Used mainly for Methicillin resistant Staphylococcus aureus (MRSA) and Methicillin resistant Staphylococcus epidermidis (MRSE).Reserved for serious infections with gram +ve.Inhibits synthesis of bacterial cell wall phospholipids and Peptidoglycan.Relatively non toxic, but can cause skin rash, phlebitis. Empiric therapy – active against G positive and negative.SE: Diarrhea, seizures if increased plasma levels. Broad spectrum, Mostly IV route and excreted by glomerular filtration. CEFOPERAZONE, CEFAMANDOLE – CI IN ALCOHOL īeta- Lactam Antibiotics Nephrotoxic Nephrotoxic & OtotoxicĬARBAPENEMS Eg Imipenem/Cilastatin Cilastatin is not a antibiotic, it’s a peptidase inhibitor that protects imipenem from degradation.Newer agent classified as 4th generation (Cefepime) has shown some effectiveness.EXCRETION : RENAL SECRETION (Ceftriaxone, Cefoperazone excreted mostly through bile)Ĭephalosporins are mostly not effective against.Ceftriaxone – good bone penetration, Neisseria.Cefoxitin – Anaerobes ( Bacteroides fragilis) abdominal sepsis and PID.
Expensive, for resistant/severe infections, Septic shock, MENINGITIS.influenza, Enterobacter, Neisseria + 1st (HEN PEcK) Less resistance, higher cost, oral/IM/IV.Broad spectrum, mostly oral, commonly used, some resistance, lower cost,.Decreased penetration of the antibiotic through the outer cell membrane prevents the drug from reaching the target pbp.īeta- Lactam Antibiotics Commonly used, some resistance, lower cost Also commonly used, less resistance, higher cost $ $ $ $ Expensive $ $ $ $ Resistant/ Severe Infections SE: all have some degree of cross reactivity w/pen allergic pt.Beta lactamase enzyme hydrolyzes the cyclic bond of the beta lactam ring-results in loss of bactericidal activity.Platelet dysfunction ( Carbenicillin & Ticarcillin.Pseudo membranous colitis may also occur. ĭIARRHEA– disruption of the normal balance of intestinal micro organisms. HYPERSENSITIVITY-the metabolite penicilloic acid serves as a hapten to cause immune reaction.DEPOT : PROCAINE PENCILLIN G, BENZATHINE PENCILLIN G.PENCILLIN V, AMOXICILLIN + CLAVULANIC ACID ORAL.Syphilis single treatment with penicillin is curative.These pbps are bacterial enzymes involved in the synthesis of the cell wall Penicillins inactivate many proteins on the bacterial cell membrane.Cell lysis occurs through osmotic pressure or activation of autolysins.Results in exposure of less stable membrane.Interfere with last step of bacterial synthesis-trans peptidation Not effective against Mycobacterium, Protozoa, Fungi & viruses.Beta- Lactam Antibiotics Strep throat IM, syphilis Skin infections fm staph/strep Bacterial URI SE: Hypersensitivity is primary problem.
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