ANTIMICROBIAL DRUGS corticosteroids, chemotherapy, or other
immunosuppressives.
Disease-producing organisms and its
characteristics:
Fungi –reproduce by both sexually and asexually &
disperses by spores (e.g., Aspergillosis, moniliasis,
histoplasmosis, and mucormycosis)
Protozoan –reproduce by both sexually and asexually.
It could be aerobic or anaerobic species that lives
mostly in moist areas (e.g., Plasmodium falciparum,
Plasmodium vivax, Plasmodium malariae and
Plasmodium ovale)
Helminths- are large parasitic worms that live and lay
eggs in warm, moist soil where sanitation and hygiene
are poor (e.g., Cestodes (tapeworms), Intestinal
nematodes (roundworms), Trematodes (flukes), and
Tissue-invading nematodes (tissue roundworms and
filarae)
Fungal Infection
An infection caused by a fungus may also be called
mycosis, tinea, or candidiasis
Types of fungal infection
• local or systemic
Local fungal infections - can be acquired by contact
with an infected person
Systemic fungal infections - usually transmitted to
an individual through inhalation into the lungs.
Types of fungal infection
1. Local infection
• dermatophytes can cause local fungal infections
involving the integumentary system including mucous
membranes, hair, nails, and moist skin areas.
2. Systemic infection
• may involve the lungs, CNS, or abdomen and are
usually transmitted to an individual through inhalation
into the lungs.
Category of fungal infection
• Mild fungal infection (e.g., tinea pedis (athlete’s
foot)
• Severe fungal infection- (e.g.,disease of the lungs
or fungal meningitis)
Classification of Fungal infection
1. Opportunistic - usually occur in the
immunocompromised or debilitated population (e.g.,
cancer or AIDS) or in those taking antibiotics,
 Other opportunistic infections are aspergillosis and
pneumocystis pneumonia
 Opportunistic infection, such as systemic
candidiasis, may occur when the body’s defense
mechanisms are impaired such that they allow
overgrowth of the fungus
2. Primary - occur in immunocompetent persons and
result from inhaled spores. Primary infections include
coccidioidomycosis, blastomycosis, histoplasmosis, and
etc.
Antifungal / Antimycotic Drugs
Antifungal / Antimycotic drugs - are used to treat
fungal infections such as the superficial infections
(mucous membranes, hair, nails, and moist skin areas,
oral candidiasis or thrush, and vaginal candidiasis); and
systemic infections (lungs, CNS, abdomen)
Types of Antifungal / Antimycotic
1. Fungistatic
2. Fungicidal depending upon the susceptibility of the
fungus and the dosage.).
Classification of Antifungal
Classification Example
Polyenes Amphotericin B, Nystatin
Amphotericin – drug of choice
for severe infection
Nystatin – Treat Candida
infection
Azoles Fluconazole - effective in
candidiasis,
coccidioidomycosis, histoplasmosis,
Ketoconazole – variety of fungal
infections
Antimetabolites Flucytosine - used in combination
with other antifungal drugs
(DNA/RNA)
Echinocandins Caspofungin – newest class of
antifungal; treat Aspergillus
Candida infections
Miscellaneous Griseolfulvin – for tinea infection
Antifungal/ Anthelmentic Herbal medicine (DOH
approved)
Akapulko (Cassia alata)
• Common names - also known as "bayabas-
bayabasan" and "ringworm bush" or Acapulkoin English
• Indications: used to treat ringworms and skin
infections. It contains chrysophanic acid, a fungicide
used to treat fungal infections, like tinea pedis, scabies,
and eczema.
• Found in: Common in the Philippines
• Parts used: Leaves by infected Anopheles mosquitoes, and it remains
one of the most prevalent protozoan diseases.
Special precautions if given orally for other
diseases: Plasmodium Specie causing Malaria:

• A strong decoction of Akapulko leaves is an • Plasmodium falciparum - is the most severe

abortifacient. Pregnant women should not take
decoction of the leaves or any part of this plant orally • Plasmodium vivax – most prevalent

Preparation: For external use • Plasmodium malariae

• Pound the leaves of the Akapulko plant, squeeze the • Plasmodium ovale
juice and apply on affected areas.
Life cycle of protozoa (malaria)
• Pounded leaves may be applied thinly on the affected
part twice a day. Marked

improvement may be expected after two to three weeks

of continuous application

 Other herbal medicine with fungicidal effect:

Bayabas

Antiprotozoan

Protozoa

• Are able to multiply in humans, which contributes to

their survival and also permits serious infections

• Transmission of protozoa that live in a human’s

intestine to another human typically occurs through a
fecal-oral route
After the mosquito infects the human, the protozoan
• Protozoa that live in the blood or tissue of humans are parasite passes through two phases
transmitted to other humans by an arthropod vector
(e.g., through the bite of a mosquito such as the 1. Tissue phase (invasion of body tissue) -produces
anopheles mosquitoes in malaria). no clinical symptoms in the human

Protozoa 2. Erythrocytic phase (invasion of the red blood

Protozoa - one-celled organisms that can be free-living
or parasitic in nature.
Classifications of protozoa
• Mastigophora – the flagellates (e.g., Gardia,
Leishmania)
• Ciliophora – the ciliates (e.g., Balantidium)
• Sarcodina – the ameba (e.g., Entamoeba)
• Sporozoa – organisms whose adult stage is not motile
(e.g., Cryptosporidium, Plasmodium)
Antiprotozoa
Antimalarial - Used to treat Malaria. A life-threatening
disease caused by multiple species of protozoan
parasites of Genus Plasmodium.
 Malaria is caused by multiple species of protozoan
parasites of the genus Plasmodium that are carried
cells) - causes symptoms of chills, fever, and sweating.
• Incubation period is 10 to 35 days, followed by flulike
symptoms.
• Preventing transmission of malaria can be done by
controlling the mosquito firstly through insecticide-
treated mosquito nets and secondly with spraying
Antimalarial drugs
• Antimalarial drugs provide treatment and prophylaxis
• Chloroquine is a commonly prescribed drug for
malaria.
• When drug-resistant malaria occurs, combinations of
antimalarial are used to facilitate effective treatment.
• If drug resistance to chloroquine occurs, another
antimalarial such as mefloquine hydrochloride (HCl) or
combinations of antimalarials with or without antibiotics
(e.g., tetracycline, doxycycline, clindamycin) may be
prescribed
Three methods used to eradicate malaria
1. Prophylaxis (prevention) and prevention of
relapse.
• Example of prophylaxis are chloroquine and
primaquine.
2. Treatment for the acute attack
fluke), Paragonimus westermani (lung fluke), and
Schistosoma species (blood flukes)
3. Intestinal nematodes (roundworms) - may feed on
intestinal tissue (Ascarislumbricoides (giant roundworm),
Necator americanus (hookworm), Enterobius
vermicularis (pinworm), Strongyloides stercoralis
(threadworm), and Trichuris trichiura (whipworm).

• Chloroquine and mefloquine are frequently used to
treat an acute malarial attack.
3. Combinations of antimalarial drug
• Mefloquine HCl and the combination drug atovaquone-
proguanil are used to treat chloroquine-resistant P.
falciparum.
4. Tissue-invading nematodes (tissue roundworms and
filarae) - Trichinellaspiralis (pork roundworm) and
Wuchereria bancrofti (filariae)
Side Effects and Adverse Reactions of
anthelmintics
• Side effects

Note: Chloroquine and hydroxychloroquine can be toxic
to children and may even cause death, therefore the
drug dose should be closely monitored
General Side Effects and Adverse Reactions to
Antimalarial drugs
• GI upset
• GI distress (e.g., anorexia, nausea, vomiting, and
occasionally diarrhea and stomach cramps).
• Neurologic problems (e.g., dizziness, weakness,
headache, and drowsiness.
• Adverse reactions do not occur frequently because the
drugs usually are given for a short period (1 to 3 days).

• Cranial nerve VIII involvement (quinine and

chloroquine)

• Renal impairment (quinine),

• Cardiovascular effects (quinine).

Antihelmintic

Helminths are large parasitic worms that live and lay

eggs in warm, moist soil where sanitation and hygiene
are poor

Transmission occurs from infected soil to the person,

whereupon the helminth then feeds on host tissue. It
enters to the human hosts via contaminated food, bites
of carrier insects, or direct penetration to skin.

Most common site for helminthiasis (worm infection)

is the intestine.

Other sites for parasitic infection

• lymphatic system blood vessels, and liver.

• These parasites cause disability and developmental

delays in children and adolescents

4 Major groups of parasitic worms

1. Cestodes (tapeworms) – enter to the intestine via
contaminated food (pork, beef, fish, and dwarf) Taenia
solium (pork tapeworm), T. saginata (beef tapeworm),
Diphyllobothrium latum (fish tapeworm), and
Hymenolepis nana(dwarf tapeworm).

2. Trematodes (flukes) - feed on the host. Fasciola

hepatica (liver fluke), Fasciolopsis buski (intestinal