MICROBES THAT ARE

CAPABLE OF CAUSING HUMAN

DISEASE, OR, INCLUDE VIRUSES,
BACTERIA, FUNGI, UNICELLULAR
ORGANISMS (PROTOZOANS), AND PATHOGENS
MULTICELLULAR ANIMALS (E.G.,
FLEAS, MITES, AND WORMS)

THE ABILITY OF AN
ORGANISM TO CAUSE DISEASE
OPPORTUNISTICPATHOGENS-ORGANI
SMS THAT USUALLY INFECT ONLY
WHEN THE BODY S IMMUNE SYSTEM
PATHOGENICITY
IS SUPPRESSED ARE CALLED

A QUANTITATIVE
MEASURE OF AN
ORGANISM S VIRULENCE
PATHOGENICITY

THE ABILITY OF A
PATHOGEN TO GROW
EXTREMELY
RAPIDLY AND CAUSE
DIRECT INVASIVENESS
DAMAGE TO SURROUNDING
TISSUES
BY THEIR SHEER NUMBERS
 ARE PROTEINS
RELEASED BY BACTERIA
INTO
SURROUNDING TISSUES
THAT HAVE
THE ABILITY TO INACTIVATE
EXOTOXINS
OR KILL
HOST CELLS

ARE HARMFUL
NON-PROTEIN CHEMICALS
THAT ARE
PART OF THE OUTER LAYER
OF THE
ENDOTOXINS
NORMAL CELL WALL OF
GRAM-NEGATIVE BACTERIA

THRIVE IN AN
OXYGEN-RICH AEROBIC
ENVIRONMENT

THOSE THAT
GROW
OPTIMALLY ANAEROBIC
WITHOUT
OXYGEN
 EXPLOITS
DIFFERENCES IN
CELL SELECTIVE
BIOLOGY BETWEEN
HOST & TOXICITY
PATHOGEN CELLS

GOLD CULTURES
STANDARD

BROAD EMPIRICAL
SPECTRUM
ANTIBIOTICS THERAPY

NARROW ( DIRECTED
SPECTRUM THERAPY
‒TICARCILLIN,
CEFTAZIDIME, PSEUDOMONAS
IMIPENEM,
MEROPENEM

METRONIDAZOLE,
CLINDAMYCIN ANAEROBES

MYCOPLASMA MACROLIDES

SYSTEMIC SYSTEMIC
FUNGI FUNGI
SOME ANTIBACTERIAL
AGENTS CAN
AMPLIFY
EACH-OTHER S
MECHANISM
SYNERGY
OF ACTION

INHIBIT PROTEIN
SYNTHESIS, BUT NEED
TO GAIN
ACCESS INTO CELL AMINOGLYCOSIDES
Β-LACTAMS
INHIBIT CELL WALL
SYNTHESIS

TARGET ANTI-CELL-WALL
PEPTIDOGLYCAN SYNTHESIS
SYNTHESIS ON
ANTIBIOTICS ‒
GRAM-POSITIVE (BACTERICIDAL)
BACTERIA

OXACILLIN
ARE
EFFECTIVE AGAINST AND
PENICILLINASEPRODUCING
BACTERIA CLOXACILLIN
(ORBENIN)
 ARE
EFFECTIVE AGAINST A AMINOPENICILLINS
WIDER RANGE -AMPICILLIN AND
OF MICROORGANISMS AND
ARE AMOXICILLIN
CALLED BROAD-SPECTRUM (AMOXIL)
PENICILLINS

ARE EFFECTIVE EXTENDED-

AGAINST EVEN MORE SPECTRUM
MICROBES, PENICILLINS
INCLUDING PSEUDOMONAS,
ENTEROBACTER, -SUCH AS
KLEBSIELLA, AND CARBENICILLIN AND
BACTEROIDES FRAGILIS PIPERACILLIN

CONTAIN A
BETA-LACTAM RING;
BACTERIA
PRODUCING FIRST-GENERATION
BETA-LACTAMASE WILL CEPHALOSPORINS
USUALLY BE RESISTANT TO
THESE
AGENTS

ARE MORE
POTENT, MORE RESISTANT
TO THE
BETA-LACTAMASE, AND
EXHIBIT A SECOND-GENERATION
BROADER SPECTRUM THAN CEPHALOSPORINS
THE
FIRST-GENERATION DRUGS
 GENERALLY HAVE
A LONGER DURATION OF ACTION,
HAVE AN EVEN BROADER SPECTRUM,
AND ARE RESISTANT TO THE
BETA-LACTAMASE. THESE ARE
SOMETIMES THE DRUGS OF CHOICE THIRD-GENERATION
AGAINST INFECTIONS BY
PSEUDOMONAS, KLEBSIELLA,
NEISSERIA, SALMONELLA, PROTEUS,
CEPHALOSPORINS
AND HAEMOPHILUS INFLUENZAE

ARE CAPABLE OF
ENTERING
THE CSF TO TREAT THIRD- AND
FOURTH-GENERATION
CENTRAL AGENTS
NERVOUS SYSTEM
(CNS) INFECTIONS

FOR GRAMNEGATIVE
INFECTIONS AND FOR
CLIENTS WHO CEPHALOSPORINS
CANNOT TOLERATE
PENICILLINS

ALLERGY,
RASH AND ADVERSE EFFECTS
OF
GI CEPHALOSPORINS
COMPLAINTS
 STABLE AGAINST
BETA-LACTAMASE AND ARE
DISTRIBUTED TO MOST • IMIPENEM
AND
TISSUES.
THEY ARE, HOWEVER,

MEROPENEM
VULNERABLE
TO BREAKDOWN BY ENZYMES
FOUND
IN RENAL TUBULI

IMPORTANT
INDICATION BACTERIAL
FOR MENINGITIS
MEROPENEM

INFLUENCED LESS
BY BETA-LACTAMASE
THAN ARE THE
AZTREONAM
PENICILLINS AND I
CEPHALOSPORIN

CONSIDERABLY
LESS ALLERGENIC THAN
THE
PENICILLINS AND
CEPHALOSPORINS AZTREONAM
AND CAN BE USED IN
PENICILLIN-ALLERGIC
SUBJECTS
 EXPLOITS
DIFFERENCES ANTI
BETWEEN PROTEIN-SYNTHESIS
EUKARYOTIC (HUMAN)
RIBOSOMES & ANTIBIOTICS ‒
PROKARYOTIC (BACTERIOSTATIC)
RIBOSOMES

ARE
SOLELY ELIMINATED
BY THE KIDNEYS AMINOGLYCOSIDES
& ARE NEPHROTOXIC

NOW USUALLY
RESTRICTED TO THE
TREATMENT OF
TUBERCULOSIS (TB) DUE TO •
THE
DEVELOPMENT OF A LARGE STREPTOMYCIN
NUMBER
OF RESISTANT STRAINS

ADMINISTERED
PARENTERALLY
TO TREAT STREPTOMYCIN
SYSTEMIC
INFECTIONS
 AVAILABLE
FOR TOBRAMYCIN
OPTHALMIC
USE

GIVEN
ORALLY FOR THE PAROMOMYCIN
TREATMENT OF
PARASITIC (HUMATIN)
INFECTIONS.

HAVE SOME OF
THE BROADEST
SPECTRUMS, BUT
THEY ARE DRUGS OF TETRACYCLINES
CHOICE FOR
RELATIVELY FEW
DISEASES.

BIND METAL IONS SUCH AS

CALCIUM, MAGNESIUM,
ALUMINUM,
AND IRON, AND
TETRACYCLINES TETRACYCLINES
SHOULD NOT BE TAKEN
WITH MILK
OR IRON SUPPLEMENTS
MOST COMMON ADVERSE
EFFECTS
ARE GI RELATED AND
INCLUDE
NAUSEA, VOMITING,
MACROLIDES
ABDOMINAL
CRAMPING, AND DIARRHEA

EXPLOITS ANTI NUCLEIC-ACID

DIFFERENCES IN THE SYNTHESIS
METABOLIC
PATHWAYS OF DNA ANTIBIOTICS ‒
SYNTHESIS (BACTERIOSTATIC):

FOR URINARY TRACT

INFECTIONS,
PNEUMOCYSTIS TRIMETHOPRIM-SULFAMETHOXAZOLE
CARINII PNEUMONIA,
SHIGELLOSIS AND
ACUTE EPIS

IS POORLY
ABSORBED AND
REMAIN IN THE
ALIMENTARY CANAL TO SULFASALAZINE
TREAT
INTESTINAL
INFECTIONS
 USED FOR
TOPICAL SULFADIAZINE
INFECTIONS

INHIBITORS
OF THE BACTERIAL
BOTH
METABOLISM OF
FOLIC ACID, OR
SMZ AND
FOLATE TMP
SELECTIVE FOR
BACTERIAL TRIMETHOPRIM-SULFAMETHOXAZOLE
FOLATE
METABOLISM

NAUSEA, VOMITING,
AND DIARRHEA
BEING THE MOST QUINOLONES
COMMON SIDE
EFFECTS
 A FREQUENT
STRATEGY TO
DECREASE THE
COMPOUND
PROBABILITY OF THE
EMERGENCE OF
DRUG
RESISTANT
ORGANISMS
THERAPY

AN INFECTION
CAUSED BY THE
ORGANISM M. TUBERCULOSIS
TUBERCULOSIS

SAFER AND
GENERALLY FIRST-LINE
THE MOST DRUGS -
EFFECTIVE

MORE TOXIC AND

LESS EFFECTIVE THAN
THE
FIRST-LINE AGENTS,
ARE USED WHEN
SECOND-LINE
RESISTANCE
DEVELOPS
 USED FOR
CLOSE CONTACTS
OR FAMILY CHEMOPROPHYLAXIS
MEMBERS OF
RECENTLY INFECTED
PATIENTS

• IT IS BACTERICIDAL
FOR ACTIVELY
GROWING ORGANISMS
BUT
DRUG OF
BACTERIOSTATIC FOR
DORMANT
MYCOBACTERIA
CHOICE

CAUSED
BY M. LEPROSY
LEPRAE
PRESENT WITH MACULAR
SKIN
LESIONS, LOSS OF
SENSATION OR
PARESTHESIA, BONE
RESORPTION,
LEPROSY
RESULTING IN LOSS OF
DIGITS
 OCCURS
IN CLIENTS WITH LEPROMATOUS
DEFECTIVE
CELL-MEDIATED LEPROSY
IMMUNITY

LESS
PROGRESSIVE AND MAY HAVE
LONG
PERIODS OF REMISSION
TUBERCULOID
FOLLOWED
BY REACTIVATION WITH MORE
LEPROSY
SEVERE NERVE INVOLVEMENT

DAPSONE,
CLOFAZIMINE, LEPROMATOUS
AND
RIFAMPIN GIVEN LEPROSY
FOR 2 TO 5 YEARS

DAPSONE
AND RIFAMPIN FOR 6
TO 12 MONTHS, TUBERCULOID
FOLLOWED BY LEPROSY
DAPSONE ALONE FOR
2 TO 3 YEARS
 SUCH AS
PREDNISONE ARE
ADDED TO THE
REGIMEN TO REDUCE CORTICOSTEROIDS
THE SEVERE
INFLAMMATION

• DRUG OF CHOICE FOR THE

TREATMENT OF M. LEPRAE
INFECTIONS, USUALLY IN
COMBINATION WITH OTHER DAPSONE
ANTILEPROSY DRUGS

MAY
SIGNIFICANTLY
REDUCE SERUM
LEVELS OF
RIFAMPIN
DAPSONE

RESERVED FOR SEVERE

INFECTIONS FROM GRAM-
POSITIVE
ORGANISMS SUCH AS S.
AUREUS AND
S. PNEUMONIAE, MOST
VANCOMYCIN
EFFECTIVE
DRUG FOR TREATING MRSA
INFECTIONS
• NEW CLASS OF
ANTIBIOTICS
CALLED THE LINEZOLID
OXAZOLIDINONES

• EFFECTIVE AGAINST BOTH

GRAM-POSITIVE AND
GRAM-NEGATIVE BACTERIA
• SUSCEPTIBLE BACTERIA
INCLUDE CLINDAMYCIN
FUSOBACTERIUM AND
CLOSTRIDIUM
PERFRINGENS

IT IS SOMETIMES THE
DRUG OF
CHOICE FOR ORAL
INFECTIONS CLINDAMYCIN
CAUSED BY
BACTEROIDES

SIDE EFFECTS:
DIARRHEA, RASHES,
DIFFICULTY
BREATHING, ITCHING, CLINDAMYCIN
AND DIFFICULTY
SWALLOWING
COMBINATION DRUG
THAT IS THE
FIRST IN A NEW QUINUPRISTIN-DALFOPRISTIN
CLASS OF
ANTIBIOTICS CALLED
STREPTOGRAMINS

• RESERVED TO TREAT
INFECTIONS
CAUSED BY QUINUPRISTIN-DALFOPRISTIN
ANTIBIOTIC-RESISTANT
GRAM-POSITIVE
ORGANISM

• INDICATED FOR
TREATMENT OF
VANCOMYCIN-RESISTANT E. QUINUPRISTIN-DALFOPRISTIN
FAECIUM
INFECTIONS

URINARY ANTISEPTICS
ARE
ANTI-INFECTIVE DRUGS
USED
URINARY
EXCLUSIVELY FOR ANTISEPTICS
URINARY TRACT
INFECTIONS
• THE TREATMENT OF
UNCOMPLICATED
ACUTE CYSTITIS,
MOST COMMONLY FOR NITROFURANTOIN
THE
PROPHYLAXIS OF
RECURRENT UTI

• ACTIVE AGAINST E. COLI,

STAPHYLOCOCCUS
SAPROPHYTICUS,
AND MANY OTHER STRAINS OF
GRAM-POSITIVE AND
GRAM-NEGATIVE AEROBES. IT IS NITROFURANTOIN
NOT
EFFECTIVE AGAINST THE
PSEUDOMONAS, PROTEUS, OR
SERRATIA SPECIES

MACROCRYSTALLINE
FORM MACRODANTIN

SUSTAINED-RELEASE
MACROCRYSTALLINE
FORM
MACROBID
• CHRONIC PULMONARY
TOXICITY
MAY NOT APPEAR
UNTIL MONTHS OR NITROFURANTOIN
YEARS AFTER THERAPY
HAS BEEN
COMPLETED