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CHEMOTHERAPY
HIGHLIGHTS
MOHAMED BAHR; MD, PHD
General Principles
Mohamed Bahr; MD, PhD
GENERAL
PRINCIPLES
Mohamed Bahr; MD, PhD
REVOLUTION
The germ theory of disease
Pasteur, 1861
Mohamed Bahr; MD, PhD
MICROORGANISMS
Bacteria Viruses Fungi
Parasites
Mohamed Bahr; MD, PhD
Chemotherapy
Antimicrobial
Agents
Antibacterial
Antifungal
Antiviral
Antiparasitic
Agents
Anthelmintics
Antiprotozoal
Anticancer
Chemotherapy
Mohamed Bahr; MD, PhD
SELECTIVE ON
MICROBES
Mohamed Bahr; MD, PhD
GOALS
Mohamed Bahr; MD, PhD
Mohamed Bahr; MD, PhD
Mohamed Bahr; MD, PhD
Mohamed Bahr; MD, PhD
Some laboratory
techniques
useful in diagnosis of
microbial diseases
Mohamed Bahr; MD, PhD
EFFECT ON BACTERIA
Mohamed Bahr; MD, PhD
Effects of
bacteri-
cidal and
bacterio-
static
drugs on
growth of
bacteria in
vitro
Mohamed Bahr; MD, PhD
ANTIBIOTIC PHARMACODYNAMIC
CATEGORIES
Determination of
MIC and MBC of
an antibiotic
Mohamed Bahr; MD, PhD
Determination of
MIC and MBC of
an antibiotic
Mohamed Bahr; MD, PhD
• Bactericidal effect is increased with drug concentration .
Optimum effect is achieved with concentrations 10 times MIC.
• Trough drug concentration may fall below MIC during dosing
interval without loss of efficacy, as bacterial regrowth is
inhibited by PAE → ↓ resistance.
• Aminoglycosides
• Quinolones
• Azithromycin
Concentration–Dependent (with PAE)
• Bactericidal effect depends on the duration that the drug level
exceeds MIC.
• Concentration should be maintained at 2-4 times MIC
throughout dosing interval, as bacterial regrowth starts very
soon after trough falls below MIC, since the drugs have no
PAE.
• β-lactams
• Vancomycin
Time-Dependent (with minimal or no PAE)
Mohamed Bahr; MD, PhD
A. Significant dose-dependent killing effect shown by tobramycin.
B. Nonsignificant dose-dependent killing effect shown by
ticarcillin.
cfu = colony forming units; MIC = minimum inhibitory
concentration.
Mohamed Bahr; MD, PhD
SPECTRUM
Mohamed Bahr; MD, PhD
Mohamed Bahr; MD, PhD
Mohamed Bahr; MD, PhD
Mohamed Bahr; MD, PhD
Mohamed Bahr; MD, PhD
Mohamed Bahr; MD, PhD
Bacterial
infections
Mohamed Bahr; MD, PhD
MECHANISM OF
ACTION
Mohamed Bahr; MD, PhDBar chart showing the six most commonly used drug families
Mohamed Bahr; MD, PhD
Bar chart with
the drugs
of choice for
treatment of
S aureus
Mohamed Bahr; MD, PhD
Mohamed Bahr; MD, PhD
RESISTANCE
Mohamed Bahr; MD, PhD
Mohamed Bahr; MD, PhD
COST
Relative cost of some drugs used for
treatment of PU caused by H pylori
Mohamed Bahr; MD, PhD
REFERENCES
Lippincott’s Illustrated Reviews, 5th ed.
Color Atlas of Pharmacology, 2nd ed.
Goodman and Gilman's The Pharmacological Basis of
Therapeutics, 12th ed.

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