BRIEF REVIEW FOR DC'S WITH PRESCRIPTION RIGHTS- AND CHIROPRACTIC STUDENTS-ANTIMICROBIAL MEDICATIONS

                                                                                      Protein Synthesis          Nucleic Acid Synthesis        Folic acid

Cell Wall Synthesis Inhibitors                                            Inhibitors                       & Replication Inhibitors       Metabolic Inhib.

Penicillins                       Cephalosporins●                        Aminoglycosides ф●  Fluoroquinolones ф ●    Sulfonamides ф●

Natural PCNs ●                        1^st Generation (gram - & +)●                Streptomycin 30S                     Ciprofloxacin                                Sulisoxazole-PABA

Penicillin G; V                             Cephalothin- endocarditis                          Gentamycin   30S                     Ofloxacin - UTI                            Sulfamethoxazole

Penicillin G procaine                   Cephapirin                                                Tobramycin   30S                     Norfloxacin                                   SulfadiazineG6PD

Pencillin G benzathine                 Cephradrine – not metabolized                 Amikacin   30S                          Sulfamethizole

Antistaph PCNs     ●               Cephalexin - not metabolized                     Netilmycin   30S                        Rifampin                                   Sulfasalazine

Methicillin  -nephrotoxicity           Cefazolin   ● surgery prophylaxis              Kanamycin 30S                         Rifampin    ●                               Sulfadoxine

Nafcillin                                       Cefadroxil SE: ototoxic & renal                   Sulfacetamide

Oxacillin                                      2^nd Generation (gram -)             ●           Tetracyclines ф                     ●DNA gyrase                             Silver sulfadiazine

Dicloxacillin-most active              Cefamandole ●–Proteus,Enterobact.           Tetracycline   30S                   ●mRNA polymerase                   Mafenide

Cloxaxillin                                  Cefaclor –H.influenza, Moxarella                  Doxycycline                            ●tRNA                                        SE: CRANK

Aminopenicillins  (BS)           Cefoxitin –PID, Gonorrhea                           Minocycline                             ●Periplasmic space                     Trimethoprim ф●

Ampicillin   ● ●                          Cefotetan ●–B. fragilis                                   Demeclocycline                       ●Penicilliase Resistant                 Trimethoprim

Amoxicillin ●                              Cefonicid                                                       Oxytetraclocycline                   ●β-lactamase Sensitive               Trimethoprim/

Antipseudodomonal PCNs    Cefprozil  -PCN R strep                                                                               ● Bile excretion/Diarrhea            Sulfamethoxazole    

Mexlocillin  -Klebsiella, Pseudo. Cefuroxime   .inf.,N.men.,S.pneu.                Chloramphenicol ф              ●Disulfiram Reaction

Piperacillin -Klebs,Pseudo, ●.    Cefpodoxime proxetil                                   Chloramphenicol 50S             ● Blocks PEP x-linking         Pyrimethamine

Azlocillin                                    3^rd Generation (Enterobacter)●                                                              ● Block nucleotide syn.    

Carbencillin                               Ceftriaxone  -N.men.,Gonorrhea,gm-           Macrolides 50S

Ticarcillin   - Psuedomonas        Ceftazidime   P.aerugin. & Pseudo               Erythromycin ф 50S

  *Burns  ●                                 Cefotaxime-S.aurs&pyogenes,E-coli            Clarithromycin- URT               Quninolones –blk DNA topoisomerases

Carbapenams (GYN,intra-A) Ceftizoxime                                                   Azithromycin

Imipenem/Cilastatin N/V,seizure Moxalactam               (BS) ●    

Meorpenam- no seizures           Cefixime  H.inf., N.Gonorrhea                    Lincosamides

Monobactams                          Cefoperazone – ● ●P. aeruginosa             Clindamycin 50S

Aztreonam-skin infections/intraA  4^th Generation (Enterobacter)●              Lincomycin 50S

                                                    Cefipime –S.pneumoniae

Vancomycin ф ☻ (gram +)                                                                        Mupirocin

Vancomycin-redneck/redman s   β-Lactamase Inhibitor●                          Mupirocin  ●

NOT-nephro,oto,thrombophelitis  Clavulanic Acid

blocks PEP synthesis              Sulbactam                                                 Streptogramins 50S

Cycloserine                               Tazobactam                                                Quinupristin  50S

Cycloserine                                                                                                    Dalfopristin  50S

Fosfomycin ¶                           Bacitracin

Fosfomycin                                  Conjuctivits, blocks PEP synthesis

                                                    Polymycin B/Colistrin - nephrotoxic

                                                    disrupt cell membranes (bacterial & fungal)-(oto, otic, topical, OE, Corneal ulcers).         

Antimycobacterials                      Antifungals              Antivirals                 Antiprotozoals               Antihelminths

Rifampin    ф                                 Polyene                   Antiherpetics             Malaria                           Nematodes

Isoniazid (INH) ф●                          Amphotercin-B ☼      Acyclovir                   Chloroquine         ¶             Pyrantel pamoate ●

Pyrazinamide-CI in gout                   Nystatin    ☼            Foscarnet                   Quinine                              Diethylcarbamazine

Ethambutol –optic neuritis (e = eye)                                   Ganciclovir                 Mefloquine ф                      Ivermectin

Streptomycin                                 Azoles ☼                 Idoxuridine                  Pyrimethamine/ Sulfadoxine   Mebendazole

                                                   Ketoconazole ф          Vidarabine                   Primaquine                          Thiabendazole

● sides effects                               Fluconazole  ☼ ●                                                                                                                   

fast→Hepatitis                                Itraconazole                       Antiretrovirals(HIV)              Ambiasis                           Trematodes & Cestodes

slow→peripheral neuropathy            Miconazole                        Didanosine                            Metronidazole ф                   Praziquantel ●

● DOC for C.meningitis                   Clotrimazole                        Zalcitabine                            Diloxanide Furoate                Niclosamide

                                                                                            Zidovudine (AZT)                   Paromomycin                            

                                                    Miscellaneous                                                              Iodoquinol                            ● pinworm

                                                    Flucytosine-converted         Other Antivirals                                                              ●schisto

                                                    Griseofulvin  ф                     Amantidine ф                        Leishmaniasis

                                                                                               Rimantadine                         Stibogluconate

                                                                                                Ribavirin                   
                                                                                                                                         Trypanosomiasis

☼ - disrupt fungal cell membranes (creates pores)                                                             Suramin

                                                                                                                                          Melarsoprol                                   ¶  = Pregnancy Safe

                                                                                                                                          Nifurtimox                                    BS = Broad Spectrum

                                                                                                                                          Pentamidine- unknown MOA ,PCP   ф  = Antipregnancy

Reasons for Concurrent Use of 1+ Antibiotics

1.        To treat a life threatening infection

2.        To treat a polymicrobial infection

3.        To achieve synergy of the drugs (obtained enhanced antibacterial activity)

a.        PCN & Aminoglycosides

                                                    i.      PCN :  cell inhibited but not killed

                                                   ii.      Amino:  Protein synthesis inhibited

                                                  iii.      Cells killed

For the Chiropractic Students of America edited by Scott D. Neff, DC DABCO MPS-BT CFE FFABS FFAAJTS and courtesy of the American Academy For Justice Through Science as taught to me in DC College