BROAD SPECTRUM ANTIBIOTICS

TETRACYCLIN MACROLIDES CHLORAMPHENICOL SULFONAMIDE TRIMETHOPRIM QUINOLONE

Mechanis - Bacteriostatic - Bacteriostatic - Bacteriostatic - Bacteriostatic - Bacteriostatic - Bactericial
m - Effective against G+ - Actively against many - Protein synthesis inhibitors - Act as competitive - Chemotherapeutic agent - Inhibit DNA replication
& G- G+ - Active against bacterial cause inhibitors of enzyme (dihydrofolate reductase & transcription
- Act by inhibiting protein meningitis (N. meningitides, S. DHPS (needed for folate inhibitor) - Enter cells via porin
synthesis of bacteria by pneumonia, H. influenza) synthesis – folate for cell - Act by interfering with the
binding to the 50S - Excellent CSF penetration) division) action of DHFR – inhibit
ribosomal element synthesis of
tetrahydrofolate reductase
- Precursor in DNA
nucleotide & thymidine
Indication - Treat mild to moderate - Typhoid - Pneumonia - Prophylaxis - Pt with infection of
infections - Multi-drug resistant salmonella - Urinary tract infection - Urinary tract infections intracellular pathogen
typhi - Shigellosis such as Mycoplasma
- 2nd line agent in treatment of - Certain protozoa pneumonia
tetracyclin-resistant chorela infections
- Brain abscess (staphylococcal or
mixed organism)
- Meningitis (for pt with severe
penicillin & cephalosporin allergy)
Contra- 1) Pregnant women - Interaction with digoxin Control the dosage for 1) Neonates Enchance toxicity
indication 2) Breast feeding may occur in some pt. 1) Neonates 2) Infant <2 months 1) Caffeine
/ women 2) Pt with abnormal liver function 3) Pregnant women 2) NSAID
interaction 3) Children <8 yrs old 3) Thephylline
4) Renal impairment Monitor plasma level for 4) Corticosteroid
pt. 1) Children <4 yrs old Drug interacton:
2) Elderly Antacid, cimetidine,
3) Pt with renal failure warfarin, phenytoin,
cyclosporine & rifampin
Adverse Serious effect on - Cholestatic jaundice - Aplastic anaemia - Crystalluria
effect calcified tissues, it - Ototoxicity - Bone marrow suppression - Hypersensitivity
can be deposit in - Accumulate in liver - Leukemia - Hemolytic anemia
bone, cause (inhibit hepatic - Gray baby syndrome
discoloration & metabolism)
hypoplasia of the
teeth
Dosage 750mg (4x daily)
Resistance 1) Reduced membrane permeability
2) Mutation of 50S ribosomal unit
3) Elaboration of chloramphenicol
acetyltransferase
Example / Erythromycin,
types Azithromycin,
Chlarithromycin