INFECTION AND ANTIBIOTICS

Be able to describe and be able to recognize the drugs used to treat common infections
including mechanism of action, adverse effects and indications/place in therapy
Antibiotics
Beta lactam antibiotics
Penicillins, Cephalosporins,
Monobactum &
Carbapenems

Tetracyclines
Tetracycline, Doxycycline,
Minocycline, Demeclocycline

Sulfonamides &
trimethoprim
Sulfamethoxazole,
Sulfadiazine, Co-trimoxazole

Nitroimidazole
Metronidazole, Tinidazole

Glycopeptides
Vancomycin, Teichoplanin
Chloramphenicol
Eye drops

Inhibit cell wall formation by inhibition of cross linking of peptidoglycan

Site of action depends on agent
Renally excreted
Extracellular distribution
Narrow > broad spectrum agents
Most significant side effect is allergy and anaphylaxis
Inhibit protein synthesis by inhibiting binding of tRNA to 30S ribosomal
subunit
Bacteriostatic
Good gram positive activity plus atypicals, some Gram negatives and
anaerobes
Anti protozoal
Biliary excretion
Oral
Contraindicated in pregnancy/children
Inhibit DNA synthesis by folate inhibition
Renal excretion
Good gram positive and negative cover
Used frequently for UTI
Can be combined with sulphamethoxazole for broader cover including
PCP and malaria
Nitroimidazole
Drug of choice for; C.diff, PID, pseudomonas colitis,, aspiration
pneumonia, pseudomembranous colitis
Destroys bacterial DNA by forming toxic metabolites
Anaerobic organisms, protozoa
IV/oral/rectal
Penetrates BBB, good abscess penetration
Hepatically metabolised, renally excreted

INFECTION AND ANTIBIOTICS

INFECTION AND ANTIBIOTICS

Mechanism of action of AB

Inhibition of cell wall synthesis

Alteration of cell membrane integrity
Inhibition of ribosomal protein synthesis

INFECTION AND ANTIBIOTICS

Suppression of DNA synthesis

Be able to describe causes for lack or inadequate response to antimicrobial therapy

Questions to ask
Is this the correct diagnosis?
Inadequate dosage (not achieving MIC).
Are we treating a resistant organism? If MRSA colonised for example need to consider MRSA as a
cause here.
In some cases further progression to an abscess may have occurred & this will need evacuation
(plastics).
Who can we discuss with?
Microbiologist / ID Specialist