Inhibit bacterial growth by interfering with cell wall synthesis

Use with Probenicid, to increase bioavailability

non-R gram + and -

Nafcillin

Dicloxacillin

only for R. Staph Aureus or Epidermitis

(gram +)

otherwise, amoxicilin + clav acid

Ampicillin

Amoxicillin

Pen G spectrum, plus Strep faecalis (enterococcus)

Non-R. gonorrhoeae and sphyilis

H. influenza

Carbenicillin indanyl

Ticarcillin

Psedomonas aeruginosa

Proteus vulgaris

w/ clavulanic acid

Piperacillin

w/ tazobactam

Spectrum similar to aminopenicillins (Ampicillin and Amoxicillin), but wider Gram - spectrum

w/ aminoglycoside for enterococci

*Gram + and Gram - mix, with P. aeruginosa

Impenem-Cilastin

Aztrenam

gram (-) only

Enterbacter, P. aeruginosa

NOT MRSA

Cross reactivity with Pens

Resits most B-lactamases

kidney damage

inhibits transpeptidase

Cefazolin

S. aureus, NOT MRSA

 surgical prohylaxis

*Klebsiella pneumoniae

E. coli

P.mirabilis

Cefoxitin

(2nd generation cephalosporins)

 Disulfiram rxn with alcohol

N. gonorrhoeae

N. meningitis

H. influenzae

B. frag

Proteus, indole

Ceftazidime

Ceftriaxone

Good CNS penitration: meningitis

CEFTRIAXONE = DOC penicillin R. N. gonorrhaeae

H. influenza

Enterobacteriaeceae

dosage reduced in renal insufficiency

Ciprofloxacin

Ofloxacin

UTIs/respiratory

Pseudomonas

Gonorrhea + C trachomatis

inhibits p450s, causes renal failure

Contra in pregnant women: photosensitivity

Levofloxacin

Fluoroquinolone

Photosensitivity, nephrotoxicity, crystalluria

Contraindicated in pregnant/nursing, because of inhibition of joint development

Gram -, Traveler's diarrhea

Sulfonamides

Bacteriostatic

Inhibits PABA for folate synthesis

Acetylated in liver

E.coli and P. mirababilis

Hemolytic anemia, rash, crystalluria at low pH

Nalidixic acid

First generation Quinolones

MOA: inhibit DNA gyrase

Trimethoprim

Sulfamethoxazole

ADR: crystalluia, hemolytic anemia

MOA: competes with PABA for dihydrofolate synthase

DOC: Pneumocystis jiroveci

Hemophilus influenzae

Chlamydria

Macrolides

Methlyation of binding sites on 50s subunit

Tetracycline

MOA: blocks 30s subunit

chelated by ions

Doxycycline

MOA: blocks 30s subunit

Chlamydria, anthrax. cholera, LD

dosage reduction not required

Fanconi syndrome

Minocycline

MOA: blocks 30s subunit

Propionibacterium (acne)

vestibular disturbances

Streptomycin

MOA: blocks protein synthesis

Plaque, tuaremia, *TB

Neomycin

Kanamycin

MOA: blocks protein synthesis

Topical, elective bowel surgery

Gentamycin

Tobramycin

MOA: irreversible blocks protein synthesis

 ONLY aerobic bacteria

Klebsiella

Proteus

Pseudomonas

Serratia

Enterobacter

Dosage must be reduced in renal failure pts

Amikacin

Netilmicin

MOA: blocks protein synthesis

Bacterial strains resistant to other aminoglycosides

*multi drug R TB

E.coli  bacteriocidal

Spectinomycin

Resistant gonorrhea*

Pts. allergic to penicillins

Bacteriostatic

Single dose*

Erythromycins

MOA: blocks 50s subunit

Strep pyogens, pneumoniae

Staph u&l RI

 Legionella

Diphtheria

Azithromycin

Hemophilus influenzae

N. gonorrhoeae

Borrelia burg (single dose)

Clarithromycin

Legionella

Chlamydia

Helicobacter

Mycobacterium avium

inhibits Cyp450s

Clindamycin

C dificile

mixed gram + and anaerobes

causes pseudomembranous colitis

bacterostatic

Vancomycin

MRSA

 Enterocoliitis, endocarditis by staphylococci

gram resistant infections

causes histamine reduction

Aztreonam

Monobactam

no cross reactivity

Chloramphenicol

Gray baby syndrome

Tetracyclines MOA

Blockage of aminoacyl-tRNA to bacterial ribosomes

GI tract distress, phototox, vestibular disturbances

Aminoglycosides ADR

Nephrotox, ototox, neuromuscular weakness

Quinolones MOA

DNA gyrase

Fluorquinolones

Photosensitivity, CNS stimulation

GABA inhibition

cardiac QT interval prolongation