A. INHIBITORI AI SINTEZEI PERETELUI CELULAR I. INHIBA SINTEZA PEPTIDOGLICANULUI SUNT BETA LACTAMICEPENICILINE

Bactericide toate beta – lactamice

De biosinteza

Benzil-penicilinaBenzatin-penicilinaFenoximetil-penici.Procaina-penicilina

CG+ / BG+ /CG- BcAnaero exceptie: -spirochete-Bacteroides fragilis

De semisinteza

Pen. rez la penicilinaza stafilococica(grup M)

-Meticilina- oxacilina- nafcilina- cloxacilina- dicloxacilina

Stafilococi producatori de penicilinaza.

Aminopeniciline grup A

-Ampicilina-Amoxicilina-Bacampicilina

CG+ / BG+ /CG BcAnaero, BG- : H.i,E.Coli, Salmonela Shigella Proteus

Peniciline cu spectu largit

Carboxipen:TicarcilinaUreidopen: Azlocilina

CG+ / BG+ /CG BcAnaero, BG- : H.i,E.Coli, Salmonela Shigella ProteusKlebsiella, Enterobact, Seratia, Pseudom.

Peniciline asociate cu inhib. de beta-lactamaze

Ampicilina+sulbactamAmoxa+ac.clavulanicTicarcilina+ac.clavul.

Staphyilococcus,E.coli,Gonorrhoeae, klebsiella Haemophilus,Shigella,Neisseria,Salmonella,Bacteroides fragilis

CEFALOSPORINE Generatia I I.v: cefalotina, Cefazolina CefapirinaOral:cefalexina Cefadroxil cefradin

CG+ / BG+ /CG BcAnaerobe, BG- : H.i,E.Coli, Salmonela Shigella ProteusKlebsiella, Staf prod de penicilinaza /H.i,anaerobi,enteroc. Listeria

Generatia II Cefalosporine propriu-zise:

Iv:-cefuroxim- cefunocid- cefamandol- ceforanid

Oral: - cefaclor- cefprozil- cefuroxima-

axetil

CG+ / BG+ /CG BG- : H.i,E.Coli, Salmonela Shigella ProteusKlebsiella, Staf prod de penicilinaza,Hi,Enterob, Serratia,Proteus

Cefamicine Iv: -cefoxitina- cefmetazol- cefotetan

CG+ / BG+ /CG BcAnaerobe, BG- : H.i,E.Coli, Salmonela Shigella ProteusKlebsiella, Staf prod de penicilinaza,Hi,Enterob, Serratia,Proteus

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Generatia III Iv: -cefotaxima- ceftriaxona- ceftizoxima- cefoperazona- ceftazidima

Orale:- cefixima -ceftibutena

Activ Pseudomonas aeruginosa

CG+ / BG+ /CG BcAnaerobe, BG- : H.i,E.Coli, Salmonela Shigella ProteusKlebsiella, Staf prod de penicilinaza,Hi,Enterob, Serratia,Proteus

Generatia IV Cefepimacefpiroma

CG+ / BG+ /CG BcAnaerobe, BG- : H.i,E.Coli, Salmonela Shigella ProteusKlebsiella, Staf prod de penicilinaza,Hi,Enterob, Serratia,Proteus,Pseudomonas

CARBAPENEME Imipenem + cilastatinMeropenemeErtapeneme

BG+ / BC-/ aerobe/ anaerobe /Inactive: Mycobact,Clamydia,M ycoplasma, Rickettsia

MONOBACTAM Aztreonam BlG- ...din fac enerobact,pseudomonas

GLICOPEPTIDE VancomicinaTeicoplanina

BG+/aerob/anaerob/

FOSFOMICINA Bc aerobe G+/ BG-/ enteroc, staf meticilino-rez.

II.Antibiotice care inhiba sinteza acizilor micolici sau arabinogalactanul din structura peretelui celular la Mycobacterium

Izoniazida - bactericidPirazinamida – bactericid numai intracel.Etambutol – bacteriostatic fata de bacili extracel

B. Antibiotice care altereaza functiile mb.citoplasmatice

Polimixine - bactericid

Polimixina BPolimixina E

Bacil/cocobacil G-/ aerobi-facultativ anaerobi/ exceptie Proteus,Serattia,..

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C. INHIBITORI AI SINTEZEI PROTEICE subunit 30S ribosomalaI(primele2) 50S II(urm6)

I .AMINOGLICOZIDE -Streptomicina-Neomicina-Kanamicina-Tobramicina- Gentamicina- Amikacina-Spectinomicina –bacteriostat.- Netilmicina

BG- facultativ anaerobi/ staf/Pseudomaonas/Enterococ/ Mycop-strepto/ yersinia.

Restul bactericid

TETRACICLINE

bacteriostatic

Biosinteza TetraciclinaOxitetraciclina

BG+/BG-/aerobe/ anaerobe/ spirochete/ micoplasme/ clamidii/ ricketti.

Fenicolii- bactericid pe HI,N.meningitidis, S.pne - bacteriostatic pe maj bact

Semisinteza DoxicilinaMinociclina

II. FENICOLI Cloramfenicol Tiamfenicol

KETOLIDE Telitromicina Asem Claritromicina,BG+/ S.pneumoniae.

MACROLIDE

bacteriostatic

- Eritromicina-Claritromicina- Diritromicina- Spiramicina

CG+/BG+ aerobi si anaerobi/Moraxella catarrahalis,Bordetella pertussis,Legionella pneumophila.Hi,Campylobacter,H.p.-claritromicina,Mycoplasma,Chlamydia,

STREPTOGRAMINE

bactericid

Pristinamicina CG+/BG+ aerobi si anaerobi/Moraxella catarrahalis,Bordetella pertussis,Legionella pneumophila.Hi,Campylobacter,H.p.-claritromicina,Mycoplasma,ChlamydiaS.pneumoniae/Enterococ faecium

LINCOSAMIDE LincomicinaClindamicina

BG+/ S.aureus/ anaerobeBG+ aerobe si anaerobe

OXAZOLIDINONE bacteriostatic

Linezolid

III. ANTIBIOTICE CARE INHIBA SINTEZA PROTEINELOR PRIN ALT MECANISMACIDUL FUSIDIC bacteriostatic

BG+ aerobe si anaerobe,

MUPIROCIN BG+

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D. INHIBITORI AI ACIZILOR NUCLEICI

CHINOLONE

bactericid

GENERATIA I Acid nalidixicAcid pipemidicAcid oxolinicCinoxacina

BG- din fam. Enterobacteriaceae

GENERATIA II NorfloxacinaCiprofloxacinaOfloxacinaPefloxacinaLomefloxacina

BG-/ P.aeruginosa/ CG-/ cocobacili G-/ Unele BG+ staf meticilino-rezistente, streptococi beta hemolitici / activitate var pe Mycoplasma si Chlamydia

GENERATIA III LevofloxacinaMoxifloxacinaSparfloxavinaGentifloxacina

BG-/ P.aeruginosa/ CG-/ cocobacili G-/ Unele BG+ staf meticilino-rezistente, streptococi beta hemolitici, S.pneumoniae., activitate imbunatatita pe Mycoplasma,Chlamydia

GENERATIA IV Trovafloxacina BG-/ P.aeruginosa/ CG-/ cocobacili G-/ Unele BG+ staf meticilino-rezistente, streptococi beta hemolitici, S.pneumoniae., activitate imbunatatita pe Mycoplasma,Chlamydia, anaerobe

RIFAMPICINA bactericid

M.tuberculosis, CG+/ CG-/ cocobacil G-/ Legionella pneumophila, Chlamydii

METRONIDAZOLbactericid

Protozoare, anaerobe, H.P

SULFAMIDE

bacteriostatic

SulfadiazinaSulfizoxazolSulfametoxazolSulfosalazinaSulfone

CG+-/BG+- exceptie P.aeruginosa, Actinomyces,

COTRIMOXAZOLbactericid

Asociatie sinergica intre sulfametoxazol si trimetroprim

NITROFURANIbactericid

NitrofurantoinFurazolidon

BG- din fam Enterobacteriaceae, exceptia Proteus, CG+ di genurile stafilococ si enterococ.

C.I - asocierea unui antibiotic BACTERICID – BACTERIOSTATIC (penicilina-tetraciclina)

- antib cu mecanism de actiune identice (2 beta lactamice )

- AMGZ. CU POLIMIXINE

- EFECT SINERGIC: AMPICILINA + GENTAMICINA -ENETROCOCI SI STREPTOCOCI

TICARCILINA + AMGZ - P.AERUGINOSA

CEFALOSPORINE + AMGZ -K.PENUMONIAE

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