introduction of antibacterial agent课件

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1、IntroductionofAntibacterialAgent-rapidapproachByIDR4Shang-YiLinClassofAntibacterialAgentβ-LactamsPenicillinsCephalosporinsAztreonamCarbapenems(Meropenem)AminoglycosidesGlycopeptides(Vancomycin,Teicoplanin)FluoroquinolonesMarcolideTrimethoprim-sulfamethoxazoleMe

2、tronidazoleTetracyclinesOxazolidinones抗生素的分類及作用機轉PK/PDConcentration-dependentAminoglycosides,Quinolones,Metronidazole,AmphotericinBTime-dependentBeta-lactam,Glycopeptide,Clindamycin,MacrolidesPenicillinsNaturalPenicillinPenicillinGBenzathinepenicillinGAntistaphy

3、lococcalpenicillinsOxacillin;dicloxacillinAminopenicillinsAmpicillin;amoxicillinAminopenicillin+blactamaseinhibitorUnasyn,AugmentinExtendedspectrumpenicillinsPeperacillin,ticarcillinExtendedspectrumpenicillins+blactamaseinhibitorPiperacillin-tazobactam,ticarcill

4、in-clavulanateIndicationofNaturalPenicillinsGrampositivebacteriaandanaerobesonlyS.pyogens–cellulitisViridansstreptococci–infectiveendocarditisNeisseriameningitis--meningococcusStreptococuspneumoniae?Spirochetes–syphilisActinomycesisraeliiClostridiumspp.Pasteurel

5、lamultocidaLeptospirainterrogans–leptospirosisLYMPHANGITISwithgroupAstreptococcuscellulitisinthekneePenicillinGcouldbeconsidered…BullaorpustuleformationStaphylococcusspp.Oxacillincouldbeconsidered…AugmentinvsUnasynAmoxicillin/clavulanicacid(Augmentin)v.sAmpicill

6、in/sulbactam(Unasyn)V.SAcinetobacterbaumanniiCost…Extendedspectrumpenicillins+blactamaseinhibitorPiperacillin(Pipril)Ticarcillin/clavulanicacid(Timentin)Piperacillin/tazobactam(Tazocin)Indication:AllcancoverPseudomonasaeruginosa(P.a)Pipril:P.aeruginosa+streptoc

7、occusTicarcillin/clavulanicacid(Timentin)P.aeruginosa+StenotrphomonasmaltophiliaTazocin:P.aeruginosa+anaerobicAdverseeffectsofpenicillinsHypersensitivity:3-10%Mildrashtolife-threateninganaphylaxisPenicillinskintestHematologicalreactionsThrombocytopenia,bleedingt

8、endencyNeutropeniaEosinophiliaGastrointestinaldisturbancesNausea,vomiting,diarrheahepatitisCentralnervoussystemtoxicitiesSeizures,hallucinations,comaDrugfeverProteinu