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Antibiotika

Penicilliner Cefalosporiner Monobactamer Carbapenemer Glycopeptider Polymycin Sulfonamid Trimetoprim. Nitrofuraner Aminoglycosider Tetracyklin Lincosaminer Oxazolidioner Rifamyciner Kinoloner Steroidantibiotika. Antibiotika. Beta-laktam antibiotika. S. S. N. N. O. O.

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Antibiotika

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  1. Penicilliner Cefalosporiner Monobactamer Carbapenemer Glycopeptider Polymycin Sulfonamid Trimetoprim Nitrofuraner Aminoglycosider Tetracyklin Lincosaminer Oxazolidioner Rifamyciner Kinoloner Steroidantibiotika Antibiotika

  2. Beta-laktam antibiotika S S N N O O Penicilliner Cefalosporiner N N O O Carbapenemer Monobactamer

  3. Tetracycliner Makrolider Sulfonamider Trimethoprim Chloramfenikol Bakteriostatisk eller baktericid • ß-lactamer • Aminoglycosider • Glycopeptider • Kinoloner • Metronidazol

  4. Antibiotika angrebspunkt Folinsyresyntesen rammes på to niveauer af Sulfonamider Og trimetoprim DNA replikationen rammes af kinoloner som Ciprofloxacin DNA Mellemprodukter folinsyresyntese ribosomer Proteinsyntesen rammes af makrolider som Erythromycin og af aminoglycosider som gentamycin Cellevægssyntesen rammes af betalactamer som Penicilliner og Cefalosporiner samt af glycopeptidet vancomycin cellevæg

  5. Resistensmekanismer 1) Ændring af angrebspunktet Enzymatisk nedbrydning (beta-laktamaser) Ændret penetration via membranporer Aktiv udpumpning (effluxpumper) Ændrede stofskifteveje

  6. Valg af antibiotika • Empirisk i henhold til klinikken. • Resistensbestemmelse in vitro • Resistensudvikling • Farmakokinetiske forhold • Pris • Håndteringsvenlighed og compliance • Økologiske konsekvenser (giftighed)

  7. Antibiotika kombinationer • Ofte anvendes 3-stof behandling • Blandingsinfektioner • Ukendt ætiologi • Ønske om forstærket virkning (synergisme) • Målrettes ofte efterfølgende iht. udredning. • OBS! indifferente og antagonistiske kombinationer

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