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Overview of By Mechanism
Natural First generation Ciprofloxacin (Cipro) Amikacin Aztreonam Ertapenem Azithromycin Vancomycin
Levofloxacin (Levaguin) Gentamicin Imienem Clarithromycin Rifampin
Moxifloxacin (Avelox) Kanamycin Meropenem Dirithromycin Doxycycline
Penicillin G Cephalothin
Norfloxacin Neomycin Erythromycin Linezolid
Penicillin-VK Cefazolin (Ancef,
Tobramycin Clindamycin Tetracycline
Kefzol)
Trimethoprim/
Cephapririn
sulfamethoxacole
Cephalexin (Keflex)
other
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(bactericidal: blocking cross Sulbactam S aureus** Reaction
linking) Tazobactam S epidermis** Hemolytic anemia
E.Coli**
Klebsiella**
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Aerobic Gram + Achilles tendon
rupture
Impaired fracture
healing
Bacteria Overview
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Clostridium tetani
Clostridium botulinum
Clostridium perfringens
Clostridium difficile
Penicillins
Mechanism
interferes with bacterial cell wall synthesis
Subclassification and tested examples
natural
penicillin G
penicillinase-resistant
methicillin (Staphcillin)
aminopenicillins
ampicillin (Omnipen, Polycillin)
Cephalosporins
Overview
bactericidal
Mechanism
disrupts the synthesis of the peptidoglycan layer of bacterial cell walls
does so through competitive inhibition on PCB (penicllin binding proteins)
peptidoglycan layer is important for cell wall structural integrity.
same mechanicsm of action as beta-lactam antibiotics (such as penicillins)
Subclassification and tested examples
first generation
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Fluoroquinolones
Mechanism
blocks DNA replication via inhibition of DNA gyrase
Side effects
inhibit early fracture healing through toxic effects on chondrocytes
increased rates of tendinitis, with special predilection for the Achilles tendon.
tenocytes in the Achilles tendon have exhibited degenerative changes when
viewed microscopically after fluoroquinolone administration.
recent clinical studies have shown an increased relative risk of Achilles tendon
rupture of 3.7.
Subclassification and tested examples
ciprofloxacin (Cipro)
levofloxacin (Levaquin)
Aminoglycosides
Mechanism
bactericidal
inhibition of bacterial protein synthesis
work by binding to the 30s ribosome subunit, leading to the misreading of mRNA.
This misreading results in the synthesis of abnormal peptides that accumulate
intracellularly and eventually lead to cell death. These antibiotics arebactericidal.
Subclassification and tested examples
gentamicin (Garamycin)
Vancomycin
Coverage
gram-positive bacteria
Mechanism
bactericidal
an inhibitor of cell wall synthesis
Resistance
increasing emergence of vancomycin-resistant enterococci has resulted in the
development of guidelines for use by the (CDC)
indications for vancomycin
serious allergies to penicillins or beta-lactam antimicrobials
serious infections caused by susceptible organisms resistant to penicillins (MRSA,
MRSE)
surgical prophylaxis for major procedures involving implantation of prostheses in
institutions with a high rate of MRSA or MRSE
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Rifampin
Linezolid
Linezolid binds to the 23S portion of the 50S subunit and acts by preventing the formation of
the initiation complex between the the 30S and 50S subunits of the ribosome
Splenectomy
Splenectomy patients or patients with functional hyposplenism require the following vaccines
and/or antibiotics
Pneumococcal immunization
Haemophilus influenza type B vaccine
Meningococcal group C conjugate vaccine
Influenza immunization
Lifelong prophylactic antibiotics (oral phenoxymethylpenicillin or erythromycin)
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