Antibiotice: clase, exemple, spectru

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Antibiotice: clase, exemple, spectru

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A. INHIBITORI AI SINTEZEI PERETELUI CELULAR

I. INHIBA SINTEZA PEPTIDOGLICANULUI SUNT BETA LACTAMICE

PENICILINE

Bactericide toate beta lactamiceDe biosintezaBenzil-penicilina

Benzatin-penicilina

Fenoximetil-penici.

Procaina-penicilinaCG+ / BG+ /CG-

BcAnaero exceptie:

-spirochete

-Bacteroides fragilis

De semisintezaPen. rez la penicilinaza stafilococica

(grup M)-Meticilina

- oxacilina

- nafcilina

- cloxacilina

- dicloxacilinaStafilococi producatori de penicilinaza.

Aminopeniciline grup A-Ampicilina

-Amoxicilina

-BacampicilinaCG+ / BG+ /CG

BcAnaero,

BG- : H.i,E.Coli,

Salmonela

Shigella

Proteus

Peniciline cu spectu largitCarboxipen:Ticarcilina

Ureidopen: AzlocilinaCG+ / BG+ /CG

BcAnaero,

BG- : H.i,E.Coli,

Salmonela

Shigella

Proteus

Klebsiella, Enterobact, Seratia, Pseudom.

Peniciline asociate cu inhib. de beta-lactamazeAmpicilina+sulbactam

Amoxa+ac.clavulanic

Ticarcilina+ac.clavul.Staphyilococcus,E.coli,

Gonorrhoeae, klebsiella Haemophilus,Shigella,

Neisseria,Salmonella,Bacteroides fragilis

CEFALOSPORINEGeneratia II.v: cefalotina,

Cefazolina

Cefapirina

Oral:cefalexina

Cefadroxil

cefradinCG+ / BG+ /CG

BcAnaerobe,

BG- : H.i,E.Coli,

Salmonela

Shigella

Proteus

Klebsiella, Staf prod de penicilinaza /H.i,anaerobi,enteroc. Listeria

Generatia IICefalosporine propriu-zise: Iv:-cefuroxim

cefunocid

cefamandol

ceforanid

Oral: - cefaclor

cefprozil

cefuroxima-axetilCG+ / BG+ /CG

BG- : H.i,E.Coli,

Salmonela

Shigella

Proteus

Klebsiella, Staf prod de penicilinaza,Hi,Enterob, Serratia,Proteus

Cefamicine Iv: -cefoxitina

cefmetazol

cefotetanCG+ / BG+ /CG

BcAnaerobe,

BG- : H.i,E.Coli,

Salmonela

Shigella

Proteus

Klebsiella, Staf prod de penicilinaza,Hi,Enterob, Serratia,Proteus

Generatia IIIIv: -cefotaxima

- ceftriaxona

- ceftizoxima

- cefoperazona

- ceftazidima

Orale:- cefixima

-ceftibutenaActiv Pseudomonas aeruginosa CG+ / BG+ /CG

BcAnaerobe,

BG- : H.i,E.Coli,

Salmonela

Shigella

Proteus

Klebsiella, Staf prod de penicilinaza,Hi,Enterob, Serratia,Proteus

Generatia IVCefepima

cefpiromaCG+ / BG+ /CG

BcAnaerobe,

BG- : H.i,E.Coli,

Salmonela

Shigella

Proteus

Klebsiella, Staf prod de penicilinaza,Hi,Enterob, Serratia,Proteus,Pseudomonas

CARBAPENEMEImipenem + cilastatin

Meropeneme

Ertapeneme BG+ / BC-/ aerobe/ anaerobe /

Inactive: Mycobact,

Clamydia,M ycoplasma, Rickettsia

MONOBACTAMAztreonam BlG- ...din fac enerobact,pseudomonas

GLICOPEPTIDEVancomicina

Teicoplanina BG+/aerob/anaerob/

FOSFOMICINABc aerobe G+/ BG-/ enteroc, staf meticilino-rez.

II.

Antibiotice care inhiba sinteza acizilor micolici sau arabinogalactanul din structura peretelui celular la MycobacteriumIzoniazida - bactericid

Pirazinamida bactericid numai intracel.

Etambutol bacteriostatic fata de bacili extracel

B. Antibiotice care altereaza functiile mb.citoplasmaticePolimixine - bactericidPolimixina B

Polimixina EBacil/cocobacil G-/ aerobi-facultativ anaerobi/ exceptie Proteus,Serattia,..

C. INHIBITORI AI SINTEZEI PROTEICE subunit 30S ribosomalaI(primele2) 50S II(urm6)

I .AMINOGLICOZIDE-Streptomicina

-Neomicina

-Kanamicina

-Tobramicina

- Gentamicina

- Amikacina

-Spectinomicina bacteriostat.

- NetilmicinaBG- facultativ anaerobi/ staf/Pseudomaonas/Enterococ/ Mycop-strepto/ yersinia.

Restul bactericid

TETRACICLINE

bacteriostaticBiosintezaTetraciclina

Oxitetraciclina BG+/BG-/aerobe/ anaerobe/ spirochete/ micoplasme/ clamidii/ ricketti.

Fenicolii- bactericid pe HI,N.meningitidis, S.pne

- bacteriostatic pe maj bact

Semisinteza Doxicilina

Minociclina

II. FENICOLICloramfenicol

Tiamfenicol

KETOLIDETelitromicinaAsem Claritromicina,

BG+/ S.pneumoniae.

MACROLIDE

bacteriostatic- Eritromicina

-Claritromicina

- Diritromicina

- SpiramicinaCG+/BG+ aerobi si anaerobi/

Moraxella catarrahalis,

Bordetella pertussis,

Legionella pneumophila.

Hi,Campylobacter,

H.p.-claritromicina,

Mycoplasma,Chlamydia,

STREPTOGRAMINE

bactericidPristinamicina

CG+/BG+ aerobi si anaerobi/

Moraxella catarrahalis,

Bordetella pertussis,

Legionella pneumophila.

Hi,Campylobacter,

H.p.-claritromicina,

Mycoplasma,Chlamydia

S.pneumoniae/Enterococ faecium

LINCOSAMIDELincomicina

Clindamicina BG+/ S.aureus/ anaerobe

BG+ aerobe si anaerobe

OXAZOLIDINONE bacteriostaticLinezolid

III. ANTIBIOTICE CARE INHIBA SINTEZA PROTEINELOR PRIN ALT MECANISM

ACIDUL FUSIDIC bacteriostaticBG+ aerobe si anaerobe,

MUPIROCIN

BG+

D. INHIBITORI AI ACIZILOR NUCLEICI

CHINOLONE

bactericidGENERATIA IAcid nalidixic

Acid pipemidic

Acid oxolinic

Cinoxacina BG- din fam. Enterobacteriaceae

GENERATIA IINorfloxacina

Ciprofloxacina

OfloxacinaPefloxacina

Lomefloxacina BG-/ P.aeruginosa/ CG-/ cocobacili G-/ Unele BG+ staf meticilino-rezistente, streptococi beta hemolitici / activitate var pe Mycoplasma si Chlamydia

GENERATIA IIILevofloxacina

Moxifloxacina

Sparfloxavina

GentifloxacinaBG-/ P.aeruginosa/ CG-/ cocobacili G-/ Unele BG+ staf meticilino-rezistente, streptococi beta hemolitici, S.pneumoniae., activitate imbunatatita pe Mycoplasma,Chlamydia

GENERATIA IVTrovafloxacina BG-/ P.aeruginosa/ CG-/ cocobacili G-/ Unele BG+ staf meticilino-rezistente, streptococi beta hemolitici, S.pneumoniae., activitate imbunatatita pe Mycoplasma,Chlamydia, anaerobe

RIFAMPICINA bactericidM.tuberculosis, CG+/ CG-/ cocobacil G-/ Legionella pneumophila, Chlamydii

METRONIDAZOL

bactericidProtozoare, anaerobe, H.P

SULFAMIDE bacteriostaticSulfadiazina

Sulfizoxazol

Sulfametoxazol

Sulfosalazina

SulfoneCG+-/BG+- exceptie P.aeruginosa, Actinomyces,

COTRIMOXAZOL

bactericidAsociatie sinergica intre sulfametoxazol si trimetroprim

NITROFURANI

bactericidNitrofurantoin

Furazolidon BG- din fam Enterobacteriaceae, exceptia Proteus, CG+ di genurile stafilococ si enterococ.

C.I - asocierea unui antibiotic BACTERICID BACTERIOSTATIC (penicilina-tetraciclina) - antib cu mecanism de actiune identice (2 beta lactamice )

- AMGZ. CU POLIMIXINE

- EFECT SINERGIC: AMPICILINA + GENTAMICINA -ENETROCOCI SI STREPTOCOCI

TICARCILINA + AMGZ - P.AERUGINOSA

CEFALOSPORINE + AMGZ -K.PENUMONIAEPAGE 1