A. INHIBITORI AI SINTEZEI PERETELUI CELULAR I.

INHIBA SINTEZA PEPTIDOGLICANULUI SUNT BETA LACTAMICE

PENICILINE De biosinteza Benzil-penicilina Benzatin-penicilina Fenoximetil-penici. Procaina-penicilina Pen. rez la penicilinaza stafilococica CG+ / BG+ /CG BcAnaero exceptie: -spirochete -Bacteroides fragilis Stafilococi producatori de penicilinaza.

De semisinteza Bactericide toate beta lactamice

Aminopeniciline grup A

-Meticilina - oxacilina - nafcilina - cloxacilina - dicloxacilina -Ampicilina -Amosicilina -Bacampicilina

Peniciline cu spectu largit

Carboxipen:Ticarcilina Ureidopen: Azlocilina

Peniciline asociate cu inhib. de betalactamaze CEFALOSPORINE Generatia I I.v: cefalotina, Cefazolina Cefapirina Oral:cefalexina Cefadroxil cefradin

Ampicilina+sulbactam Amoxa+ac.clavulanic Ticarcilina+ac.clavul.

Generatia II

Cefalosporine propriuzise:

Cefamicine

Iv:-cefuroxim cefunocid cefamandol ceforanid Oral: - cefaclor cefprozil cefuroximaaxetil Iv: -cefoxitina cefmetazol cefotetan

CG+ / BG+ /CG BcAnaero, BG- : H.i,E.Coli, Salmonela Shigella Proteus CG+ / BG+ /CG BcAnaero, BG- : H.i,E.Coli, Salmonela Shigella Proteus Klebsiella, Enterobact, Seratia, Pseudom. Staphyilococcus,E.coli, Gonorrhoeae, klebsiella Haemophilus,Shigella, Neisseria,Salmonella,Bacteroid es fragilis CG+ / BG+ /CG BcAnaerobe, BG- : H.i,E.Coli, Salmonela Shigella Proteus Klebsiella, Staf prod de penicilinaza/H.i,anaerobi,enter oc. Listeria CG+ / BG+ /CG BG- : H.i,E.Coli, Salmonela Shigella Proteus Klebsiella, Staf prod de penicilinaza,Hi,Enterob, Serratia,Proteus CG+ / BG+ /CG BcAnaerobe, BG- : H.i,E.Coli, Salmonela Shigella Proteus Klebsiella, Staf prod de penicilinaza,Hi,Enterob, Serratia,Proteus CG+ / BG+ /CG BcAnaerobe, BG- : H.i,E.Coli, Salmonela Shigella Proteus Klebsiella, Staf prod de penicilinaza,Hi,Enterob, Serratia,Proteus CG+ / BG+ /CG BcAnaerobe, BG- : H.i,E.Coli, Salmonela Shigella Proteus Klebsiella, Staf prod de penicilinaza,Hi,Enterob, Serratia,Proteus,Pseudomonas

Generatia III

Iv: -cefotaxima - ceftriaxona - ceftizoxima - cefoperazona - ceftazidima Orale:- cefixima -ceftibutena Cefepima cefpiroma

Activ Pseudomonas aeruginosa

Generatia IV

CARBAPENEME

Imipenem + cilastatin Meropeneme Ertapeneme Aztreonam Vancomicina Teicoplanina

MONOBACTAM GLICOPEPTIDE FOSFOMICINA

BG+ / BC-/ aerobe/ anaerobe / Inactive: Mycobact, Clamydia,M ycoplasma, Rickettsia BlG- ...din fac enerobact,pseudomonas BG+/aerob/anaerob/ Bc aerobe G+/ BG-/ enteroc, staf meticilino-rez. Izoniazida - bactericid Pirazinamida bactericid numai intracel. Etambutol bacteriostatic fata de bacili extracel

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

B. Antibiotice care altereaza functiile mb.citoplasmatice C. INHIBITORI AI SINTEZEI PROTEICE I .AMINOGLICOZIDE

Polimixine bactericid

Polimixina B Polimixina E

Bacil/cocobacil G-/ aerobifacultativ anaerobi/ exceptie Proteus,Serattia,..

subunit 30S ribosomalaI(primele2) 50S II(urm6) BG- facultativ anaerobi/ staf/Pseudomaonas/Enterococ/ Mycop-strepto/ yersinia. Restul bactericid BG+/BG-/aerobe/ anaerobe/ spirochete/ micoplasme/ clamidii/ ricketti. Fenicolii- bactericid pe HI,N.meningitidis, S.pne - bacteriostatic pe maj bact Asem Claritromicina, BG+/ S.pneumoniae. CG+/BG+ aerobi si anaerobi/ Moraxella catarrahalis, Bordetella pertussis, Legionella pneumophila. Hi,Campylobacter, H.p.-claritromicina, Mycoplasma,Chlamydia, CG+/BG+ aerobi si anaerobi/ Moraxella catarrahalis, Bordetella pertussis, Legionella pneumophila. Hi,Campylobacter, H.p.-claritromicina, Mycoplasma,Chlamydia S.pneumoniae/Enterococ faecium BG+/ S.aureus/ anaerobe BG+ aerobe si anaerobe

TETRACICLINE bacteriostatic II. FENICOLI KETOLIDE MACROLIDE bacteriostatic

-Streptomicina -Neomicina -Kanamicina -Tobramicina - Gentamicina - Amikacina -Spectinomicina bacteriostat. - Netilmicina Biosinteza Tetraciclina Oxitetraciclina Semisinteza Doxicilina Minociclina Cloramfenicol Tiamfenicol Telitromicina - Eritromicina -Claritromicina - Diritromicina - Spiramicina

STREPTOGRAMINE bactericid

Pristinamicina

LINCOSAMIDE

OXAZOLIDINONE bacteriostatic III. ANTIBIOTICE CARE INHIBA SINTEZA PROTEINELOR PRIN ALT MECANISM ACIDUL FUSIDIC bacteriostatic MUPIROCIN BG+ aerobe si anaerobe, BG+

Lincomicina Clindamicina Linezolid

D. INHIBITORI CHINOLONE GENERATIA I

AI

ACIZILOR

NUCLEICI

bactericid

GENERATIA II

GENERATIA III

Acid nalidixic Acid pipemidic Acid oxolinic Cinoxacina Norfloxacina Ciprofloxacina Ofloxacina Pefloxacina Lomefloxacina Levofloxacina Moxifloxacina Sparfloxavina Gentifloxacina Trovafloxacina

BG- din fam. Enterobacteriaceae

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

GENERATIA IV

RIFAMPICINA bactericid METRONIDAZOL bactericid SULFAMIDE bacteriostatic COTRIMOXAZOL bactericid NITROFURANI bactericid

BG-/ P.aeruginosa/ CG-/ cocobacili G-/ Unele BG+ staf meticilino-rezistente, streptococi beta hemolitici, S.pneumoniae., activitate imbunatatita pe Mycoplasma,Chlamydia, anaerobe M.tuberculosis, CG+/ CG-/ cocobacil G-/ Legionella pneumophila, Chlamydii Protozoare, anaerobe, H.P Sulfadiazina CG+-/BG+- exceptie P.aeruginosa, Actinomyces, Sulfizoxazol Sulfametoxazol Sulfosalazina Sulfone Asociatie sinergica intre sulfametoxazol si trimetroprim Nitrofurantoin Furazolidon 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 TICARCILINA + AMGZ CEFALOSPORINE + AMGZ -ENETROCOCI SI STREPTOCOCI - P.AERUGINOSA -K.PENUMONIAE