Antimicrobial Drugs

Lecture 4 & 5

Learning Objective
 Mechanism of action of antimicrobial drugs (absorption ; hepar, distribution, metabolism, excretion or
eliminations ; urine) = ADME
 Through : oral, sublingual, submuscular, subcutan, inhalasi. Changing drugs from inactive  active
 Name the classes of antimicrobial drugs

Definitions

Antimicrobials (AMs)are drugs that kill or inhibit growth of microorganisms. (bacteriostatic ; inhibits and
bactericidal ; kills)

Basic ways antimicrobial therapy is used,

Empiric therapy : Initiation of treatment prior to determination of a firm diagnosis (kebanyakan orang
Indonesia menjalani empiric untuk mengetahui antibiotic mana yang akan di prescribe)
Definitive therapy : Microorganism (MO) & susceptibilities are known. (sudah tau kulturnya)

Prophylaxis : Prevent initial or recurrent infection (pre-post operation biar ga terinfeksi penyakit)

The use of “double coverage” (two antibiotics used to provide coverage for the same organism) is based upon
the assumptions:
1. provide a broad spectrum of coverage for empiric treatment
2. provide additive or synergistic effects
3. may decrease or prevent the emergence of resistant

How to Determine Using The AM?

• Identify presence of infection
– Systemic signs and symptoms
• High Fever
• Elevated WBC, Neutrophil
• Urine : Nitrite (+), Leucocyte Esterase (+).
– Local signs and symptoms
• Erythema
• Purulent drainage
– Organ specific signs and symptoms
• Flank pain
• Stiff neck with severe headache
• Confirm the pathogen (culture & resistant test, Gram stain)
• Selective empiric therapy

Bacteria by Site of Infections

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Antibacterial Mechanism of Actions

Antibiotics inhibits  nucleic acid synthesis  cell membrane intregrity  metabolic pathways  protein
synthesis  cell wall (peptidoglycan) synthesis
Penicillin  amoxixilin
Monobactams & Carbapenems 
Analgesic  paracetamol,
(COPAS PUNYA LUNA)

Pharmacodynamic
I. Inhibition of cell wall synthesis
 Beta-lactam : penicillins,cephalosporins, carbapenems, and monobactams
 Mechanism of Action:
o β-lactam inhibit transpeptidase necessary in the final state of peptidoglycan (the component
of the cell wall) synthesis
o penicillin-binding proteins (PBPs) present in bacteria that vary in number and affinity to β-
lactam.
o PBPs target by the AMs lead to lysis or collaps of membrane potential