from Prof. Hussien Khairy lectures professor of general Surgery KasrAlainy school of medicine - Cairo university prepared by Mohamed Alasmar - General Surgery resident

1. Antibiotics
From Prof. Dr. Hussien Khairy
Lectures
By
Mohamad Alasmar

2. Oral The Prototype
Penicillin V Crystalline Penicillin
Long Acting ● Benzyle Penicillin
● Penicillin G
Benzathine Penicillin Reversed Spectrum
● 2-4 weeks
● Ttt of lymphoedema
Selexid
Broad Spectrum In UTI
AntiPsodomonal
Amoxicillin +clavulanic Acid =
Augmentin Carbinicllin
Ampicillin +Sulbactam = Ticaracillin +clavulanic Acid =
Unasyn Timentin
Anti Beta Lactamase
Pipracillin
Flucxacillin
Flucluxacillin

3. Spectrum Side Effects
G +ve Spirocheats
Very Safe
● So used in long term Prophylaxis
● Allergy
Anaerobs NOT
● Enceph;opathy
G –ve ● Electrolytes load
● E Coli Route
● Shigella
● Salmonella Parentral
● Psodomona
s
Excretion
Mechanism of Action Kidney
Cell Wall By Tubular Secretion
Cidal

4. First Generation
Second Generation
Cephradine
Mefoxine
Velosef ® Effective against anaerobes
Third Generation
Forth Generation
Cefoprazone Maxipime®
Cefobid®
Cefotoxime
Meningitis
Ceftriaxone
Rocephen®
Long half life

5. Side Effects
Spectrum
Safe
G –ve G+ve ● Allergy may present
Share Pinicillins in allergy in 10% of
Some against anaerobes cases
● Hypoprothrombinaemia
Mefoxine Route
Oral • Parentral
1st • 2nd • 3rd • 4th
Mechanism of Action
1. Resist beta lactamase
Cell wall 2. Parenteral
3. G –ve effective
Cidal 4. Broader spectrum
Like Pinicillins Excretion
Kidney
By Tubular Secretion

6. Imipenim + Aztreonam
Cilastitin Azactam ®
Enzyme Inhibitor ● Very narrow spectrum
Inhibit distruction by Kidney ● G –ve onle
● Parentral
= Tienam ®
● The broadest spectrum ever
● Parentral

7. Clavulanic Acid
+ Amoxicillin •
Augmantin
+Ticaracillin •
Tementin
Sulbactam
+ Cephoperazon •
Sulperazon
+Ampicillin •
Unasyn
Tazobactam

8. Erythromycin
● Like Pinicillin Azithromycin
● Used in Pinicillin Allergy
● Bowel Preparation Zithromax ®
Long Half life
1 tablet daily
Used in chest infection
Clarythromycin Haemophilus influenza
AntiHelicobacter pylori

9. Spectrum Side Effects
NOT G-ve GIT upsets
G +ve
Anaerobes Route
● Bowel Preparation Oral
● Like Pinicillin
Excretion
Mechanism of Action
Biliary
Ptn Synthesis
Hepatic
Static •Cidal
According to the dose

10. Garamycin
● Very potent
Tobramycin ● Very toxic
● Very cheep
Nebcin ®
The safest Streptomycin
In TB
Amikacin
Amikin ® Kanamycin
● Very toxic
Broadest Spectrum
● Very old
Neomycin
● Bowel Preparation with
Metronidazol

11. Side Effects
Spectrum
Nephrotoxic
G +ve
G –ve Ototoxicity
Neurotoxcity
NOT effective against
anaerobes Route
Parentral
Not absorbed by bowel
Mechanism of Action
Ptn Synthesis Excretion
Cidal Kidney
Should enter the cell By GF
Needs energy = O2 Not by excretion
So can not act on anaerobes So lower the dose in cases with renal
impairment

12. Ceprofloxacin Levofloxacin
Drug of Choice in
● Entric Infection
Tavanic ®
● UTI ● Pneumococci
● Prostatitis ● G +ve
Ofloxacin
Tarvid ®
● UTI
● Typhoid

13. Spectrum Side Effects
G +ve
Safe
G –ve Musculoskeletal Side Effects
● UTI ● Young Age • Arthropathy
● Enteric ● Old Age • Tendonitis
Infection Not recommended in young age
Better than Route
AminoGlycosid
Because its less
Oral & Parentral
side efects
Mechanism of Action
Excretion
DNA Synthesis
Kidney
Gyrase Inhibitor By GF
Topoisimerase Inhibitor
Relax supercoils of DNA to be
duplicated

14. Spectrum
Side Effects
AntiBiotic Associated
colitis =
Psudomembranous
colitis
By Cl. Difficil Route
ttt
● Vencomycin Parentral
● Metronidazol
Mechanism of Action Excretion
Ptn Synthesis Kidney

15. Route Spectrum
Oral ●Amebiasis
IV expensive
Suppositories ●Trichomonas
Excretion ●Giardia
Kidney ●Anaerobs
Side Effects
●Hilicobacter
Metallic taste
Neurotoxic pylori
Nausea
Alcohol • Disulfuram like

16. Route
MRSA
Oral Methicillin resistent staph. Aureus
Produced By Fluxacillin &
Mechanism of Action Flucluxacillin
Cell Wall Synthesis Pseudomembranous
colitis
Produced By Clindamycin
Cl. Difficile
Endocarditis

17. ● Metronidazole
● Penicillins
● Erythromycin
● Tienam
● Clindamycin
● Mefoxine