antibiotics.txt

• Macrolides, tetracyclines, and aminoglycosides
• Azithromycin (Zithromax)
• Erythromycin (E-mycin, PCE, Ery-Tab�
• Doxycycline (Vibramycin�)
• Gentamicin (Garamycin�)

• Interfere with bacterial cell wall synthesis - bactericidal.
• Original penicillins had primarily gram (+) activity. New agents offer almost exclusive gram (-) coverage.
• First Generation (G+): Penicillin G, Penicillin VK (Veetids�)
• Penicillinase Resistant (used for penicillin-resistant bacteria): Cloxacillin (Cloxapen), Dicloxacillin (Dynapen, Pathocil), Nafcillin (Unipen�)
• Second Generation (G+, some G-): Amoxicillin (Amoxil, Trimox�), Amoxicillin/Clavulanic Acid (Augmentin�)
• Third Generation (mostly G+): Ticarcillin (Ticar), Ticarcillin/Clavulanic Acid (Timentin�)
• Fourth Generation (exclusively G-): Mezlocillin (Mezlin�), Piperacillin (Pipracil�),

• Interfere with bacterial cell wall synthesis - bactericidal.
• Original agents have a little broader spectrum than penicillin, new agents almost exclusively gram (-) activity.
• First Generation (G+ and limited G-): Cephalexin (Keflex�)
• Second Generation (primarily G-): Cefaclor (Ceclor)
• Third Generation (almost exclusively G-): Cefdinir (Omnicef)

• Inhibit protein synthesis in the cell by binding to the 30S ribosome - bactericidal.
• Exclusively gram (-) coverage. Used to treat very serious gram (-) infections in the hospital setting.
• Gentamicin (Garamycin�)
• Tobramycin (Nebcin�)
• Aminoglycosides cause nephrotoxicity and ototoxicity

• Inhibit the enzyme, DNA gyrase, which helps the cell replicate DNA to make new cells - bactericidal.
• Very broad spectrum antibiotics with good gram (+) and gram (-) coverage.
• Ciprofoxacin (Cipro�): has important drug interactions with antacids and theophylline
• Levofloxacin (Levaquin)
• Moxifloxacin (Avelox�)
• Key points: taken with milk or food

• Inhibit synthesis of folic acid by the cell - bacteriostatic. Only effective on bacteria that must synthesize their own folic acid.
• Provide both gram (+) and gram (-) coverage. Often used to treat urinary tract infections.
• Co-trimoxazole (Bactrim�, Septra)
• Key points: allergy, take with plenty of water

• Inhibit protein synthesis in the cell by binding to the 50S ribosome - may be bacteriostatic or bactericidal.
• Produce gram (+) and gram (-) coverage. Also useful in tuberculosis and other infections seen in HIV positive patients.
• Azithromycin (Zithromax)
• Erythromycin (E-mycin, PCE, Ery-Tab�), cause stomach upset.

• Inhibit protein synthesis in the cell by binding to the 30S ribosome - bacteriostatic.
• Provide both gram (+) and gram (-) coverage.
• Doxycycline (Vibramycin�)
• Patients taking tetracyclines are more sensitive to the sun and will burn easily.
• Tetracyclines bind with elements like calcium aluminum, magnesium and iron.
• Because tetracyclines bind to calcium, they should not be used in young children with growing bones in teeth.

• 1st and 2nd generation penicillin: Penicillin VK (Veetids�), Amoxicillin (Amoxil, Trimox�), Amoxicillin/Clavulanic Acid (Augmentin�)
• 1st generation Cephalosporins: Cephalexin (Keflex�)
• Quinolones: Ciprofoxacin (Cipro�), Levofloxacin (Levaquin), Moxifloxacin (Avelox�)
• Sulfonamides/Trimethoprim: Co-trimoxazole (Bactrim�, Septra)
• Tetracyclines: Doxycycline (Vibramycin�)
• Macrolides: Azithromycin (Zithromax), Erythromycin (E-mycin, PCE, Ery-Tab�)

• 3rd and 4th Generation penicillin
• 2nd and 3rd generation Cephalosporins
• Quinolones: Ciprofoxacin (Cipro�), Levofloxacin (Levaquin), Moxifloxacin (Avelox�)
• Sulfonamides/Trimethoprim: Co-trimoxazole (Bactrim�, Septra)
• Aminoglycosides: Gentamicin (Garamycin�)
• Tetracyclines: Doxycycline (Vibramycin�)
• Macrolides: Azithromycin (Zithromax), Erythromycin (E-mycin, PCE, Ery-Tab�)

• Quinupristin/Dalfopristin
• injectable antibiotics
• vancomycin resistant enterococcus & methocillin resistant staphylococcus

• Linezolide
• injectable antibiotics
• vancomycin resistant enterococcus & methocillin resistant staphylococcus

• Metronidazole
• Disrupting DNA structure

Nystatin

Ceftriaxone

Cidal

Ciprofloxacin

zidovudine

fluconazole

azithromycin

terazol

amphotericinb

gentamicin

• Valacyclovir (Valtrex): Herpes simplex I (fever blisters)
• Zidovudine (Retrovir, AZT): Reverse-Transcriptase Inhibitors
• Indinavir (Crixivan): Protease Inhibitors
• Maraviroc (Selzentry�): Cellular Chemokine Receptor (CCR5) Antagonist
• Raltegravir (Isentress�): Integrase Inhibitors
• Enfuvirtide (Fuzeon�): Fusion Inhibitors
• Maraviroc (Selzentry�) Cellular Chemokine Receptor (CCR5) Antagonist
• Raltegravir (Isentress�); Integrase Inhibitors
• Enfuvirtide (Fuzeon�): Fusion Inhibitors
• Ganciclovir (Cytovene�): Cytomegalovirus (CMV)
• Amantadine (Symmetrel�): Influenza A Virus
• Adefovir (Hepsera�): Chronic Hepatitis B
• Ribavirin (Copegus�, Rebetol�, Virazole�): Chronic Hepatitis C

Fluconazole (Diflucan�)

A bacteriostatic antibiotic inhibits reproduction of the organism, but does not kill the bacteria.

A bactericidal antibiotic kills the offending bacteria.

The different types of bacteria an antibiotic is active against. Most antibiotics are active against primarily gram (+) bacteria or primarily gram (-) bacteria. However, some newer agents offer coverage against both.

Some bacteria are able to produce substances that destroy antibiotics before they are able to kill the bacteria. When this happens, we say the bacteria is no longer susceptible to the agent or it has become resistant.

• Infection
• Incubation Period
• Prodromal Period
• Acute Period
• Decline/Convalescent Period