Get Antibiotic Basics for Clinicians: The ABCs of Choosing the PDF

By Alan R. Hauser MD PhD

ISBN-10: 1451112211

ISBN-13: 9781451112214

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Extra info for Antibiotic Basics for Clinicians: The ABCs of Choosing the Right Antibacterial Agent Second Edition

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Among the third-generation cephalosporins, ceftriaxone is notable for its long half-life. This agent is widely used because of the convenience of its once per day dosing. FOURTH-GENERATION CEPHALOSPORINS As mentioned earlier, the third-generation cephalosporins are powerful antimicrobial agents but suffer from susceptibility to the chromosomally encoded inducible AmpC ␤-lactamases of many of the Enterobacteriaceae. In addition, activity against P. aeruginosa is gained only at the expense of diminished antistaphylococcal activity.

Acremonium. N CH N N CH2 N N N C CH2S R1 C S CH3 R2 FIGURE 5-11. indd 32 Structure of cefazolin. 12/15/11 2:24 AM CHAPTER 5 ■ Antibiotics that Target the Cell Envelope 33 OCH3 S H2NOC C C HOOC CH N N S S N CH2 R1 N CH3 R2 FIGURE 5-12. circled. Structure of cefotetan. The methoxy group characteristic of the cephamycins is They have a methoxy group in place of the hydrogen on the ␤-lactam ring of the cephalosporin core (Fig. 5-12). Thus, these agents are not actually cephalosporins but are included in this group because they are chemically and pharmacologically similar.

To be effective, ␤-lactam agents must successfully navigate around each of these potential pitfalls. It is important to note that ␤-lactam antibiotics are a heterogeneous group of compounds; some may be blocked at certain steps through which others may proceed without difficulty. indd 20 12/15/11 2:23 AM CHAPTER 5 ■ Antibiotics that Target the Cell Envelope 21 β-lactam Human cell plasma membrane 1 Efflux pump 2 Outer membrane Porin 3 6 Peptidoglycan β-lactamase 4 5 PBP Inner membrane FIGURE 5-4.

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Antibiotic Basics for Clinicians: The ABCs of Choosing the Right Antibacterial Agent Second Edition by Alan R. Hauser MD PhD


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