin

• nitroimidazole (flagyl) - bacterocidal, targets dna
• -anerobic, protozoa
• -C. diff, rosacea, fungating tumors, h.pylori
• -amoebiasis, giardiasis, trichomoniasis, chlamydia
• AE: alcohol -> nausea/vomiting

• Fluoroquinolones - bind dna/dna gyrase -> cell death
• -most overused class
• -avoid in kids/pregnancy
• -gn, pseudomonas, some +
• -h flu/pneumo/mycoplasm/chlamydia/legionella

• First Generation Cephalosporin
• NO Anaerobes
• NO LAME - Listeria, Atypical (Myco, Chlamydia), MRSA, Enterococcus
• Mostly GP coverage, some GN
• -staph, strep, PEcK (Proteus, E coli, Klebsiella)

2nd Generation Cephalosporin

• -less GP than 1st Gen
• -More GN: HEN (H. Flu, Enterobacter aerogenes, Neisseria), PEcK

3rd Gen Cephalosporins

• -less GP coverage
• -hospital acquired infections: GNs
• -ESBLs reduce utility of 3rd gen
• -meningitis (penetrate cns) - pneumococci, meningococci, h. flu, e. coli, klebsiella
• -only recommended for N. gonorrhea

• 4th Gen Cephalosporins
• -increased GP coverage
• -increased resistance to B-lactamases
• -crosses bbb - meningitis
• -Pseudomonas

Penicllin binding proteins - transglycosylate and transpeptidation of the bacterial cell wall

-beta-lactams bind to PBPs -> activates bacterial autolysis enzymes

• 1 Penicilins
• 2 Cephalosporins
• 3 Carbapenems
• 4 Monobactams

• -glycopeptide antibiotic
• -binds D-ala on wall ->cidal
• IV/IM

• -GP only, extracellular only
• -drug of last resort, for MRSA, Pseudomembranous colitis (C.diff); breeds VRE (enterococcus)