抗生素简介ppt课件

1、“The future is not what it used to be-Yogi Berra細菌抗藥性產生有效治療病人Chinese Emperor Shen Nung (神農氏) wrote a treatise on the use of chang shan(常山 in fever.2735 BC發燒、休克意識不清感染？不需运用抗生素細菌、病毒細菌、病毒黴菌或其他黴菌或其他感染部位？泌尿道、呼吸道获得適當檢體做培養Urine, Blood, Sputum.有抗微生物藥劑可有效治療？選擇適當抗微生物藥劑否是是否nSNOOOOCH2OCCH3SONCONHHNH2COSultamicil

2、linNSNH2CHCONHHCH3CH3COOHOAmpicillinNSOOCH3CH3COOHOSulbactamEsterase1. Campoli-Richards DM, Brogden RN. Drugs 1987;33:577609.2. Friedel HA et al. Drugs 1989;37:491522.CH3COCH3CH3HWilliams JD. Int J Antimicrob Agents 2019;12(Suppl 1):S3S7.Inhibitor inactivates-lactamase-Lactam can reach penicillin-bi

3、nding protein (PBP)-Lactam alone may be degraded by -lactamase With inhibitorWithout inhibitor-Lactam-Lactamase inhibitor-Lactamasenot reported; Pen-S, penicillin-susceptible isolates. aUsing NCCLS breakpoints. bNo NCCLS breakpoints available; data presented as MIC90 ( g/ml).1. Marshall SA et al. Di

4、agn Microbiol Infect Dis 2019;21:15368.2. Johnson DM et al. Diagn Microbiol Infect Dis 2019;25:41.3. Cullman W. J Chemother 2019;7:215.Acinetobacter spp. (n=70)2 17.195.7Pseudomonas aeruginosa (n=569)2 1.85.3A/S, ampicillin/sulbactam; -lac+, -lactamase-producing isolates.aUsing NCCLS breakpoints. bN

5、o NCCLS breakpoints available; data presented as MIC90 ( g/ml).1. Smayevsky J et al. Diagn Microbiol Infect Dis 2000;37:2614.2. Marshall SA et al. Diagn Microbiol Infect Dis 2019;21:15368.Fusobacterium spp. 322Peptostreptococcus spp. 81A/S, ampicillin/sulbactamaMIC90 based on ampicillin concentratio

6、nEdnie LM et al. Antimicrob Agents Chemother 2019;42:5962.nBacteroides fragilis, Bacteroides spp., Clostridium, Fusobacterium and Peptostreptococcus spp.nnErythema multiformnDrug-induced systemic lupus erythematosus NOONHCOCH3FNOH5Morpholino group enhances pharmacokinetic profile & improves wate

7、r solubilityStrategically located fluorine atom improves activityC - 5 acylaminomethyl group essential5 - (S) - configuration necessaryN - Aryl group requiredInitiation Factors30S ribosomemRNA50S ribosome30S + mRNAfMet - tRNAElongation Factors70S Initiation ComplexPeptide ProductElongationAminoglyco

8、sidesMacrolides StreptograminsLinezolid blocks formation of the initiation complexLinezolid MIC (mg/L)SpeciesN0.1250.250.5124S. aureus (oxacillin-R)958834S. aureus (oxacillin-S)15521449CoNS (oxacillin-R)104346541CoNS (oxacillin-S)6932937E. faecalis150221442E. faecium392361SPNE (penicillin-S)14941685

9、431SPNE (penicillin-I)1305177632SPNE (penicillin-R)481819191Streptococcus spp.80240317Conclusions: There was no difference in linezolid susceptibility betweencountries or between multiresistant and susceptible strains. Resistance tolinezolid was not detected in more the 2,000 clinical isolates in the WesternPacific.Asia - Pacific ZAPSOral bioavailability100% (based on AUC)Food effectNo effect on extent