ANTIBACTERIAL

AGENTS

ANTIBACTERIAL AGENTS
Are prescribed to combat
disease producing
microorganisms ( pathogens)
Used interchangeably with
antimicrobial and antibiotic

What are disease producing

pathogens?

Bacteria
Viruses
fungi

ANTIBACTERIAL AGENTS

Penicillins
Cephalosporins
Macrolides
Tetracyclines
Aminoglycosides
Fluoroquinolones

BACTERIOSTATIC
Inhibit the growth of bacteria
Tetracycline and sulfonamides

BACTERICIDAL

Kills bacteria
Penicillins and
cephalosporins

BACTERIA
Single cell organisms lacking a
true nucleus and nuclear
membrane
Bacillus rod shape
Cocci- spherical
Gram positive-retain purple stain
Gram negative-not stained

MECHANISM OF
ANTIBACTERIAL ACTION

Inhibition of bacterial wall synthesis

Alteration of membrane permeability
Inhibition of protein synthesis
Inhibition of the synthesis of bacterial
RNA and DNA
Interference with metabolism within the
cell

Mechanism of Action
ACTION
Inhibition of
cell wall
synthesis

EFFECT
Bactericidal
effect
Enzyme
breakdown of cell
wall
Inhibition of
enzymes in
synthesis of cell
wall

DRUGS
Penicillin
Cephalosporins
Bacitracin
Vancomycin
Amphotericin B

Mechanism of Action
ACTION
Alteration in
membrane
permeability

EFFECT
Bacteriostatic
or bactericidal
effect
Membrane
permeability
increase

DRUGS
Nystatin
Polymyxin
Colistin

Mechanism of Action
ACTION
Inhibition of
protein
synthesis

EFFECT
Interferes with
protein
synthesis w/o
affecting the
normal cells

DRUGS
Aminoglycosid
es
Tetracyclines
Erythromycin
lincomycin

Mechanism of Action
ACTION
Interference
with cellular
metabolism

EFFECT
Interferes with
steps of
metabolism
within the cell

DRUGS
Sulfonamides
Trimetoprim
Isoniazid
Nalidixic acid
Rifampin

Pharmacokinetics
Must penetrate bacterial cell wall and
have an affinity to the binding sites
on the bacterial cell
Steady state of the antibacterial drug
occurs after the fourth to fifth half
lives
Eliminated through the urine after
the 7th half life

Pharmacodynamics
Attain bactericidal effect if within
or above the minimum effective
concentration (MEC)

General adverse reaction to

antibacterial drugs

Allergy/hypersensitivity
Superinfection
Organ toxicity

Allergy and hypersensitivity

May be mild to severe

Sensitivity test must be
performed prior to
administration of the
prescribed dose

Superinfection
Secondary infection when normal
microbial flora of the body is
disturbed

Organ toxicity
Liver and kidneys are affected

NARROW SPECTRUM
ANTIBIOTICS
Effective against one type of
organism
Penicillin and erythromycin against
gram positive

BROAD SPECTRUM
Effective against gram positive and
gram negative organisms
Used when offending organism is
not identified
Tetracyclines and cephalosporins

PENICILLINS AND
CEPHALOSPORINS

Penicillins
Natural antibacterial agent obtained
from the mold genus Penicillium
Miracle drug
Pen G was the first to be administered
orally and by injection
Pen V-next type produced
Food interferes with absorption

Penicillins
Beta lactam antibiotics
Beta lactamases- produced by
bacteria and inactivates penicillin

BASIC PENICILLINS

Penicillin G procaine
Penicillin G benzathine
Penicillin G sodium
Penicillin V potassium

Broad spectrum penicillins

Ampicillin ( Cloxapen)
Amoxicillin ( Amoxil )
Bacampicillin ( Spectrobid)
Amoxicillin-clavulanate
(Augmentin)
Ampicillin sulbactam (Unasyn)

Penicillinase resistant penicillins

( Antistaphylococcal penicillins )

Used to treat penicillinase

producing S aureus
Cloxacillin (Cloxapen) and
dicloxacillin ( Dynapen)-oral prep
Nafcillin (Unipen) and oxacillin
( Prostaphin) IV and IM prep

EXTENDED SPECTRUM PENICILLINS

Antipseudomonal penicillins
Useful against Klebsiella
pneumoniae, enterobacter,
acinetobacter
Carbenicillin indanyl ( Geocillin)
Mezlocillin sodium (Mezlin)

Beta Lactamase Inhibitors

Broad spectrum antibiotic ( amoxicillin)
combined with a beta lactamase (enzyme
inhibitor/clavulanic acid)= amoxicillinclavulanic acid ( Augmentin)
Examples :
Oral use : amoxicillin-clavulanic acid
( Augmentin)
Parenteral use: ampicillin sulbactam
( Unasyn),piperacillin-tazobactam (Zosyn) and
ticarcillin-clavulanic acid ( Timentin)

GENERAL SIDE EFFECTS AND

ADVERSE REACTIONS

Side effects and adverse reactions

Hypersensitivity
Superinfection
Nausea
Vomiting
Diarrhea
Rash
Anaphylactic reaction

NURSING INTERVENTIONS
Carry out C and S test before the start
of therapy
Check for signs of superinfection
Examine patient for allergic reaction
Have epinephrine ready for severe
allergic reaction
Check for bleeding with high doses of
penicillin

Client teachings
Instruct client to take entire prescribed
dose
Client allergy should wear medic alert
bracelet
Encourage increase fluid intake