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Antibacterial antibiotics

Cell wall synthesis inhibitors lactams (given with lactamase inhibitor eg clavulanate as co-amoxiclav)
Resistance: plasmid, lactamase, cell permeability

DNA Gyrase inhibitor (disrupts integrity of supercoiled DNA) Flouroquinolones (eg ciprofloxacin,levofloxacin)
Good Gram -, poor Gram +, good oral absorption 2nd line UTI, ICU inf., salmonellosis, gram_ osteomyelitis

Penicillins (eg penicillin G, ampicillin, amoxicillin)


Inhibit transpeptidases (wall peptide cross-linking) & disinhibit autolysins) Allergic? Give macrolide (clarithromycin or erythromycin) or vancomycin

Cephalosporins (4 gen. eg cefazolin, cefaclor) (vs HENPEcK*) Carbapenems (eg imipenem/cilastatin) Monobactams (eg aztreonam)

DNA strand breakage (under anaerobic conditions) Metronidazole (Flagyl) surgical prophylaxis, H.pylori, abdo. sepsis,
aspiration pneumo, Cl.difficile colitis interactions: disulfiram effect

Vancomycin, teicoplanin
complex resistance VanR & S detect vancomycin VanH converts pyruvatelactate VanA/B produce D-ala-lac instead of D-ala-ala

DNA

RNA Pol. inhibitor Rifampicin

mRNA THF (tetraOH folate)

DHF (diOH folate)

bacterial cell
50S 30S

Cell membrane disruptor Amphotericin B

Protein synthesis inhibitor (ribosome 30S) Aminoglycosides (eg gentamicin)


Ototoxicity, nephrotoxic, regular serum assays Difficult hospital UTI, sepicemia, endocarditis, neutropenic sepsis (in combo)

cell membrane periplasmic space

Anti-metabolites Trimethoprim
Broad-spectrum, mainly UTI With sulphamethoxazole as cotrimoxazole in Pneumocystis carinii pneumonia (pathognomic for AIDS)

cell wall

Tetracycline (block A site) - yellow

teeth

PABA (para-aminobenzoic acid)

Sulfonamides
(eg sulphamethoxazole)
* HENPEcK = Haemophilus influenzae, enterobacter aerogenes, Neisseria spp.,Proteus mirabilis, Escherichia coli, Klebsiella pneumoniae

Protein synthesis inhibitor (ribosome 50S) Chloramphenicol (blocks peptidyl transferase) Macrolides (block translocation eg erythromycin) clarithromycin - limited Gm- cover, better tolerated than erythromycin Lincosamides (block aa. translocation eg clindamycin) Gary Bass 2006