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NR566-Advanced Pharmacology for Care of the Family
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NR566-Advanced Pharmacology for Care of the Family ### β-lactam Antibiotic Mechanism of Action - Mechanism: All antibiotics in this class disrupt bacterial cell wall synthesis. ### Empiric Therapy - Definition: Initiating treatment without waiting for culture results or before obtaining cultur...

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  • July 7, 2024
  • 66
  • 2023/2024
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NR566-Advanced Pharmacology for Care of the Family
### β-lactam Antibiotic Mechanism of Action


- Mechanism: All antibiotics in this class disrupt bacterial cell wall synthesis.




### Empiric Therapy


- Definition: Initiating treatment without waiting for culture results or before obtaining culture results.




### Immediate Empiric Antibiotics


- Critically Ill Patients: Administer immediate empiric antibiotics after obtaining the first set of cultures;

do not wait for results.




### Bactericidal Antibiotics


- Mechanism: Directly kill bacteria. Examples include aminoglycosides, beta-lactams, fluoroquinolones,

metronidazole, most antimycobacterial agents, streptogramins, and vancomycin.


- Preferred for: Immunocompromised patients, such as those with diabetes, HIV, or cancer, and those

with severe infections.




### Bacteriostatic Agents


- Mechanism: Inhibit bacterial growth, allowing the host's immune system to eliminate the bacteria.

Examples include clindamycin, macrolides, sulfonamides, and tetracyclines.

,### β-lactam Antibiotics


- Examples: Penicillins, cephalosporins, carbapenems, monobactams.




### Penicillins Mechanism of Action


- Mechanism: Weaken bacterial cell wall by:


1. Inhibiting transpeptidases.


2. Activating autolysins (disinhibition).




### Penicillin Binding Proteins (PBPs)


- Definition: Transpeptidases, autolysins, and other bacterial enzymes collectively referred to as PBPs,

which penicillins must bind to for antibacterial effects.




### Gram-positive Bacteria


- Structure: Composed of two layers—the cytoplasmic membrane and a thick cell wall. Penicillins are

generally very effective against these bacteria.




### Gram-negative Bacteria

,- Structure: Composed of three layers—the cytoplasmic membrane, a thin cell wall, and an additional

outer membrane. Only certain penicillins, such as ampicillin, can cross and reach the PBPs.




### Four Major Groups of Penicillins


1. Narrow-spectrum penicillins that are penicillinase-sensitive.


2. Narrow-spectrum penicillins that are penicillinase-resistant (antistaphylococcal penicillins).


(3) broad-spectrum penicillins (aminopenicillins)




(4) extended-spectrum penicillins (antipseudomonal penicillins).




narrow-spectrum penicillins: Penicillinase sensitive penicillins ✅Penicillin G, Penicillin V




narrow-spectrum penicillinase sensitive susceptible pathogens ✅Streptococci, Neisseria, anaerobes




very narrow antimicrobial spectrum and are used only against penicillinase-producing strains of

staphylococci (S. aureus and S. epidermidis). ✅narrow-spectrum penicillins: penicillinase resistant

penicillins




narrow-spectrum penicillins: penicillinase resistant penicillins ✅Nafcillin, Oxacillin, Dicloxacillin

, narrow-spectrum- penicillinase resistant susceptible pathogens ✅S. Aureus, S. Epidermidis




Drugs of choice for most staphylococcal infections ✅penicillinase-resistant penicillins (Nafcillin,

Oxacillin, Dicloxacillin)




Broad spectrum Penicillin: Aminopenicillins ✅Ampicillin, Amoxicillin




Broad spectrum Aminopenicillin susceptible pathogens ✅Haemophilus influenzae, Escherichia coli,

Proteus mirabilis, enterococci, Neisseria gonorrhoeae




Extended spectrum penicillins (antipseudomonal penicillin) ✅Piperacillin




Has the same antimicrobial spectrum as penicillin G, plus increased activity against certain gram-

negative bacilli, including Haemophilus influenzae, Escherichia coli, and Salmonella and Shigella ✅Broad

spectrum Penicillin: Aminopenicillins




First line for acute otitis media and sinusitis ✅Amoxicillin

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