Biology and Epidemiology of Disease (BED)

BED12 Introduction to Antibiotics

GROUP DRUG NAME THERAPEUTIC EFFECT safe and narrow spectrum, used against Gram-positive cocci (Streptococci, Staphylococci, Clostridia) and some Gram-negative cocci (Neisseria) broader spectrum of activity, good oral absorption, used against Gram-negative bacilli (eg. 50% of E. coli, H. influenza), acquired resistance is common penicillinase-stable penicillin, not activated by staphylococcal -lactamase, narrow spectrum, used for sensitive Staphylococcus aureus infections (not MRSA) good Gram-positive activity orally active retain Gram-positive activity, also exhibit Gram-negative activity, oral and intravenous (IV) majority via IV administration, good Gram-negative activity, have streptococcal activity, less staphylococcal activity USED TO TREAT meningitis, endocarditis, cellulitis

Penicillin G (Benzylpenicillin)

Penicillins

Ampicillin (Amoxicillin)

urinary tract infection, respiratory tract infection

Flucloxacillin Beta-Lactam Antibiotics

1st Generation 2nd Generation

Cefaclor Cefuroxime

respiratory tract infection, urinary tract infection respiratory tract infection, surgical prophylaxis meningitis, healthcare-associated infections (HCAI)

Cephalosporins

3rd Generation

Cefotaxime

*There is cross-reactivity between penicillins and cephalosporins in 10% of patients who are allergic to penicillin. Monobactams Carbapenems Beta-Lactamase Inhibitors Co-Amoxiclav (Amoxicillin plus Clavulanic Acid) clavulanic acid is a -lactamase inhibitor added to amoxicillin, stable to -lactamase, broad spectrum, used on aerobes and anaerobes

Biology and Epidemiology of Disease (BED)

BED12 Introduction to Antibiotics

GROUP DRUG NAME Gentamicin Aminoglycosides Amikacin Streptomycin Ciprofloxacin Nalidixic Acid Levofloxacin Moxifloxacin THERAPEUTIC EFFECT only given by intravenous injection, not absorbed when administered orally, active against Gram-negative bacilli (S. aureus, Mycobacteria, Brucella), causes renal toxicity, causes ototoxicity (hearing and balance) active against Gram-negative bacilli Gram-positive activity USED TO TREAT Gram-negative septicaemia, combination: intraabdominal infection (mixed flora), synergy: endocarditis

Quinolones

NEW NEW

patients in ICU, patients with cystic fibrosis

Other Antibiotics

Metronidazole

Metronidazole

anti-anaerobic agent, anti-protozoal agent broad spectrum of activity, may be combined with sulphonamide (called co-trimoxazole)

combination: prophylaxis in bowel surgery, abdominal sepsis urinary tract infection, co-trimoxazole: Pneumocystis carinii infection methicillin-resistant Staphylococcus aureus (MRSA) infection (IV), C. difficile (oral) atypical bacterial infection such as legionella, H. pylori, mycoplasma

Trimethoprim

Trimethoprim

Vancomycin Glycopeptides Teicoplanin Erythromycin Macrolides Clarithromycin

narrow spectrum, Gram-positive activity