Las 7 Pcol
Las 7 Pcol
Las 7 Pcol
AGENTS
GROUP 7
CASE ONE
A 44- year-old female presented to the hospital 3 days
ago with severe cellulitis and a large abscess on his
left leg. Incision and drainage were performed on the
abscess, and cultures revealed methicillin-resistant
Staphylococcus aureus (MRSA). She is given
Daptomycin once-daily outpatient intravenous therapy
at 6 mg/kg per day
SPECTRUM OF ACTIVITY OF DAPTOMYCIN
inactivation of antibiotic by
B-lactamase
modification of target
PBPs
impaired penetration
of drug to target PBPs
antibiotic efflux
CASE THREE
A 68-year-old male presents from a nursing home
with fever, increased urinary frequency and urgency,
and mental status changes. He is allergic to
penicillin. Aztreonam 500 mg IV every 8 hours is given
as the most appropriate choice for gram-negative
coverage of this patient’s urinary tract infection.
AZETREONAM
Aztreonam is a monocyclic beta-lactam antibiotic
Exhibits a potent and specific activity against a wide
variety spectrum of gram-negative aerobic bacteria
It has no useful activity against gram-positive
bacteria/anaerobes
Aztreonam, unlike the majority of beta-lactam
antibiotics, does not induce beta-lactamase activity
AZETREONAM PHARMACODYNAMICS
B.) DISTRIBUTION
distributes widely to most body fluids and
tissues - cross placenta and enter breast milk
AZETREONAM PHARMACOKINETICS
C.) METABOLISM
metabolized mainly in the liver
D.) ELIMINATION
adults with normal renal function ( 1.7-2.9 hrs)
adults with end stage renal disease (6-8 hrs)
MICROORGANISMS SUSCEPTIBLE TO
AZTREONAM
Acinetobacter anitratus,
Escherichia coli
Pseudomonas aeruginosa
Proteus mirabilis
CLINICAL USES OF AZTREONAM
Treatment of urinary tract
Lower respiratory tract
Intra-abdominal infections
Septicemia
Endometritis
Pelvic cellulitis
ADVERSE EFFECTS
Dermatologic
rash
painful injection site reactions
Gastrointestinal
nausea
vomiting
diarrhea
CASE FOUR
A 21-year-old female presents to the emergency
room with headache, stiff neck, and fever for 2 days
and is diagnosed with meningitis. Cefotaxime
200mg/kg/day IV is given as the best choice for the
treatment of meningitis in this patient.
CLASSIFY CEFOTAXIME. WHAT ARE THE OTHER
CEPHALOSPORINS WITH THE SAME CLASS AS CEFOTAXIME?
Bacteriostatic
antibiotics suppress the growth of bacteria
β-lactam antibiotics
antibiotics that contain a beta-lactam ring in their chemical
structure. This includes penicillin derivatives, cephalosporins
and cephamycins, monobactams, carbapenems and
carbacephem
Beta-lactamases
diverse class of enzymes produced by bacteria that break open the
beta-lactam ring, inactivating the beta-lactam antibiotic
Minimum inhibitory concentration (MIC)
defined as the lowest concentration of an antimicrobial agent that
will inhibit the visible growth of a microorganism after overnight
incubation.
The Minimum Bactericidal Concentration (MBC)
the lowest concentration of an antibacterial agent required to kill a
bacterium over a fixed, somewhat extended period, such as 18 hours
or 24 hours, under a specific set of conditions
Penicillin-binding proteins (PBPs)
Membrane-associated proteins involved in the biosynthesis of
peptidoglycan (PG), the main component of bacterial cell
walls.
Peptidoglycan
An essential component of the bacterial cell envelope that
protects the cell from bursting due to turgor and maintains cell
shape. Composed of glycan chains connected by short
peptides, peptidoglycan forms a net-like macromolecule
around the cytoplasmic membrane.
Selective toxicity
The ability of an antimicrobial agent to kill or harm the
microorganism cells without harming the cells of the host
organism.
Transpeptidase
Catalyzes the nucleophilic carbonyl substitution process
required for the cross-linking of the peptidoglycan in bacterial
cell walls. Antibiotics like penicillin primarily target it.
Minimum Inhibitory Concentration (MIC)
The higher the drug concentration relative to the pathogen
minimum inhibitory concentration (MIC), the greater the rate
and extent of antimicrobial activity.
Time-dependent killing
The time-dependent killing pattern is dependent on the
duration of pathogen exposure to an antibiotic
Post-antibiotic effect (PAE)
Refers to a period of time after complete removal of an
antibiotic during which there is no growth of the target
organism.
THANK YOU!