Beta-Lactam 💌 other cell wall active antibiotic
by āļ™āļēāļ‡āļŠāļēāļ§āļ“āļąāļāļ“āļīāļŠāļē āļ›āļĢāļ°āļŠāļĄāļšāļļāļ 633070160-5

Beta-Lactam compound

Antibiotics

Inhibit bacterial cell wall synthesis

; inhibit murain polymer crosslink

a four membered B-lactam ring

Penicillins

Cephalosporins

Carbapenems

Reaction site at Transpeptidase <PBP>

Anti-Staphylococal penicillin

Amino penicillin

Natural penicillin

Antipseudomonase penicillin

Penicillin G <IV>

Penicillin V <Oral form>

penicillin G procaine ; benzathine suspension <IM>

Resistance to many G+ve and G-ve
cocci

G-ve diplococci: Neisseria meningitides

G+ve rod anerobes: Clostridium tetani

Spirochetes: syphilis

Prophylaxis of rheumatic fever

Pharmacokinetics

food āļĢāļšāļāļ§āļ™āļāļēāļĢāļ”āļđāļ”āļ‹āļķāļĄ āļ„āļ§āļĢāļāļīāļ™āļāđˆāļ­āļ™āļ­āļēāļŦāļēāļĢ

āļŦāļĨāļąāļāđ†āļ‚āļąāļšāļ—āļēāļ‡āđ„āļ•

āđ„āļĄāđˆāđ€āļ‚āđ‰āļēCSFāđƒāļ™āļ āļēāļ§āļ°āļ›āļāļ•āļī

Resistant to staphylococcal B-lactamase

āļ•āļąāļ§āļ­āļĒāđˆāļēāļ‡āļĒāļē

Cloxacillin

dicloxacillin <āļ™āļīāļĒāļĄāđƒāļŠāđ‰>

methicillin

āļĢāļąāļāļĐāļē S. aureus infection

vancomycin āđƒāļŠāđ‰āđƒāļ™ Methicillin resistance S. aureus (MRSA)

Sensitive to G+ve

S. pyogenes

S. pneumoniae

āļ•āļąāļ§āļ­āļĒāđˆāļēāļ‡āļĒāļē

Ampicillin

Amoxicillin

āļŦāļĄāļđāđˆāļšāļ§āļāļāļĢāļ”āļ­āļ°āļĄāļīāđ‚āļ™āļ­āļĒāļđāđˆ side chain āļ—āļģāđƒāļŦāđ‰āđ€āļ‚āđ‰āļēāđ„āļ›āļ‚āđ‰āļēāļ‡āđƒāļ™cell āļœāđˆāļēāļ™ porin

sensitive to G –ve

H. influenzae

E. coli

āļ­āļēāļŦāļēāļĢāļĢāļšāļāļ§āļ™āļāļēāļĢāļ”āļđāļ”āļ‹āļķāļĄ

āļ­āļēāļŦāļēāļĢāđ„āļĄāđˆāļĢāļšāļāļ§āļ™āļāļēāļĢāļ”āļđāļ”āļ‹āļķāļĄ

Sensitive to B-lactamase āđāļāđ‰āđ‚āļ”āļĒ āđ€āļ­āļēāļĒāļēāđ„āļ›āļˆāļąāļšāļāļąāļš B-lactamase inhibitor

Clinical Use

Uncomplicated ear nose and throat
infections

Clinical Use

Uncomplicated ear nose and throat infections

āļ›āđ‰āļ­āļ‡āļāļąāļ™āļœāļđāđ‰āļ›āđˆāļ§āļĒendocarditisāļ—āļĩāđˆāļ•āđ‰āļ­āļ‡āđ„āļ›āļ—āļģāļ‡āļģāļ—āļąāļ™āļ•āļāļĢāļĢāļĄ

resistance to some B-lactamase

āļĢāļąāļāļĐāļē

Enterobacter

Klebsiella

enterococci

Pseudomonas

Piperacillin āđƒāļ™āļœāļđāđ‰āļ›āđˆāļ§āļĒāļ•āļīāļ”āđ€āļŠāļ·āđ‰āļ­āđƒāļ™āļĢāļž.

Adverse reaction

Hypersensitivity

Interstitial nephritis

Seizure

3rd gen <>Gr-

4th <Gr+> Cefepime

2nd gen āļ”āļĩāļ§āđˆāļē1 āđāļ•āđˆāđ„āļĄāđˆāđ€āļ—āđˆāļē3<Gr-,+>

1st gen <most Gr+>

Cefazolin

Cefazolin & cephalexin

treat skin and soft
tissue infection

pre-op

Cefuroxime

H. influenzae

cefoxitin

āļĢāļąāļāļĐāļē B. fragilis

community acquired
pneumonia

intra-abdominal and pelvic infection

Resistance to many B-lactamase
and ESBL

Ceftriaxone, cefotaxime

Ceftazidime, cefoperazone

Pneumonia

Pyelonephritis

Community acquired meningitis

HAP

Ceftazidime āđƒāļŠāđ‰āđ€āļĒāļ­āļ° āļĢāļąāļāļĐāļēMelioidosisāđ„āļ”āđ‰

Adverse reaction

Hypersensivity reaction

Renal toxicity

Cefoperazone āļ‰āļĩāļ”āļ§āļīāļ”KāļĢāđˆāļ§āļĄ

Disulfiram like reaction

Vit K coagulation factor
āļ•āđˆāļģ

Monobactam

Against āđāļ„āđˆāđāļāļĢāļĄāļĨāļš

B-lactamase inhibitors

broad spectrum ;āļ—āļąāđ‰āļ‡āļšāļ§āļāđāļĨāļ°āļĨāļš āđāļ•āđˆāđ„āļĄāđˆ MRSA

āļ•āļąāļ§āļ­āļĒāđˆāļēāļ‡āļĒāļē

Imipenem

meropenem āđƒāļŠāđ‰āđ€āļĒāļ­āļ°

āļ—āļģāļ‡āļēāļ™āđ„āļĄāđˆāđ„āļ”āđ‰āđ€āļĄāļ·āđˆāļ­āđ€āļˆāļ­human renal enzyme

Adverse reaction

no antimicrobial
activity

B-lactam ATB+ B-lactamase inhibitors

Amplicillin + sulbactam (UnasynÂŪ)

Piperacillin + Tazobactam (TazocinÂŪ)

Amoxicillin + clavulanic acid (AugmentinÂŪ)

āđ„āļ›āļĒāļąāļšāļĒāļąāđ‰āļ‡āđƒāļ„āļĢāļšāđ‰āļēāļ‡āļ™āđ‰āļē

gram-positive cocci + lactamase-
āļˆāļēāļ strains of S. aureus

gram-negative aerobes āļĒāļāđ€āļ§āđ‰āļ™ Pseudomonas āđāļ•āđˆTazocināļ—āļģāđ„āļ”āđ‰āļ­āļĒāļđāđˆ

Clinical Use

Intra-abdominal and pelvic infection

Aspiration pneumonia
āđƒāļ™āļ„āļ™āđ„āļ‚āđ‰āđ„āļĄāđˆāļ—āļĩāđˆāđ€āļāđ‡āļšāđāļšāļšāļ›āļāļ•āļīāđ„āļĄāđˆāđ„āļ”āđ‰

other cell wall active agents

Vancomycin āļĢāļēāļ„āļēāđāļžāļ‡

Inhibit transglycosylase (minor)

Against G+ve rod, cocci → MRSA

Bind to D-Ala-D-Ala portion of peptapeptide

Adverse reaction

Red man syndrome āđƒāļŦāđ‰āļĒāļēāđ€āļĢāđ‡āļ§āđ„āļ› āļĄāļąāļ™āđ„āļ›āļāļĢāļ°āļ•āļļāđ‰āļ™āļ āļđāļĄāļīāļ„āļļāđ‰āļĄāļāļąāļ™āđ€āļĢāđ‡āļ§

nephrotoxicity , ototoxicity āļ•āđ‰āļ­āļ‡ monitor āļĢāļ°āļ”āļąāļšāđ€āļĨāļ·āļ­āļ”

hypersensitivity rash

Helicobacter pylori (combination with other drugs)

Uncomplicated UTI in pregnancy