A.

INHIBITORI AI SINTEZEI PERETELUI CELULAR

I. INHIBA SINTEZA PEPTIDOGLICANULUI SUNT BETA LACTAMICE
PENICILINE De Benzil-penicilina CG+ / BG+ /CG-
biosinteza Benzatin-penicilina BcAnaero exceptie:
Fenoximetil-penici. -spirochete
Procaina-penicilina -Bacteroides fragilis
De Pen. rez la -Meticilina Stafilococi producatori
semisinteza penicilinaza - oxacilina de penicilinaza.
Bactericide toate stafilococica - nafcilina
beta – lactamice (grup M) - cloxacilina
- dicloxacilina
Aminopeniciline -Ampicilina CG+ / BG+ /CG
grup A -Amoxicilina BcAnaero,
-Bacampicilina BG- : H.i,E.Coli,
Salmonela
Shigella
Proteus
Peniciline cu Carboxipen:Ticarcilina CG+ / BG+ /CG
spectu largit Ureidopen: Azlocilina BcAnaero,
BG- : H.i,E.Coli,
Salmonela
Shigella
Proteus
Klebsiella, Enterobact,
Seratia, Pseudom.
Peniciline Ampicilina+sulbactam Staphyilococcus,E.coli,
asociate cu inhib. Amoxa+ac.clavulanic Gonorrhoeae,
de beta- Ticarcilina+ac.clavul. klebsiella
lactamaze Haemophilus,Shigella,
Neisseria,Salmonella,B
acteroides fragilis
CEFALOSPORINE Generatia I I.v: cefalotina, CG+ / BG+ /CG
Cefazolina BcAnaerobe,
Cefapirina BG- : H.i,E.Coli,
Oral:cefalexina Salmonela
Shigella
Cefadroxil
Proteus
cefradin Klebsiella, Staf prod de
penicilinaza
/H.i,anaerobi,enteroc.
Listeria
Generatia II Cefalosporine Iv:-cefuroxim CG+ / BG+ /CG
propriu-zise: - cefunocid BG- : H.i,E.Coli,
- cefamandol Salmonela
- ceforanid Shigella
Proteus
Oral: - cefaclor
Klebsiella, Staf prod de
- cefprozil penicilinaza,Hi,Enterob,
- cefuroxima- Serratia,Proteus
axetil
Cefamicine Iv: -cefoxitina CG+ / BG+ /CG
- cefmetazol BcAnaerobe,
- cefotetan BG- : H.i,E.Coli,
Salmonela
Shigella
Proteus
Klebsiella, Staf prod de
penicilinaza,Hi,Enterob,
Serratia,Proteus
1
 Generatia III Iv: -cefotaxima CG+ / BG+ /CG
- ceftriaxona BcAnaerobe,
- ceftizoxima BG- : H.i,E.Coli,
- cefoperazona Activ Pseudomonas Salmonela
- ceftazidima aeruginosa Shigella
Orale:- cefixima Proteus
-ceftibutena Klebsiella, Staf prod de
penicilinaza,Hi,Enterob
, Serratia,Proteus
Generatia IV Cefepima CG+ / BG+ /CG
cefpiroma BcAnaerobe,
BG- : H.i,E.Coli,
Salmonela
Shigella
Proteus
Klebsiella, Staf prod de
penicilinaza,Hi,Enterob
,
Serratia,Proteus,Pseud
omonas
CARBAPENEME Imipenem + cilastatin BG+ / BC-/ aerobe/
Meropeneme anaerobe /
Ertapeneme Inactive: Mycobact,
Clamydia,M
ycoplasma, Rickettsia
MONOBACTAM Aztreonam BlG- ...din fac
enerobact,pseudomona
s
GLICOPEPTIDE Vancomicina BG+/aerob/anaerob/
Teicoplanina
FOSFOMICINA Bc aerobe G+/ BG-/
enteroc, staf meticilino-
rez.
II. Izoniazida - bactericid
Antibiotice care inhiba sinteza Pirazinamida – bactericid numai intracel.
Etambutol – bacteriostatic fata de bacili extracel
acizilor micolici sau
arabinogalactanul din structura
peretelui celular la Mycobacterium

B. Antibiotice care altereaza functiile Polimixine - Polimixina B Bacil/cocobacil G-/

mb.citoplasmatice bactericid Polimixina E aerobi-facultativ
anaerobi/ exceptie
Proteus,Serattia,..

2
C. INHIBITORI AI SINTEZEI PROTEICE subunit 30S ribosomalaI(primele2) 50S II(urm6)

I .AMINOGLICOZIDE -Streptomicina BG- facultativ anaerobi/

-Neomicina staf/Pseudomaonas/Enterococ/ Mycop-strepto/
-Kanamicina yersinia.
-Tobramicina
- Gentamicina
- Amikacina Restul bactericid
-Spectinomicina –bacteriostat.
- Netilmicina
TETRACICLINE Biosinteza Tetraciclina BG+/BG-/aerobe/ anaerobe/ spirochete/
Oxitetraciclina micoplasme/ clamidii/ ricketti.
bacteriostatic Semisinteza Doxicilina
Minociclina
II. FENICOLI Cloramfenicol Fenicolii- bactericid pe HI,N.meningitidis, S.pne
Tiamfenicol - bacteriostatic pe maj bact
KETOLIDE Telitromicina Asem Claritromicina,
BG+/ S.pneumoniae.
MACROLIDE - Eritromicina CG+/BG+ aerobi si anaerobi/
-Claritromicina Moraxella catarrahalis,
- Diritromicina Bordetella pertussis,
bacteriostatic - Spiramicina Legionella pneumophila.
Hi,Campylobacter,
H.p.-claritromicina,
Mycoplasma,Chlamydia,
STREPTOGRAMINE Pristinamicina CG+/BG+ aerobi si anaerobi/
Moraxella catarrahalis,
Bordetella pertussis,
bactericid Legionella pneumophila.
Hi,Campylobacter,
H.p.-claritromicina,
Mycoplasma,Chlamydia
S.pneumoniae/Enterococ faecium
LINCOSAMIDE Lincomicina BG+/ S.aureus/ anaerobe
Clindamicina BG+ aerobe si anaerobe
OXAZOLIDINONE Linezolid
bacteriostatic

III. ANTIBIOTICE CARE INHIBA SINTEZA PROTEINELOR PRIN ALT MECANISM

ACIDUL FUSIDIC BG+ aerobe si anaerobe,
bacteriostatic
MUPIROCIN BG+

3
 D. INHIBITORI AI ACIZILOR NUCLEICI

CHINOLONE GENERATIA I Acid nalidixic BG- din fam. Enterobacteriaceae

Acid pipemidic
Acid oxolinic
Cinoxacina
bactericid GENERATIA II Norfloxacina BG-/ P.aeruginosa/ CG-/ cocobacili G-/ Unele
Ciprofloxacina BG+ staf meticilino-rezistente, streptococi beta
Ofloxacina hemolitici / activitate var pe Mycoplasma si
Pefloxacina Chlamydia
Lomefloxacina
GENERATIA III Levofloxacina BG-/ P.aeruginosa/ CG-/ cocobacili G-/ Unele
Moxifloxacina BG+ staf meticilino-rezistente, streptococi beta
Sparfloxavina hemolitici, S.pneumoniae., activitate
Gentifloxacina imbunatatita pe Mycoplasma,Chlamydia

GENERATIA IV Trovafloxacina BG-/ P.aeruginosa/ CG-/ cocobacili G-/ Unele BG+

staf meticilino-rezistente, streptococi beta
hemolitici, S.pneumoniae., activitate imbunatatita
pe Mycoplasma,Chlamydia, anaerobe
RIFAMPICINA M.tuberculosis, CG+/ CG-/ cocobacil G-/ Legionella pneumophila, Chlamydii
bactericid
METRONIDAZOL Protozoare, anaerobe, H.P
bactericid
SULFAMIDE Sulfadiazina CG+-/BG+- exceptie P.aeruginosa, Actinomyces,
Sulfizoxazol
bacteriostatic Sulfametoxazol
Sulfosalazina
Sulfone
COTRIMOXAZOL Asociatie sinergica intre sulfametoxazol si trimetroprim
bactericid
NITROFURANI Nitrofurantoin BG- din fam Enterobacteriaceae, exceptia Proteus,
bactericid Furazolidon CG+ di genurile stafilococ si enterococ.

C.I - asocierea unui antibiotic BACTERICID – BACTERIOSTATIC (penicilina-tetraciclina)

- antib cu mecanism de actiune identice (2 beta lactamice )
- AMGZ. CU POLIMIXINE

- EFECT SINERGIC: AMPICILINA + GENTAMICINA -ENETROCOCI SI STREPTOCOCI

TICARCILINA + AMGZ - P.AERUGINOSA
CEFALOSPORINE + AMGZ -K.PENUMONIAE