Medications for the Treatment of

Infections

Antibiotic vs. Antibacterial

• Used interchangeably• Origin of antibiotic includes any

antimicrobial agent• Antibacterial used to treat bacterial

infection

Classification of Antibacterial Drugs

• Chemical structure• Mechanism of action• Bactericidal vs. Bacteriostatic• Narrow spectrum• Broad spectrum

Antibacterial Agents

• Classification according to mechanism of action

Antimicrobial Resistance

• Drug resistance

Penicillins

• the first -lactam antibiotic• Inhibits cell wall synthesis• Bactericidal • The spectrum of action:

– Most of the Gram-positive bacteria and Gram-negative cocci

• Primary uses– Urinary tract infection– Respiratory tract infection– Infections of heart– syphilis

Cephalosporins

-lactam antibiotic• Inhibits cell wall

synthesis• Bactericidal • Both gram-positive and

gram-negative activity• Cephalosporins are

classified in generations• Primary uses

– Respiratory tract– Urinary tract– Bacteremia– Skin and soft tissues

Carbapenems

-lactam antibiotic• Inhibits cell wall

synthesis• Bactericidal • Broad spectrum only• Primary uses

– Skin– Urinary tract– Intra-abdominal– Pelvic– Pneumonia

Tetracyclines

• Inhibits protein synthesis• Bacteriostatic• Broad spectrum• Adverse effects

– Epigastric burning, nausea, vomiting, diarrhea, photosensitivity

• Primary use– RMSF– Cholera– Lyme disease– Mycoplasma pneumoniae

Macrolides

• Inhibits protein synthesis• Bacteriostatic• Adverse effects

– Epigastric irritation, nausea, vomiting• Primary use

– Respiratory tract– Genital– GI– Skin and soft tissue

Aminoglycosides

• Inhibits protein synthesis• Gram (-) bacteria

– Urinary and respiratory tract infections– Topical - skin, eyes, ears

• Narrow spectrum• Adverse reactions

– Ototoxicity– Nephrotoxicity

Fluoroquinolones

• Inhibit DNA synthesis• Bactericidal• Broad spectrum• Primary use

– Urinary tract– Respiratory tract– Prostate, GI– Bones, joints, soft tissues

• Adverse reactions– Nausea, vomiting, headache, dizziness

Glycopeptides

• Inhibit cell wall synthesis• Gram positive cocci• Critically ill or

hypersensitivity to the β-lactams

• Last line of defense for cases of MRSA– Vancomycin

• Side effects– 'Red man syndrome’– Nephrotoxicity– Neutropenia and deafness

• Oral and intravenous

Topical Antibacterial Agents

• Use is mostly prophylactic– Can treat some superficial wound

infections

• Topicals typically contain mixture of antibacterial agents

• “Trainer’s trick” caring for turf burn

Antifungals

• 2 types – Oral used for subcutaneous and systemic mycoses– Topical used for superficial mycoses

• Work by disrupting fungal membrane functions• If using oral form to fight tenacious infection

(under nail beds), may be advised to take prior to exercise– Perspiration distributes medication

• Often effects areas of high moisture

Antifungals

• Ointments work better than powders• May be combined w/ a topical

corticosteroid• Types

Role of Athletic Trainer

• Educate regarding infections• Educate regarding compliance• Monitor for allergies• Monitor for common adverse

reactions• Monitor for effectiveness