Kill bacteria primarily by inhibiting protein

synthesis

Uses: gram negative microorganisms

UTI, meningitis, wound infections, septicemia

Amikacin

Gentamicin

eomycin

!treptomycin

Kanamycin

"toto#icity

ephroto#icity

$otent broad%spectrum antibiotics resistant

to beta%lactamase en&ymes secreted by
bacteria

Inhibits bacterial cell wall synthesis

Imipenem%'ilastatin% an inhibitor of the

renal dipeptidase en&yme dehydropeptidase
I(

'ilastatin% no antimicrobial property but

prevents the inactivation of imipenem(

Indications: )ower respiratory tract Infection

!evere infections

*oripenem

+rtapenem

,eropenenem

!evere diarrhea

'onfusion, di&&iness, sei&ure

$hlebitis

Acts by inhibiting the bacterial en&yme that

is necessary for cell wall synthesis(

!emisynthetic derivatives

!tructurally and pharmacologically

related
to penicillins

-actericidal action

-road spectrum

*ivided into groups according to their

antimicrobial activity

.irst generation

!econd generation

Third generation

.ourth generation

.ifth generation /not yet marketed0

Good gram%positive coverage

!treptococci, staphylococci

$oor gram%negative coverage

+( coli, !almonella

$arenteral and $" forms

+#amples

cefadro#il
cephradine

cefa&olin

cephale#in

Used for surgical prophyla#is, and for

susceptible staphylococcal infections

cefa&olin /Ancef and Kef&ol0: I1 or I,

cephale#in /Ke2e#0: $"

Good gram%positive coverage

-etter gram%negative coverage than

3rst generation

+#amples:

cefaclor

cefpro&il

cefo#itin

cefuro#ime

loracarbef

cefotetan

cefo#itin /,efo#in0: I1 and I,

Used prophylactically for abdominal or

colorectal surgeries
Also kills anaerobes

cefuro#ime

4inacef is parenteral form5 'eftin is $"

!urgical prophyla#is

*oes not kill anaerobes

,ost potent group against gram%negative bacteria
)ess active against gram%positive bacteria
+#amples
ceftibuten
cefota#ime
cefta&idime
cefdinir
cefti&o#ime
ceftria#one
cefta&idime

ceftria#one /6ocephin0

I1 and I,, long half%life, once%a%day dosing

+limination is primarily hepatic

+asily passes meninges and di7used into '!.

to treat '! infections

cefta&idime /'epta&0

I1 and I, forms
+#cellent gram%negative coverage

Used for di8cult%to%treat organisms such as

Pseudomonas spp(

+liminated by renal instead of biliary route

+#cellent spectrum of coverage

6esistance is limiting usefulness

-roader spectrum of antibacterial

activity than third generation, especially
against gram%positive bacteria

Uncomplicated and complicated UTI

cefepime /,a#ipime0

'eftobipriole /not available0

-roader spectrum of antibacterial

activity

+7ective against a wide variety of

organisms
,6!A

Pseudomonas spp(

!imilar to penicillins

,ild diarrhea, abdominal cramps, rash, pruritus,

redness, edema

$otential cross%sensitivity with penicillins if

allergies e#ist

*iarrhea

!econdary infections

9epatoto#icity

ephroto#icity

9ypoprothrombinemia

+lectrolyte imbalance

Thrombophlebitis

demeclocycline /*eclomycin0

o#ytetracycline

tetracycline

do#ycycline /*ory#, 1ibramycin0

minocycline

tigecycline /Tygacil0

atural and semisynthetic

"btained from cultures of Streptomyces

-acteriostatic:inhibit bacterial growth

Inhibit protein synthesis

!top many essential functions of the

bacteria

-ind /chelate0 to 'a

;<
and ,g
;<
and Al
=<

ions to form insoluble comple#es

Thus, dairy products, antacids, and iron

salts reduce oral absorption of tetracyclines

!hould not be used in children under age >

or in pregnant?lactating women because
tooth discoloration will occur if the drug
binds to the calcium in the teeth

@ide spectrum

Gram%negative and gram%positive organisms,

proto&oa, Mycoplasma, Rickettsia, Chlamydia,
syphilis, )yme disease, acne, others

*emeclocycline is also used to treat !IA*9

by inhibiting the action of A*9

!trong a8nity for calcium

*iscoloration of permanent teeth and tooth

enamel in fetuses and children, or nursing
infants if taken by the mother

,ay retard fetal skeletal development if taken

during pregnancy

Alteration in intestinal 2ora may result in:

!uperinfection /overgrowth of nonsusceptible

organisms such as Candida0

*iarrhea
$seudomembranous colitis

,ay also cause:

1aginal candidiasis

Gastric upset

+nterocolitis

,aculopapular rash

"ther e7ects