-
Classification - target
1. Cell membrane toxin
(từ ngoài, đục lỗ)
- 1. Polymycin e.g. colistin
- -> Gram -ve
- 2. Cyclic lipopeptide e.g. daptomycin
- -> G+ve, MRSA + VRE
-
Classification - target
2. Inhibit cell wall synthesis
- 1. beta lactam: penicillin, cephalosporins, carbapenems
- e.g benxylpenicillin, ceftriaxone, meropenem
- -> - G+ve
- - G-ve: 3rd gen ceph's, carbapenems
- 2. glycopeptides e.g. vancomycin, teicoplanin
- -> MRSA, C.diff
-
Classification - target
3. Inhibit protein systhesis
- 1. Aminoglycosides e.g. gentamicin
- -> G-ve sepsis
- 2. Tetrecyclines e.g. Doxycycline
- -> Intracellular - chlamydia
- 3. Macrolides e.g. Erythromycin, clarithromycin
- -> G+ve (PCN) allergy
- 4. Chloramphenicol e.g. eye drops
- -> Bacterial conjunctivitis
- 5. Oxaolidionones e.g. linezolid
- -> G+ve, MRSA + VRE
-
Classification - target
4. Inhibit DNA synthesis
- 1. Fluroquinolones e.g. ciprofloxacin
- -> G-ve
- 2. Nitroimidazoles e.g. metronidazole
- -> Anaerobes + protozoa
-
Classification - target
5. Inhibit RNA synthesis
- Rifamycin e.g Rifampicin
- -> Mycobacteria - used in TB
-
Classification - target
6. Inhibit folate mechanism
- 1. Sulfonamides e.g. sulphamethoxazole
- -> PCP (with trimethoprim - co-trimoxazole)
- 2. Diaminopyrimidines e.g. trimethroprim
- -> UTI
-
Broad spectrums 4x e.g
(both G+ve and -ve)
- - Co-amoxiclav
- - Tazocin
- - Ciprofloxacin
- - Meropenem
-
Narrow spectrum x3
- - Flucoxacillin
- - Trimethoprim
- - Gentamicin
-
4 mechanisms of antibiotic resistance
BEAT drug action
- 1. Bypass abx-sensitive step in pathway
- e.g. MRSA
- 2. Enzyme-mediated drug inactivation
- e.g B-lactamases
- 3. Impairment of Accumulation of the drug
- e.g. tetracycline resistance
- 4. Modification of the drug's Target in the microbe
- e.g. Quinolone resistance
-
Typical abx
against various focal and systemic infections
(Site, organism/severity/circumstances, Abx)
(skin, pharyngitis, pneumonia community & hosp)
- 1. Skin - S.aureus
- -> Flucoxacillin (unless allergy, MR-)
- 2. Pharyngitis - b-haemolytic Streptococcus
- -> Benzylpenicillin
- 3. Community - acquired pneumonia
- a) mild -> amoxicillin
- b) severe -> cefuroxime + clarithromycin
- 4. Hospital - acq pneumonia
- -> cefuroxime
-
Typical abxagainst various focal and systemic infections
(Site, organism/severity/circumstances, Abx)
( Bacterial meningitis, Sepsis)
- 5. Bacterial meningitis - meningococcus/streptococcus
- -> Ceftriaxone (amox if listeria likely, young/old/IC)
- 6. Sepsis
- a) severe-> cefuroxime, metronidazole +- Gent
- b) neutropenic -> tazocin + gentamicin
-
Typical abx
against various focal and systemic infections
(Site, organism/severity/circumstances, Abx)
(UTI, colitis)
- 7. UTI
- a) community -> trimethoprim (3 days)
- b) nosocomial -> augmentin or cephalexin
- 8. Colitis - Clostridium difficile
- => Metronidazole PO (stop ceph!)
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