•G(+): either inducible or constitutive and are ofter plasmid mediated
(2) Change permeability of outer membrane (3) Altering their PBP
β-Lactams
Penicillin groups: penicillin ring Cephalosporin groups: cephalosporin ring Monobactams: Aztreonam Carbapenems: (1) Imipenem-Cilastatin (Tienam) (2) meropenem (Mepem)
Chapter Outline
◇ Learning objectives ◇ Antibacterial Antibiotics
• Mechanisms of action and resistance • Spectrum of coverage • Pharmacology and adverse effects
抗菌药（英文PPT）Antimicrobials
Learning Objectives
Recognize the different classes of antimicrobials and their mechanisms of action. Identify the spectrum of coverage for specific antimicrobials. Describe possible adverse effects and drug interactions caused by antimicrobials. Select appropriate antimicrobials for various pathogens.
Anaerobic:
Endospore-forming: clostridium Non-endospore-forming: Actinomycetes
GRAM-NEGATIVE
Aerobic cocci: Neisseria-- N. gonorrhoeae, N.
meningitidis; Moraxella
★ ★
★ ★ ★
β-Lactams
Binding to penicillin-binding-protein (PBP) inner cell membrane endogeneous bacterial autolysis Activity depend on: (1) PBP type (2) degree of affinity to a particular PBP
β-Lactams : Penicillins
Penicillin G-like drugs:
Penicillin G/ Penicillin V
Penicillinase-resistant penicillins:
Dicloxacillin / Oxacillin / Methicillin / Nafcillin
Micrococcaceae family aureus: S. aureus non-aureus: S. epidermis
GRAM-POSITIVE RODS
Aerobic:
Endospore-forming: Bacillus Regular, non-endospore-forming: Listeria Irregular, non-endospore-forming: Corynebacterium
GRAM-POSITIVE COCCI
Micrococcaceae family M. luteus, M. roseus, and M. varians.
α-hemolysis: S. pyogenes β-hemolysis: S. agalactiae γ-hemolysis: Enterococcus / non-Enterococcus S. pneumoniae
Ampicillin-like drugs (Amino-PCNs)
Ampicillin / Ampicillin + sulbactam (Unasyn) A; clavulanic acid (Augmentin)
◇ Antifungal Drugs ◇ Antiviral Drugs ◇ Summary ◇ Review Questions
Pharmacology
Basctericidal / bacteriostatic Mode of action: concentration-dependent / time-dependent killing effect Minimal inhibitory concentration (MIC) Postantibiotic effect (PAE) Syngery / Indifference / Antogonism
Anaerobic cocci: Vellionella Rods:
(1) Enterobacteriaceae: Escherichia coli, Shigella, Salmonella, Klebsiella, Enterobacter, Proteus… (2) Pleomorphic: Haemophilus, Legionella, Pasteurella, Brucella (3) Miscellaneous: Vibrio, Campylobacter, Helicobacter (4) Nonfermenters: Pseudomonas, Acinebacter, Flavobacterium
β-Lactams
Resistance:
(1)β-Lactamase enzyme:
• nosocomial G (-) organisms: encoded on bacterial chromosomes, plasmid mediated, or carried on transposons