Session 5 - Antibiotics Flashcards
How do antibiotics damage bacteria but not host cells?
By exploiting the differences that exist between the structure and physiology of the prokaryotic bacterial cells and the host eurkaryotic cells
What are two different overall mechanisms by which antibiotics effect bacteria
Bacteriostatic (inhibit bacterial growth)
Bacteriacidal (kill bacteria)
Give four sites on bacteria targeted by antibiotics
Peptidoglycan cell wall
Nucleic acids
Protein synthesis
Cytoplasmic membrane
Why can bacterial cell walls be targeted, and by which three main classes of AB?
Peptidoglycan cell wall only present in prokaryotic cell.
Penicillins
Cephalosporins
Glycopeptides
Why can nucleic acids be targeted, and by which three classes of AB?
Bacterial genome is a single, circular strand of DNA unenclosed by a nuclear envelope, in contrast to eukaryotic chromosomal arrangement within the nucleus Antifolates
Quinolones
Rifampicin
How can protein synthesis be targeted, and name three ABs which do thus
Bacterial ribosome (50s+30s subunits) is different to the mammalian ribosome (60s+40s subunits) Aminoglycosides Tetraclyclines Macrolides Chloramphenicol Fusidic acid
How can the cell membrane of bacteria be targeted, and give 1 AB that does thus
Bacterial plasma membrane does not contain any sterols, unlike mammalian. Polymyxins
Give four primary reasons for prophylaxis of bacterial infections
o Peri-operative (Prevention of surgical site infections) o Short term Meningitis contacts o Long term Asplenia (encapsulated bacteria) Immunodeficiency
Give two ways ABs can be used to treat significant bacterial iunfections
o Treatment of cultured, proven infection
o Empirical treatment of suspected infection
What is the ideal antibiotic? (2)
o Clean killing of infecting bacteria
Minimal impact on non-target commensal organisms
No resistance in any surviving pathogens
o No adverse effects on patient
Give 8 factors which help determine the likely infectious agent in an infection
o Anatomical Site o Duration of illness o Past medical history o Occupational history o Travel history o Time of year o Age o Personal background
Give four factors which determine which antibiotics are likely to be effective
o Community or healthcare onset? o Severity of infection o Baseline rate of resistance o Immune status of patient Immunocompromised patients will need IV Antibiotics immediately
What three factors do you need to consider when choosing best antibiotic?
o Efficacy
o Cost
o Administration Route
Give some common antibiotic adverse drug reactions
Pharmcological (toxicities, drug interactions)
Allergic reactions
Impact on normal flora (c.diff)
What is therapeutic drug monitoring?
Therapeutic drug monitoring is used to ensure and adequate, non-toxic dose.