抗生素(英文)-Miscellaneous-Antibiotics.ppt

Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,*,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,*,Miscellaneous Antibiotics,Polymyxins,Active against gram-negative including pseudomonas.,Polymyxin B is only available.,Bactericidal inhibits cell wall synthesis.,Used only topically.,Highly nephrotoxic.,Spectinomycin,Bactericidal,inhibits protein synthesis by binding to 30S ribosomal subunits.,Active against gram positive&gram negative organisms.,Rapidly absorbed after intramuscular injection.,Excreted through kidney.,Clinical uses,As an alternative treatment for drug-resistant gonorrhea or gonorrhea in penicillin allergic patients.,No cross-resistance with other drugs used in gonorrhea.,A single intramuscular dose is given,Adverse effects,Pain at the site of injection,Fever And nausea,Nephrotoxicity(rare),Pharmacokinetics,Given orally or intravenously,Highly bound to plasma proteins,Distributes well into all body fluids&tissues,except,brain&CSF.,Penetrates well into abscess&is taken up by phagocytic cells.,Metabolized by the liver.,Both active drug&active metabolites are excreted in bile&urine,No dosage adjustment is needed for renal failure.,Clinical uses,Severe anaerobic infections(bones and joints).,Conjunctivitis.,In combination with aminoglycoside or cephalosporin to treat penetrating wounds of the abdomen&the gut.,Infections in female genital tract(septic abortion,pelvis abscess).,Adverse Effects,Diarrhea,nausea,Skin rash,Antibiotic-associated colitis,Impaired liver function,Neutropenia(not common),Vancomycin,Bactericidal,Inhibits bacterial cell wall synthesis,Active on gram-positive bacteria including,-lactamase producer&those resistant to methicillin.,Clinical uses,Endocarditis or sepsis mainly caused by methicillin,resistant staphylococci.,Alternative to penicillin in enterococcal endocarditis(in combination with gentamicin).,Meningitis(in combination with cephalosporin),Orally only,for the treatment of antibiotic-associated enterocolitis,Bacitracin,Bactericidal,Inhibits cell wall synthesis,Active against gram+ve organisms,Used,only,topically in skin,eye,nose infections.,As ointment in combination with polymyxin or neomycin for mixed bacterial infections.,As solution in saline for irrigation of joints,wounds or pleural cavity.,Adverse Effects,Highly nephrotoxic producing proteinuria,hematuria,Hypersensitivity reactions,Cycloserine,Bactericidal,Inhibits bacterial cell wall,Effective on gram-positive&gram-negative organisms as well as M.tuberculosis.,Rapidly absorbed orally,Widely distributed in body tissues&fluids.,Excreted as active form in urine,Used in treatment of pulmonary&extrapulmonary tuberculosis,C.N.S.toxicity,(headaches,tremors,acute psychosis,convulsions),Contraindicated in epileptic&psychotic patients,