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Anubloucs ln ually Llfe
anan amyaLhanee, h.u
Anumlcroblal
8acLerla
vlrus
lungl
araslLe
A compound or subsLance LhaL lnhlblLs or kllls
Lhe mlcroorganlsms (paLhogens)
8acLerla --> Anublouc
vlrus --> Anuvlral
lungl --> Anufungal
araslLe --> Anuparasluc
Anubloucs
A compound or subsLance LhaL kllls or slows
down (lnhlblLs) Lhe growLh of bacLerla
The first antibiotic in the world
Penicillin
8aslc 8acLerlology
lree-llvlng, slngle cell organlsms
A few mlcromeLers ln lengLh
8eproduces by cellular dlvldlng (blnary sslon)
no sexual reproducuon

8acLerlal CrowLh
8lnary llsslon
Lxponenual CrowLh
8acLerlal SLrucLure
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8acLerlal Cell
- protect the cell
- genetic material
- cell movement
- contains organelles
- controls permeability
Cell Wall CharacLerlsucs
Cram osluve
Cram negauve
Lipid
Carbohydrate
Cram sLalnlng :
meLhod for dlerenuaung
bacLerla based on properLy of
call walls whlch are able Lo
be sLalned by dlerenL color
Cllnlcal 8acLerlology
Cram osluve Coccl
Cram osluve 8acllll
Cram negauve Coccl
Cram negauve 8acllll
Anaerobes
SplrocheLes
MycobacLerla
Cram osluve Coccl
!"#$%&'()())*+
!"-.$"()())*+
!"#$%&'()())*+ #*-.*+
- Skin infection
- Pus ,wound
!"-.$"()())*+ $/.*0(/1#.
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Cram osluve 8acllll
2'(+"-131*0
4#)1''*+
2(-&/.5#)".-1*0
61+".-1#
7)8/(0&).+
9()#-31#
2'(+"-131*0 "."#/1
- Tetanus
2'(+"-131*0 $.-:-1/;./+
- Gas gangrene
Cram negauve Coccl
9.1++.-1# ;(/(--%.#

- Gonorrhea
Cram negauve 8acllll
<= )('1
>'.5+1.''#
!#'0(/.''#
?15-1(
@+.*3(0(/#+

Cram negauve 8acllll
- Cystitis - Diarrhea
- Wound
- Respiratory tract infection
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Anublouc name
ln general, drug (also for anublouc) has aL leasL 3 names

Chemlcal name : (2S,38,68)-6-[[(28)-2-amlno-2-(4-
hydroxyphenyl)aceLyl]amlno]-3,3-
lmeLhyl-7-oxo-4-Lhla-1-
azablcyclo[3.2.0]hepLane-2-
carboxyllc acld
Common name : Amoxlclllln
1rade name : Amoxll, 1rlmox, MoxaLag
Classlcauon of Anubloucs
Chemlcal SLrucLure
SpecLrum of AcuvlLy
Mechanlsm of Acuon
Anublouc AcuvlLy
Bacteriostatic
- just inhibits or
slows down of
bacterial growth

- Host immunity will
be able to get rid
of the bacteria then
Bacteriacidal
- Kill the bacteria


Depends on spectrum of Activity
lndlcauons for Anublouc 1reaLmenL
1. 8acLerlosLauc ln comblnauon wlLh bacLerlosLauc
Synerglsuc eecLs or none
2. 8acLerlcldal ln comblnauon wlLh bacLerlcldal
Synerglsuc eecLs
3. 8acLerlcldal ln comblnauon wlLh bacLerlosLauc,or vlce versa
AnLagonlsuc eecLs

Depends on spectrum of Activity
Anublouc AcuvlLy
1. Narrow spectrum : Active to few species of bacteria
(some Gram positive cocci / or
some Gram negative bacilli)
2. Intermediate spectrum
: Active to several species of bacteria
both Gram positive and Gram negative ,
but not to other microbial
3. Broad spectrum : Active to several species of bacteria and
also other microbial including virus, fungi
and parasite
Depends on spectrum of Activity

1. lnhlbluon of Cell Wall SynLhesls
2. lnhlbluon of Cell Membrane
SynLhesls
3. lnhlbluon of roLeln SynLhesls
4. lnhlbluon of unA SynLhesls
3. lnhlbluon of MeLabollc aLhway
uepends on mechanlsm
of Acuon
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1. Cell Wall lnhlblLors
All bacLerla (excepL A&)($'#+0#) conLaln cell wall
1. Cell Wall lnhlblLors
Safe Lo human (human cells do noL have cell wall)
Cell wall lnhlblLors lnhlblL Lhe cell wall synLhesls process
Lx: enlclllln

Without cell wall, bacteria are no longo live
Bactericidal
Bacterial cell lysis
1. Cell Wall lnhlblLors
Beta-lactam group
Penicillin
Cephalosporin
Monobactam
Carbapenem
lnhlblLors of Cell Wall SynLhesls
1. Cell Wall lnhlblLors
Common use in penicillin group


Amoxicillin+clavulanic
Ampicillin

Cloxacillin

Penicillin
Plgh specLrum
Low specLrum
1. Cell Wall lnhlblLors
Allergy :Rash
:Nausea
:Diarrhea
:Shock

Common possible side effects
- Person with allergic status should avoid this group of drug
- Penicillin is so allergenic !!
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2. Cell Membrane lnhlblLors
Cell membrane conLrol cellular permeablllLy
(selecL and conLrol subsLance Lo go Lhrough Lhe cells)
2. Cell Membrane lnhlblLors
LecL human cells (human cells also have cell membrane)
Cell membrane lnhlblLors rupLure bacLerlal cell
membrane
8acLerlal cells loss permeablllLy conLrol and no longer llve
Bactericidal
Bacterial cell lysis
Lx: olymyxln group
3. roLeln SynLhesls lnhlblLors
ln bacLerlal cells, proLelns are synLheslzed by
organelle named rlbosome

3. roLeln SynLhesls lnhlblLors
roLelns acL as subsLraLe and enzyme ln bacLerlal
meLabollsm
lmporLanL for bacLerlal growLh, cellular repalr
lf proLeln synLhesls ls lnhlblLed, no longer proLeln produced
Bacteriostatic
Bacterial growth stops!!
3. roLeln SynLhesls lnhlblLors
Lx:
1eLracycllne
Chloramphenlcol
Amlnoglycoslde
Macrollde
Llncosamlde

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3. roLeln SynLhesls lnhlblLors
1eLracycllne groups
8road specLrum!!
1onsllllus / acne / dlarrhea/ malarla..
1oxlc Lo llver and kldney
Cause bone malformauon and yellow LeeLh
uo noL use wlLh chlldren under 12 yrs and Lhe pregnancles

3. roLeln SynLhesls lnhlblLors
Chloramphenlcol groups
8road specLrum
used under sLrlcLly conLrol
1yphold fever and encephallus
Cause aplasuc anemla

4. unA SynLhesls lnhlblLors
Culnolones lnhlblL bacLerlal unA from unwlndlng
and dupllcaung
Lx: noroxacln

Bacteriostatic
3. MeLabollc aLhway lnhlblLors
MeLabollsm ls lmporLanL ln llvlng organlsm
Sulfonamlde groups lnhlblL bacLerlal meLabollc paLhway
Bacteriostatic
Bacterial growth stops!!
3. MeLabollc aLhway lnhlblLors
Lx: Sulfonamldes

1. lnhlbluon of Cell Wall SynLhesls
2. lnhlbluon of Cell Membrane
SynLhesls
3. lnhlbluon of roLeln SynLhesls
4. lnhlbluon of unA SynLhesls
3. lnhlbluon of MeLabollc aLhway
uepends on mechanlsm
of Acuon
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8ouLe of AdmlnlsLrauon
Cral rouLe lnLravascular (lv) rouLe
8ouLe of AdmlnlsLrauon
1oplcal rouLe
lndlcauon of Anublouc AdmlnlsLrauon
8efore meal : 30 mln - 1 hr
lor acld-sensluve drug

Aer meal : 2 hr
lor acld-sensluve drug

Aer meal : 30 mln
lor besL absorpuon wlLhouL nausea



lndlcauon of Anublouc AdmlnlsLrauon
lor acld-sensluve drug, conslder noL Lo have
wlLh [ulce or sour frulL

lood can lnLeracL wlLh some drug (LeLracycllne),
conslder noL Lo have LogeLher



roper use of Anubloucs
1. 8e used wlLh only bacLerlal lnfecuons

*SympLom always mlsundersLood as bacLerlal lnfecuon
MouLh ulcer
!olnL swollen from physlologlcal auack
lever ??

*Many compllcauons resulL ln fever
(cancer, vlral lnfecuon, medlcauon)

*lever from bacLerlal lnfecuon
lever wlLh dlarrhea
lever wlLh sore LhroaL
lever wlLh pus
roper use of Anubloucs
2. 8e Lhoughuul for Lhe common causauve organlsms
and Lhelr anublouc reslsLance pauerns

*ln order Lo selecL Lhe rlghL anublouc Lo Lhe organlsms
wlLh less chance of anublouc reslsLance developmenL

3. Anublouc should be used followlng Lhe rule of Lhumb

*lnlual sLage of lnfecuon : narrow specLrum rsL
*Chronlc lnfecuon : broad specLrum
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roper use of Anubloucs
4. erlod of LreaLmenL depends on bacLerlal characLers

-ln general, Lhe sulLable perlod ls 3-7 days
-lasL-grower bacLerla : Slngle hlgh dose
-Slow-grower bacLerla : Long Lerm Lherapy
3. 8e consldered for person wlLh some condluons

regnancy should avold LeLracylclne
roper use of Anubloucs
6. use few anublouc as posslble
1o avold : posslble anLagonlsm
drug allergy (ln hosL)
drug reslsLance (ln bacLerla)
opporLunlsuc lnfecuons
wasLe Lhe money
7. 8e consldered for pauenL's background
lnclude: allerglc sLaLus background dlsease
money sLaLus slLe of lnfecuon
age dose
healLh sLaLus
CuLcomes from anublouc mlsuse
1. Anublouc reslsLance
2. CpporLunlsuc lnfecuon

ex: 2#/313#
R
R
R
antibiotic
CuLcomes from anublouc mlsuse
3. urug allergy
ex: enlclllln
4. 1oxlc and slde eecL

Chloramphenlcol : anemla
LryLhromycln : Loxlc Lo llver
1eLracycllne : bone malformauon
yellow LeeLh
CuLcomes from anublouc mlsuse
3. vlLamln declency
ex: vlL 8 / vlL k
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upper 8esplraLory 1racL lnfecuon
1onsllllus :
Common paLhogen : Cram posluve coccl
enlclllln, Amoxlclllln


vlral lnfecuon 8acLerlal lnfecuon
pus
Lower 8esplraLory 1racL lnfecuon
neumonla :
Common paLhogen : Cram posluve coccl
Cram negauve bacllll
enlclllln, Amoxlclllln


CasLrolnLesunal 1racL lnfecuon
ularrhea :
Common paLhogen : Cram negauve bacllll
Culnolone, 1eLracycllne


urlnary 1racL lnfecuon
Cysuus :
Common paLhogen : Cram negauve bacllll
Cram posluve coccl
Cephalosporln, Amplclllln, Culnolone


Skln lnfecuon
vlral lnfecuon 8acLerlal lnfecuon
Common paLhogen : Cram posluve coccl
olymyxln (ollmenL)


CenlLal 1racL lnfecuon
Syphllls :
Common paLhogen : SplrocheLe
enlclllln (ln[ecuon)