- Samiullah Auti M-Pharm in Pharmacology

DefinationClassificationSide effectsReferences

Antibiotics are the chemical substances produced by a micro organisms which has the capacity to inhibit the growth or kill the other micro organism.

Identification of organism

Safety of the drugSite of infection

Patients medical history

Usually identified through gram stain or culture

Some drugs cross Blood brain barrier whereas others do not

Allergies,immune status,renal and hepatic conditions,pregnancy and lactation status

Beta lactamsCarbapenemsMacrolidesLincosamidesAminoglycosidesFluoroquinolonesCephalosporins

Cell wall synthesis inhibitors

Penicillins,Cycloserine,Cephalosporins,Vancomycin

Protien synthesis inhibitors

Chloramphenicol,Clindamycin,Erythromycin,Aminoglycosides

DNA synthesis inhibitors

Qninolones,Flouroquinolones,rifampin

Cell memebrane disrupter Polyene antimicrobials like

Amphotericicn B

Organisms PENICILLINS

Gram -PositiveStrep,Group A,B,C,GStrep PneumoniaStaph.aureus(MSSA)L.monocytogenes

Penicillin G Penicillin V + + + + 0 0 + 0

Colaxcillin + + + 0

Amox +Clav + + + +

Pipercillin + + 0 +

Gram-NegativeN.MeningitidisH.InfluenzaProteus mirabilisProteus vulgaris

+ 0 0 0 0 0 0 0

0 0 0 0

+ + + +

0 0 + +

AnaerobesActinomycesBacteroides Fragilis

+ - o -

o o

+ +

+ +

Organisms

AMINO GLYCOSIDES

Gram-positiveStaph.aureus(MSSA)Strep.Pneumonia

Gentamicin + 0

Amikacin + 0

Tobramycin + 0

Gram-NegativeM.CatarrhalisH.InfluenzaE.ColiKlebsiella spProteus VulgarisPs.aeruginosa

+ + + + + +

+ + + + + +

+ + + + + +

Organisms FLOUROQUINOLONES

Gram-positiveStrep.group,A,B Strep.pneumoniaStaph.aureus(MSSA

Staph.epidermisL.monocytogenes

Ciprofloxacin - - + + +

Ofloxacin - - + + -

Lomefloxacin 0 0 + + -

Levofloxacin + + + + -

Sparfloxacin + + + + -

Gram-negativeN.GonnorhoeaeN.MeningitidisH.InfluenzaE.ColiKlebsiella sp.Enterobacter spSalmonella sp.

++++++ +

+++++++

+++++++

+++++++

+++++++

Organism CEPHALOSPORINSGram-positive

Strep.group,A,B,C Strep.pneumoniaStaph.aureus(MSSA)

Viridans streptococcus

1st generation 2nd generation 3rd generation

Cephalexin + + + +

Cefuroxime + + + +

Cefotaxime + + + +

Gram-negativeM.CattarhalisH.InfluenzaE.ColiKlebsiella sp.Protes mirabilis

+ + + + +

+ + + + +

+ + + + +

ANTIBIOTICS

ADVERSE EFFECTS

PENICILLINS Hypersensitivity reaction, Seizures, Diarrhea, Hemolytic anemia

CEPHALOSPORINS Nephrotoxicity,Bronchospasm,Uriticaria,Hypothrombinemia

AMINOGLYCOSIDES Ototoxicity,Nephrotoxicity,Neuromascular paralysis,Contact dermatitis.

MACROLIDES Epigastric distress,,Cholestatic jaundice,Ototoxicity.

TETRACYCLINES Hypoplasia of teeth,Hepatotoxicity,Phtosensitivity,Vestibular reactions,Nausea and Vomitting.

CHLORAMPHENICOL

Bone marrow suppression,Aplastic anaemia,Gray baby syndrome.

CEFTAROLINE fosamil(Teflaro)Teflaro)oIts an advanced generation cephalosporin antibiotic active against methicillin-Resistant Staphylococcus aureus(MRSA) and Gram positive bacteria.It retains the activity of later generation cephalosporins having broad spectrum activity against Gram-ve bacteria.Its currently being investigated for community acquired pneumonia and complicated skin and skin structure infections.

Ceftaroline is developed by Forest laboratories,USA and received approval on October 29-2010.

FIDAXOMICIN (Dificid)Its the first in a new class of narrow spectrum macrocyclic antibiotic.Its an fermentation product obtained from the actinomycete dactylosporangium aurantiacum subspeices.Its an non-systemic , bactericidal and has demonstarted selective eradication of pathogenic “Clostridium difficile “with minimal disruption to multi speices of bacteria that’s make up the normal healthy Intestinal flora.

FIDAXOMICIN is approved by by US FDA on April 10,2011 and is marketed by Optimer Pharmaceuticals by trade name Dificid for the treatment of Clostridium difficile infection.

Mechanism of actionIt works by inhibiting the bacterial enzyme RNA polymerase resulting the death of Clostridium difficile .

1.Lippincott’s illustrated reveiws,Pharmacology 4th edition, by Richard A.harvey:Pamela C.Champe, published by Wolters Kluwer-2009

.Adis R& D Profiles Fidoximicin OPT 80-:PAR 101(http;//adisoline.com/drugslfulltext/2010/10010/Fidaxomicin_lipiarmycin_OPT_80_.5 Drugs in R & D(open acess):28th May2010-volume 10-issue1-pp 37-45.

.R corey:WilcoxM,talbot GH,et al..CANVAS-1:R andomised , double- blinded, phase 3 study(P903- 06) of the efficacy and safety of Ceftaroline vs vancomycin plus aztreonam complicated skin and skin structure infections;2008,Interscience conference on antimicrobial agents and chemotherapy/Infections diseases society of America conference.