Antibiotics

RANGE OF ACTION:

Penicillin G:

This narrow, some Gram + cocci (streptococci); cocci Gram – (meningitis, gonorrhea); Gram + bacterium (Listeria, Corynebacterium); strict anaerobic Gram positive bacterium (Clostridium) and spirochetes (Treponema, Leptospira).

Penicillin M:

Spectrum identical to that of penicillin G plus an activity on penicillinase-producing staphylococci but Meti-S.

Penicillin A:

Streptococci; meningitis; BGN (Listeria, Salmonella, Shigella, Proteus mirabilis, E. coli, Haemophilus influenzae).

Cephalosporins:

G1, 2

Most Gram-positive cocci (in particular staphylococci Meti-R); few bacilli Gram – (Klebsiella, Haemophilus, Proteus …)

G3:

Very active meningococcus, gonococcal, streptococci; Gram-negative bacilli.

Aminoglycosides:

Gram + cocci (Staph Meti-S …) cocci Gram -; gram positive bacilli and the majority of Gram negative rods (Enterobacteriaceae, Pseudomonas …).

Macrolides:

Intracellular bacteria (chlamydia, rickettsia);mycoplasma; Treponema; streptococci; staphylococci;Corynebacterium, Clostridium.

Quinolones:

Intracellular bacteria (Legionella …) Gram bacilli – (KES, Pseudomonas inconstant); staph Meti-S; meningococcal and gonococcal …

Phenicols:

Gram positive cocci; Listeria; Enterobacteriaceae; Haemophilus influenzae; spirochetes; intracellular bacteria;anaerobes.

Cyclins:

Intracellular bacteria (Chlamydia, Mycoplasma, Rickettsia, Brucella); spirochetes (Leptospira …) Vibrio cholerae

Rifamycin:

Mycobacteria; Gram-positive bacteria (Staph including Meti-R; streptococcus meningitis …) certain Gram – (Legionella, Brucella)

Glycopeptides:

Narrow spectrum: staphylococcus (even ori-R), enterococci, streptococci, anaerobic Gram (even C. difficile), Corynebacterium.

– Penicillin G is ineffective against Gram-negative bacilli

– Penicillinase produced by staphylococci does not inactivate penicillins M, carbapenems, cephalosporins, or inhibitors of beta-lactamases.

– Germs resistant to aminopenicillin: KES germs (Klebsiellas, Enterobacter, Serratia), Pseudomonas aeruginosa, Acinetobacter, bacteroide.

– The carboxypénicillines (Ticarcillin) and ureidopenicillin (piperacillin)

– For cephalosporins first and second generation of the tissue distribution is good except in the CSF. They are less active than penicillin G against streptococci and enterococci inactive.

– The enterococci, Listeria Meti-R and staphylococci are always resistant to cephalosporins regardless of their generation.

– Cefotaxime is not very active on Pseudomonas aeruginosa, whereas the opposite is true for ceftazidime (Fortum®)

– Enterobacteriaceae and Pseudomonas are always resistant to macrolides. Best anti-Staph activity for synergistines.

– Spectinomycin is an aminoglycoside that has an anti-gonococcal elective activity.

– Aminoglycosides should always be used in combination. They are used in the majority of severe sepsis aerobic germ: BGN, Staph. They are little used in meningitis (except Listeria) and pneumonia due to their poor dissemination.

– Fluoroquinolones are inactive against streptococci, anaerobic, and on much METI-R staphylococci

– Phenicols: bacteriostatic; broad spectrum; tissue distribution (including meningitis) and intracellular excellent.

– Myelosuppression is dose dependent very rare; it is unpredictable (regardless occur several months after the judgment); it is observed that for chloramphenicol (half in half of the cases).

– Glycopeptides vancomycin, teicoplanin