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CHEMOTHERAPYHIGHLIGHTS
MOHAMED BAHR; MD, PHD
General Principles
Mohamed Bahr; MD, PhD
GENERAL PRINCIPLES
Mohamed Bahr; MD, PhD
REVOLUTIONThe germ theory of disease
Pasteur, 1861
Mohamed Bahr; MD, PhD
MICROORGANISMS
Bacteria Viruses
Fungi Parasites
Mohamed Bahr; MD, PhD
Chemotherapy
Antimicrobial Agents
Antibacterial
Antifungal
Antiviral
Antiparasitic Agents
Anthelmintics
Antiprotozoal
Anticancer Chemotherapy
Mohamed Bahr; MD, PhD
SELECTIVE ON MICROBES
Mohamed Bahr; MD, PhD
GOALS
Mohamed Bahr; MD, PhD
Mohamed Bahr; MD, PhD
Mohamed Bahr; MD, PhD
Mohamed Bahr; MD, PhD
Some laboratory techniquesuseful in diagnosis of microbial diseases
Mohamed Bahr; MD, PhD
EFFECT ON BACTERIA
Mohamed Bahr; MD, PhD
Effects of bacteri-cidal andbacterio-static drugs ongrowth of bacteria in vitro
Mohamed Bahr; MD, PhD
ANTIBIOTIC PHARMACODYNAMIC CATEGORIES
Determination of MIC and MBC of an antibiotic
Mohamed Bahr; MD, PhD
Determination of MIC and MBC of an antibiotic
Mohamed Bahr; MD, PhD
Concentration–Dependent (with PAE)
• Bactericidal effect is increased with drug concentration . Optimum effect is achieved with concentrations 10 times MIC.• Trough drug concentration may fall below MIC during dosing interval without loss of efficacy, as bacterial regrowth is
inhibited by PAE → ↓ resistance.• Aminoglycosides• Quinolones• Azithromycin
Time-Dependent (with minimal or no PAE)
• Bactericidal effect depends on the duration that the drug level exceeds MIC.• Concentration should be maintained at 2-4 times MIC throughout dosing interval, as bacterial
regrowth starts very soon after trough falls below MIC, since the drugs have no PAE.• β-lactams• Vancomycin
Mohamed Bahr; MD, PhD
A. Significant dose-dependent killing effect shown by tobramycin. B. Nonsignificant dose-dependent killing effect shown by
ticarcillin.cfu = colony forming units; MIC = minimum inhibitory
concentration.
Mohamed Bahr; MD, PhD
SPECTRUM
Mohamed Bahr; MD, PhD
Mohamed Bahr; MD, PhD
Mohamed Bahr; MD, PhD
Mohamed Bahr; MD, PhD
Mohamed Bahr; MD, PhD
Mohamed Bahr; MD, PhD
Bacterial infections
Mohamed Bahr; MD, PhD
MECHANISM OF ACTION
Mohamed Bahr; MD, PhDBar chart showing the six most commonly used drug families
Mohamed Bahr; MD, PhD
Bar chart with the drugsof choice for treatment ofS aureus
Mohamed Bahr; MD, PhD
Mohamed Bahr; MD, PhD
RESISTANCE
Mohamed Bahr; MD, PhD
Mohamed Bahr; MD, PhD
COST
Relative cost of some drugs used for treatment of PU caused by H pylori
Mohamed Bahr; MD, PhD
REFERENCESLippincott’s Illustrated Reviews, 5th ed.
Color Atlas of Pharmacology, 2nd ed.
Goodman and Gilman's The Pharmacological Basis of
Therapeutics, 12th ed.
