Introduction of antibiotics pdf

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Micro sponges are typically used and nowadays used as the oral dosage form. The effect of beta-lactams is mostly expressed against multiplying bacteria that are building their cell wall intensively. They are not effective against microbes without the peptodoglycan-containing cell wall chlamydiae, mycoplasmata, rickettsiae, mycobacteria. Pharmacokinetics: Many beta-lactams are acid-labile and decompose with gastric juice. In addition, absorption of beta-lactams from the gastrointestinal tract is limited.

For these reasons, majority of beta-lactams has been prepared only in parenteral form. Esterified beta lactams are administered with food orally. Beta-lactams are spread mostly in the extracellular space. The penetration across biological barriers is limited, sometimes it can be reversed with higher dosing.

Intracellular penetration of beta-lactams is poor. The vast majority of beta-lactams are excreted through the kidneys but exceptions do exist oxacillin, cefoperazone, ceftriaxone. They have short half life ranging from an hour penicillin, oxacillin, cephalotin to ,5 hours. An exceptional long half time has ceftriaxone 8 hrs allowing once daily administration. Pharmacodynamics: It depends on the time above MIC minimum inhibitory concentration.

The target of dosing is to keep the level of antibiotic above MIC at the site of infection as long as possible. The peak concentration is not very important. Undesirable effects: No serous side effects but can cause allergic reactions which leads to circulation collapse……death e.

Details of drugs in this group 1. Penicillins The group can be divided in four subgroups: A. Natural penicillins They have narrow spectrum containing gram-positive and —negative cocci streptococci, pneumococci, enterococci, meningococci , gram-positive bands corynebacteria, L. Anti-staphylococcal penicillins They are resistant to staphylococcal beta-lactamase but not to other beta-lactamases produced by gram-negative microbes.

Examples: methicillin only parenteral forms , nafcillin, oxacillin, cloxacillin, dicloxacillin. Oxacillin is the only drug registered in the Czech Republic. The daily dosage of oxacillin is 2g - 12g. These microbes used to be simultaneously resistant to macrolides and lincosamides. Drug of choice in this situation is vancomycin. The drugs owe spectrum similar to natural penicillin with extension against common gram- negative bacteria like Escherichia coli, Salmonella enterica, Shigella sp.

They are more effective than natural penicillin against enterococci and listeriae. The daily dosage of ampicillin is 2g - 12g. Aminopenicillins should not be prescribed for patients suffering from tonsillitis until infectious mononucleosis has been excluded. Patients with mononucleosis readily develop severe maculopapular exanthema even after a few tablets of aminopenicillin. This effect is caused by production of heterophile antibodies and should not be interpreted as true and lasting allergy.

On the other hand, these antibiotics are needless and should not be prescribed against streptococci, enterococci or other bacteria that do not produce beta-lactamase.

Penicillins effective against pseudomonads and other problematic gram-negative pathogens owing natural resistance. Their use is similar to the basic drugs. Cefalosporins Divided into four subgroups called generations. Also used in corynabacteria, meningococci, and some community-acquired stems of gram- negative rods like Escherichia coli or Proteus mirabilis.

The drugs are active against anaerobes in the extent similar to penicillin. Examples cefalotin - CLT, cefazolin — CZL for parenteral administration , cefalexin - CLX, cefadroxil - CDR, cefaclor — CCL for oral administration nd st 2 generation: Contain antibacterial activities of the 1 generation and extend to further community-acquired gram-negative bacteria like Haemophilus influenzae, Moraxella catarrhalis, or less susceptible strains of E.

They can be used for prophylaxis in surgery as well. Cefoxitin — CXT only parenteral administration. However, the stronger is the anti-pseudomonadal effect, the weaker is the activity against staphylococci and other gram-positive microbes. Ceftazidim — CTZ, cefoperazon — CPR for parenteral administration th st nd rd 4 generation: This group have a broad spectrum summarizing the 1 , 2 and 3 generation. Drugs include cefpirom, cefepim only parenteral administration 3. Carbapenems Examples: imipenem, meropenem only parenteral administration.

Monobactams Examples: Aztreonam only parenteral administration. Monocyclic beta-lactams are active against Enterobacteriaceae, Pseudomonas, and other gram-negative aerobic microorganisms. They resist many bacterial beta-lactamases. They may also injure bacterial protoplasts or interfere with RNA synthesis. Pharmacokinetics: The drugs are not absorbed from the gastrointestinal tract.

Penetration across biological barriers is poor. The drugs are excreted almost exclusively by glomerular filtration. They perform postantibiotic effect of about 2 hours. Disposal: Reserve antibiotics for the treatment of serious gram-positive infections. They are used when beta-lactams can not be given because of allergy of the patient or because of resistance of the microbe.

The dosage must be balanced very carefully because of significant nephrotoxicity and ototoxicity of the drug. In the treatment period, renal function should be monitored thrice or twice a week. Adverse effects of vancomycin involve fever, chills, exanthema, and phlebitis at the site of infusion. Reversible leukopenia, thrombocytopenia, or eosinophilia may develop as well. Renal failure and hearing loss are the most fearing sequellae of treatment with vancomycin: nevertheless, they are not frequent when the above mentioned recommendations are kept.

Vancomycin can also be given orally when pathogenic bacteria are localized in intestinal lumen. The typical example is colitis caused by Clostridium difficile. Teicoplanin: This antibiotic penetrates better in tissues except brain. It has a very long half-time hours and can accumulate in organism. The first three doses should be given in hour period for saturation, then the drug can be given once daily or in every-other-day regime. Teicoplanin is well tolerated and can be administered in a rapid infusion, slow intravenous injection, or intramuscular injection.

The adverse effects are much less frequent. The allergy and also resistance is only partially crossed between vancomycin and teicoplanin. They act in several sites of bacterial cell outer membrane, ribosomes. A very important feature of aminoglycosides is synergism with the wall-affecting antibiotics beta-lactams, glycopeptides.

This synergism is expressed against some gram-positive streptococci, enterococci as well as gram-negative E. Aminoglycosides are not effective against anaerobes, spirochetae genus Leptospira, Borrelia, Treponema , obligatory intracellular pathogens chlamydiae, rickettsiae, legionellae , and capsulated pathogens pneumococci, Salmonella typhi, Haemophilus influenzae. Account of drugs: streptomycin It is an old drug used in the treatment of tuberculosis.

There are some more indications for the very special situations severe infections caused by enterococci highly resistant to gentamicin.

Tobramycin is somewhat more effective against Pseudomonas. Netilmicin is slightly less nefrotoxic. In practice, the difference between these antibiotics is not very significant. They do not work stronger than gentamicin but are somewhat less nefrotoxic. Pharmacokinetics of aminoglycosides is similar to that of vancomycin.

They are not absorbed from the gastrointestinal tract. Volume of distribution correlates closely with the volume of extra-cellular fluid. The drugs are excreted unchanged by glomerular filtration. Pharmacodynamics: The bactericidal effect is concentration-dependent. It relates to the peak concentration of the antibiotic at the site of infection. Postantibiotic effect PAE lasts several hours depending on the reached peak concentration. Amir, Wells, C. Jechorek, and S. Hung, N. Bos, and N. Evidence for the Enteric salmonellosis disrupts the microbial translocation of Enterococcus faecalis ecology of the murine gastrointestinal tract.

Lupp, C. Robertson, M. Wickham, Maddaus, R. Sekirov, O. Champion, E. Gaynor, Jechorek, and R. Role of and B. Host-mediated intestinal anaerobic bacteria in colonization inflammation disrupts the intestinal resistance. Cell Host Microbe Maddaus, C. Reynolds, R. Jechorek, and R. Stecher, B. Robbiani, A. Walker, A. Role of anaerobic flora M. Westendorf, M. Barthei, M. Kremer, S. Macpherson, J. Buer, J. Parkhill, G. Dougan, C.

Salmonella entericaserovar Miller, C. Salmonella infection following Bartlett, J. Moon, T. Chang, N. Role of 59— Clostridium difficile in antibiotic-associated Rakoff-Nahoum, S. Paglino, F. Eslami- pseudomembranous colitis. Varzaneh, S. Edberg, and R. Gastroenterology — Recognition of commensal microflora Kelly, C.

Cell — Barthel, M. Hapfelmeier, L. Quintanilla- [Mechanical ventilation associated Martinez, M. Kremer, M. Rohde, M. Med Intensiva; Hogardt, K. Pfeffer, H. Russmann, and W. Chastre J, Fagon JY. Ventilator- D.

Pretreatment of mice with associated pneumonia. Incidence and risk factors of host. Bohnhoff, M. Results from a multicenter prospective Enhanced susceptibility to Salmonella study on patients. European infection in streptomycin treated mice.

Cooperative Group on Nosocomial Infect. Intensive Care Med. Que, J. Effect Nosocomial infections in U. Sekirov, I. Tam, M. Jogova, M. Li, C. Lupp, and B. Am J Antibiotic-induced perturbations of Med. Pneumonia in intubated trauma Immun. Microbiology and outcomes. Merrell, D. The RespirCrit Care Med. Craig CP, Connelly S. Effect of during infection and plays a role in acid intensive care unit nosocomial pneumonia tolerance. Am J Infect Control Am J comparing adult critical-care populations.

Mennigen, R. Probiotic mixture VSL 3 protects the epithelial barrier by Pathophysiology of airway colonization in maintaining tight junction protein critically ill COPD patient. Curr Drug expression and preventing apoptosis in a Targets Apr. Bercault N, Boulain T. Mortality rate PhysiolGastrointest Liver Physiol. Zheng, Y. Interleukin care unit: a prospective case-control study.

Nat Med. Cash, H. L, Whitham, C. V, Behrendt, C. Med Intensiva Symbiotic bacteria Donskey CJ.