A.

INHIBITORI AI SINTEZEI PERETELUI CELULAR

I. INHIBA SINTEZA PEPTIDOGLICANULUI : BETA LACTAMICE
PENICILINE De biosinteza Benzil-penicilina CG+ / BG+ /CG-
Benzatin-penicilina Bacterii Anaerobe exceptie:
Fenoximetil-penici. -spirochete
Procaina-penicilina -Bacteroides fragilis
De semisinteza Pen. rez la -Meticilina Stafilococi producatori de penicilinaza.
penicilinaza - oxacilina
Bactericide toate stafilococica - nafcilina
beta – lactamice
(grup M) - cloxacilina
- dicloxacilina
Aminopeniciline -Ampicilina CG+ / BG+ /CG-
grup A -Amoxicilina Bacterii Anaerobe
-Bacampicilina BG- : H.i, E.Coli , Salmonela, Shigella
Proteus
Peniciline cu Carboxipen:Ticarcilina CG+ / BG+ /CG-
spectu largit Ureidopen: Azlocilina Bacterii Anaerobe
BG- : E.Coli , Salmonela, Shigella
Proteus
Klebsiella, Enterobacter, Serratia,
Pseudomonas,H.i.
Peniciline Ampicilina+sulbactam Staphyilococcus ,E.coli, Neisseria
asociate cu Amoxa+ac.clavulanic gonorrhoeae,Moraxella catarrhalis
inhib. de beta- Ticarcilina+ac.clavul. Klebsiella, Haemophilus, Shigella,
lactamaze Salmonella ,Bacteroides fragilis
CEFALOSPORINE Generatia I I.v: Cefalotina CG+ / BG+ /CG-
Cefazolina Bacterii Anaerobe
Cefapirina BG- : H.i, E.Coli , Salmonela, Shigella
Oral: cefalexina Proteus
cefadroxil Klebsiella, Staf prod de penicilinaza
cefradin
Generatia II Cefalosporine Iv: - cefuroxim CG+ / BG+ /CG-
propriu-zise: - cefunocid Bacterii Anaerobe
- cefamandol BG- : E.Coli , Salmonela, Shigella
- ceforanid Proteus
Oral: - cefaclor Klebsiella, Staf prod de penicilinaza,
cefprozil Hi,Enterob, Serratia
cefuroxima-
axetil
Cefamicine Iv: cefoxitina
cefmetazol
cefotetan
 Generatia III Iv: -cefotaxima CG+ / BG+ /CG-
ceftriaxona Bacterii Anaerobe
ceftizoxima BG- : E.Coli , Salmonela, Shigella
cefoperazona Activ Klebsiella, Staf prod de penicilinaza,
ceftazidima Pseudomonas Hi,Enterob, Serratia,Proteus
Orale: cefixima aeruginosa
ceftibutena
Generatia IV Cefepima
cefpiroma
CARBAPENEME Imipenem + cilastatin G+/ G- aerobe& anaerobe
Meropeneme Inactive: Mycobacterium
Ertapeneme Clamydia, Rickettsia
Mycoplasma
MONOBACTAM Aztreonam BG- din familia Pseudomonas
Enterobacteriaceae
GLICOPEPTIDE Vancomicina G+ aerob+anaerob
Teicoplanina Staphylococcus + Streptococcus
pneumoniae+ Enterococcus
multirezistenti
FOSFOMICINA Bc aerobe G+/ G-
Pseudomonas aeruginosa,
Staphylococcus meticilino rezistenti,
Enterococcus

II.Antibiotice care Izoniazida - bactericid

Pirazinamida – bactericid numai intracelelulari
inhiba sinteza Etambutol – bacteriostatic fata de bacili extracelulari
acizilor micolici sau
arabinogalactanul
din structura
peretelui celular la
Mycobacterium
B.ANTIBIOTICE CARE ALTEREAZA FUNCTIILE MEMBRANEI CITOPLASMATICE
POLIMIXINE Polimixina B BG- / CBG- anaerobi si facultativ
Bactericid Polimixina E anaerobi
Exceptie: Proteus, Serattia,
Morganella, Providencia
C. INHIBITORI AI SINTEZEI PROTEICE
a) Se fixeaza pe subunitatea 30S
AMINOGLICOZIDE -Streptomicina BG- facultativ anaerobi
-Neomicina Stafilococi
-Kanamicina Pseudomaonas aeruginosa
-Tobramicina Enteroccocus
- Gentamicina Myccobacterium
- Amikacina Francisella tularensis
-Spectinomicina –bacteriostatic Yersinia pestis
- Netilmicina
TETRACICLINE Biosinteza Tetraciclina G+/G- aerobe & anaerobe
Oxitetraciclina spirochete,micoplasme, clamidii, rickettsi
Bacteriostatic Semisinteza Doxicilina
Minociclina Exceptie: Pseudomaonas aeruginosa
b) Se fixeaza pe subunitatea 50S
FENICOLI Cloramfenicol BG+/BG- aerobe+ anaerobe
Tiamfenicol spirochete,micoplasme, clamidii, rickettsi
- bactericid pe H,influenzae,
N.meningitidis, S.pneumoniae
- bacteriostatic pe majoritatea bacteriilor
KETOLIDE Telitromicina Asemanator macrolide + S.pneumoniae
rezistent
MACROLIDE - Eritromicina CG+/BG+ aerobi si anaerobi
-Claritromicina Moraxella catarrahalis,
- Diritromicina Bordetella pertussis,
bacteriostatic - Spiramicina Legionella pneumophila.
H,influenzae,Campylobacter,
Helycobacter,
Mycoplasma,Chlamydia
STREPTOGRAMINE Pristinamicina CG+/BG+ aerobi si anaerobi
Moraxella catarrahalis,
Bordetella pertussis,
bactericid Legionella pneumophila.
H,influenzae,Campylobacter,
Helycobacter,
Mycoplasma,Chlamydia,
S.pneumoniae/Enteroccocus faecium/
S.aureus
LINCOSAMIDE Lincomicina G+, S.aureus, bacterii anaerobe
Clindamicina Exceptie: Enteroccocus

OXAZOLIDINONE Linezolid G+ anaerobi si aerobi

bacteriostatic
c) Antibiotice care inhiba sinteza proteinelor prin alt mechanism
ACIDUL FUSIDIC G+ aerobe si anaerobe
bacteriostatic
MUPIROCIN G+
 D. INHIBITORI AI ACIZILOR NUCLEICI
CHINOLONE GENERATIA I Acid nalidixic BG- din fam. Enterobacteriaceae
Acid pipemidic
Acid oxolinic
Cinoxacina
bactericid GENERATIA II Norfloxacina BG-/CG-/ CB G-/ Unele BG
Ciprofloxacina stafilococi meticilino-rezistenti,
Ofloxacina streptococi beta hemolitici
Pefloxacina Mycoplasma ,Chlamydia
Lomefloxacina
GENERATIA III Levofloxacina BG-/CG-/ CBG-/ Unele BG
Moxifloxacina stafilococi meticilino-rezistenti,
Sparfloxavina streptococi beta hemolitici , S.pneumoniae
Gentifloxacina Mycoplasma ,Chlamydia
GENERATIA IV Trovafloxacina BG-/CG-/CB G-/Unele BG+/bacterii anaerobe
stafilococi meticilino-rezistenti,
streptococi beta hemolitici , S.pneumoniae
Mycoplasma ,Chlamydia
RIFAMPICINA CG+/ CG-/ CBG-
bactericid Legionella pneumophila, Chlamydii ,M.tuberculosis
METRONIDAZOL Protozoare
bactericid Bacterii anaerobe, Helicobacter pylori
SULFAMIDE Sulfadiazina CG+/CG-/BG+/BG-
Sulfizoxazol Exceptie: P.aeruginosa, Actinomyces
bacteriostatic Sulfametoxazol
Sulfosalazina
Sulfone
COTRIMOXAZOL Asociatie sinergica intre
bactericid sulfametoxazol si trimetroprim
NITROFURANI Nitrofurantoin BG- din fam Enterobacteriaceae,
bactericid Furazolidon Exceptie: Proteus,
CG+ din genurile stafilococ si
enterococ.

C.I - asocierea unui antibiotic BACTERICID – BACTERIOSTATIC (penicilina-tetraciclina)

- antib cu mecanism de actiune identice (2 beta lactamice )

- AMGZ. CU POLIMIXINE

- EFECT SINERGIC: AMPICILINA + GENTAMICINA -ENETROCOCI SI STREPTOCOCI

TICARCILINA + AMGZ - P.AERUGINOSA

CEFALOSPORINE + AMGZ -K.PENUMONIAE