【抗生素精品课件】Introduction for Antibiotics
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【医学精品课件之抗生素】Introduction of Antibacterial Agent
【医学精品课件之抗生素】Introduction of Antibacterial Agent
PK/PD
➢Concentration-dependent
Aminoglycosides, Quinolones, Metronidazole, Amphotericin B
➢Time-dependent
➢ 4th generation Cephalosporins
1st generation Cephalosporins
1. Cefazolin (1–2 g IV/IM q8h) 2. Oral form: Nakacef 2# qid
Indication: staphylococci, streptococci, Escherichia coli, Klebsiella, Proteus species.
Gram positive bacteria and anaerobes only ➢ S. pyogens – cellulitis ➢ Viridans streptococci – infective endocarditis ➢ Neisseria meningitis -- meningococcus ➢ Streptococus pneumoniae ? ➢ Spirochetes – syphilis ➢ Actinomyces israelii ➢ Clostridium spp. ➢ Pasteurella multocida ➢ Leptospira interrogans – leptospirosis
➢ Piperacillin (Pipril) ➢ Ticarcillin/clavulanic acid (Timentin) ➢ Piperacillin/tazobactam (Tazocin)
PK/PD
➢Concentration-dependent
Aminoglycosides, Quinolones, Metronidazole, Amphotericin B
➢Time-dependent
➢ 4th generation Cephalosporins
1st generation Cephalosporins
1. Cefazolin (1–2 g IV/IM q8h) 2. Oral form: Nakacef 2# qid
Indication: staphylococci, streptococci, Escherichia coli, Klebsiella, Proteus species.
Gram positive bacteria and anaerobes only ➢ S. pyogens – cellulitis ➢ Viridans streptococci – infective endocarditis ➢ Neisseria meningitis -- meningococcus ➢ Streptococus pneumoniae ? ➢ Spirochetes – syphilis ➢ Actinomyces israelii ➢ Clostridium spp. ➢ Pasteurella multocida ➢ Leptospira interrogans – leptospirosis
➢ Piperacillin (Pipril) ➢ Ticarcillin/clavulanic acid (Timentin) ➢ Piperacillin/tazobactam (Tazocin)
抗生素英文课件精品ANTIBIOTICS(33p)
killed the bacteria that causes syphilis • Compound was called salvarsan but was
quite toxic to the host
Antibiotics
• Natural compounds produced by microorganisms that inhibit the growth of other microbes
class of antibiotics
Penicillin
• Wonder drug
• Killed bacteria with few side effects on the patient
• SELECTIVE TOXICITY
• Penicillin was NOT the first anti-bacterial compound
• Chloramphenicol, erythromycin (G+), streptomycin, tetracyclines
Injury to plasma membrane
• Changes to permeability of membrane causes loss of metabolites
ANTIBIOTICS
From the Greek: anti - against bios - life
Chemotherapy
• Paul Ehrlich • Use of chemical agent to kill bacteria and
not harm the host • Search for the “Magic bullet” • Developed an arsenic compound that
quite toxic to the host
Antibiotics
• Natural compounds produced by microorganisms that inhibit the growth of other microbes
class of antibiotics
Penicillin
• Wonder drug
• Killed bacteria with few side effects on the patient
• SELECTIVE TOXICITY
• Penicillin was NOT the first anti-bacterial compound
• Chloramphenicol, erythromycin (G+), streptomycin, tetracyclines
Injury to plasma membrane
• Changes to permeability of membrane causes loss of metabolites
ANTIBIOTICS
From the Greek: anti - against bios - life
Chemotherapy
• Paul Ehrlich • Use of chemical agent to kill bacteria and
not harm the host • Search for the “Magic bullet” • Developed an arsenic compound that
抗生素PPT课件(英文精品) Chemotherapeutic Agents Antibiotics
is n o t s u p p o rte d
M acintosh P IC T im age form at
is not supported
Chemotherapeutic Agents / Antibiotics, chapter 34-39
•Antibacterial compounds (procaryotes)
is not supported
M acintosh P IC T im age form at
is not supported
M acintosh P IC T im age form at
is not supported
M acintosh PICT im age form at
is not supported
Vorikonazol Flukonazol (Racemate)
M a c iIntratkoonaszol:h P I C T im a g e fo rm a t
is n o t s u p p o rte d
SAR: -Weakly basic azole ring, imidazol / 1,2,4-triazol (less tox. humans), pKa 6.5-6.8 -2 or 3 other aromatic rings -Cl (or F) on at least one aromatic ring (F i flukonazol) -Lipophilic structures (as lanosterol)
is n o t su p p o rted
Proad spectrum. Some effect on certain protozoa.
Isolated, Streptomyces sp.
M acintosh P IC T im age form at
is not supported
Chemotherapeutic Agents / Antibiotics, chapter 34-39
•Antibacterial compounds (procaryotes)
is not supported
M acintosh P IC T im age form at
is not supported
M acintosh P IC T im age form at
is not supported
M acintosh PICT im age form at
is not supported
Vorikonazol Flukonazol (Racemate)
M a c iIntratkoonaszol:h P I C T im a g e fo rm a t
is n o t s u p p o rte d
SAR: -Weakly basic azole ring, imidazol / 1,2,4-triazol (less tox. humans), pKa 6.5-6.8 -2 or 3 other aromatic rings -Cl (or F) on at least one aromatic ring (F i flukonazol) -Lipophilic structures (as lanosterol)
is n o t su p p o rted
Proad spectrum. Some effect on certain protozoa.
Isolated, Streptomyces sp.
抗生素英文课件精品ANTIBIOTICS(39p)
Agents can either be “–cidal” or “-static” in action Bacteriocidal agents most important in serious, life-threatening
infections where the host mechanisms may be compromised
b-Lactam Antibiotics
What is a b-lactam?
Family of structurally related compounds Contain the b-lactam root
b
N
O
H
Reactive amide due to ring strain
The family of b-lactams
Fleming – 1929 – antibacterial activity of penicillin discovered Florey and Chain – 1938 – First clinical use of penicillins
What is an antibiotic? Definition: 1. A product of metabolism of other organisms 2. A synthetic product that is a structural analogue of a naturally occurring antibiotic 3. Antagonizes the growth or survival of one or more species of microorganisms 4. Effective in low concentrations
infections where the host mechanisms may be compromised
b-Lactam Antibiotics
What is a b-lactam?
Family of structurally related compounds Contain the b-lactam root
b
N
O
H
Reactive amide due to ring strain
The family of b-lactams
Fleming – 1929 – antibacterial activity of penicillin discovered Florey and Chain – 1938 – First clinical use of penicillins
What is an antibiotic? Definition: 1. A product of metabolism of other organisms 2. A synthetic product that is a structural analogue of a naturally occurring antibiotic 3. Antagonizes the growth or survival of one or more species of microorganisms 4. Effective in low concentrations
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Anaerobic bacteria
Gram-positive
Cocci
Streptococcus, Gemella Peptococcus,
Peptostreptocuccus
Bacilli
Clostridium(C. perfringes, C. tenani, C. difficile, C. botulinum )
Gram-negative bacteria
▪ Enterobacteriaceae
➢ E. coli ➢ Klebsiella spp. ➢ Proteus spp. ➢ Salmonella spp. ➢ Shigella spp. ➢ Enterobacter spp. ➢ Citrobacter spp. ➢ Serratia spp. ➢ Edwardsiella spp. ➢ Yersinia spp.
Monobactam Carbapenem ß-lactam/ß-lactamase inhibitor
Penicillins
Natural penicillins
Penicillin G (IV) Penicillin V (oral)
Penicillinaseresistant penicillins
S. viridans and S. pneumoniae
beta hemolysis complete hemolysis Group A Strep
= S. pyogenes
Gamma hemolysis nonhemolytic Some Group D Strep.
S. pyogenes (Group A,
Propionibacterium Bifidobacterium Lactobacillus
Gram-negative
Bacilli
Fusobacterium Bacteroides Prevotella Campylobacter
Cocci
臨床上常見的致病菌
Gram-positive bacteria
▪ NFGNB
➢ Pseudomonas aeruginosa
➢ Acinetobacter baumannii
➢ Stenotrophomonas maltophilia
(Pseudomonas maltophilia)
➢ Burkholderia cepacia
(Pseudomonas cepacia)
Bacillus cereus
Diptheroids
Corynebacterium diptheriae JK group Corynebacterium Listeria monocytogenes
Aerobic Gram-negative bacteria
Bacilli
Enterobacteriaceae NFGNB: Glucose Non-fermentative
Gram-negative bacilli
Haemophilus species (H. influenzae; H. parainfluenzae)
Legionella pneumophilia
Cocci
Neisseria gonorrhoeae (gonococcus) Neisseria meningitidis (meningococcus) Moraxella catarrhalis
Staphylococcus aureus Streptococcus Enterococcus
Gram-negative bacteria
E. coli, Klebsiella, Proteus(EKP) Enterobacter, Serratia
Non-fermentative Gram-negative bacilli (NFGNB)
ß hemolytic) Pharyngitis Impetigo
Viridans group (alpha hemolytic) Endocarditis
S. pneumoniae
(Pneumococcus) Bacteremia Pneumonia Meningitis
Gram-positive bacilli
Gram-positive bacteria Gram-negative bacteria
Streptococci(1)
Classification
• Lancefield: based on the antigenic characteristics of the outer membrane
Haemophilus influenzae
Meningococcus
Anaerobic bacteria
Bacteroides fragilis Others
ß-Lactam antibiotics
Penicillin Cephem
Cephalosporin Cephamycin
臨床上常見的致病微生物
• Bacteria • Viruses • Fungi • Mycobacterium • Mycoplasma • Proobic
Gram-positive bacteria Gram-negative bacteria
Anaerobic
Introduction for Antibiotics
R3 孔祥琪
Last revised: July 6, 2003 Section of Infectious Diseases Department of Internal Medicine National Taiwan University Hospital, Taipei
• Brown: type of hemolysis • Clinical: combines Lancefield,
Brown, disease producing characterstics
Streptococci(2)
alpha hemolysis incomplete hemolysis