ANTI-

INFECTIVE
AGENTS
THE ANTI-INFECTIVE

 Anti-infective agents are drugs that are designed to act selectively on foreign organisms that have invaded and infected the bod y

 Ideally, anti-infectives would be toxic to the infecting organisms only and would have no effect on the host cell. This is known as
Selective Toxicity.
➢ Selective Toxicity – the ability to affect certain proteins or enzyme systems that are used by the infecting organisms but not b y the human
cell.

 Anti-infective range from:

 Antibiotics
 Antifungals
 Antiprotozoals
 Antihelmintics
 Antivirals
 Antimycobacterial
GENERAL MECHANISMS OF ACTION OF ANTI-
INFECTIVE

 Some interfere with the biosynthesis of bacterial cell wall.

❖ Ex. Penicillins

 Some anti-infectives prevent the cells of the invading organisms from using
substances essential to their growth and development
❖ Ex. Sulfonamides
GENERAL MECHANISMS OF
ACTION OF ANTI-INFECTIVE
 Some anti-infectives interfere with the steps
involved in protein synthesis.
❖ Ex. Aminoglycosides

 Some anti-infectives interfere with DNA synthesis.

❖ Ex. Fluoroquinolones

 Other anti-infectives alter the permeability of the

cell memebrane to allow the components to leak
out.
ANTI-INFECTIVE ACTIVITY

Spectrum – range of effectiveness of an antibiotic.

Narrow Spectrum
➢ Anti-infectives affect only a few bacterial types.
➢ Ex. Early penicillins

Broad Spectrum
➢ Anti-infectives affect many types bacteria.
➢ Ex. Meropenem
ANTI-INFECTIVE ACTIVITY

 Bacteriostatic
➢ Anti-infectives that interfere with the ability of the cell to reproduce without killing
them.
➢ Ex.Tetracycline

 Bactericidal
➢ Antibiotics that can aggressively cause bacterial death
➢ Ex. Penicillin
ANTI-INFECTIVE THERAPY

 The goal of anti-infective therapy is the reduction of the invading organisms to a

point at which the human immune response can take care of the infection.

 If the drug would eliminate all forms of the organisms by itself it might be toxic
to the to the host itself.
  Immuno-compromised patients
have difficulty in using anti-
infectives.

ANTI- ➢ Malnutrition
➢ Age

INFECTIVE ➢ AIDS
Anti-infective drugs cannot totally

THERAPY eliminate the pathogen without

causing severe toxicity in the host.
These patients do not have the
immune resposne on place to deal
with even a few invading organisms.
COMMON ADVERSE REACTIONS
TO ANTI-INFECTIVE THERAPY

❑ Nephrotoxicity
➢ Anti-infectives that are metabolized and excreted in the kidney most frequently
cause kidney damage.
➢ My lead to renal damage and renal failure
➢ Keep the patient well hydrated
❖ Ex.Aminoglycosides
COMMON ADVERSE REACTIONS
TO ANTI-INFECTIVE THERAPY

❑ Gastro-intestinal toxicity
➢ Direct toxic effect to the cells of the GI tract
➢ Some anti-infectives are toxic on the mucosal lining of the GIT and can cause
nausea, vomiting, stomach pain or diarrhea
➢ Some drugs are toxic to liver cells and can cause hepatitis or liver failure
COMMON ADVERSE REACTIONS
TO ANTI-INFECTIVE THERAPY

❑ Neurotoxicity
➢ When drugs can pass through the brain barrier and accumulate in the nervous tissues,
they can interfere with neural function.
❖ Ex.Aminogycosides
o Accumulates in the 8th cranial nerve causing dizziness, vertigo and loss of hearing

❖ Ex. Chloroquine
o Accumulates in the retina and optic nerves causing blindness
COMMON ADVERSE REACTIONS
TO ANTI-INFECTIVE THERAPY

❑ Hypersensitivity
➢ Most antibiotics can induce the body’s immune response to produce allergic
responses.
➢ Allergic reactions

❑ Super-infections
➢ Broad spectrum anti-infecties can destroy the normal flora which can cause
oppurtunustic microorganisms to be active.
RESISTANCE

 Indiscriminate use of anti-infectives drugs has serious consequences.

 Unnecessary exposure of organisms to these drugs lead to the development of

resistant strain.
ACQUIRING RESISTANCE

 Producing an enzyme that deactivates the anti-infective drugs.

 Ex. Penicillinase

 Changing cellular permeability to prevent the drug from entering the cell.

 Altering binding sites on the membrane which no longer accept the drug.

 Producing a chemical that act as an antagonist to the drug.