Understanding Antimicrobial Drugs and Antibiotics

1. Chapter 20: Antimicrobial Drugs Chapter 20: Antimicrobial Drugs

2. What are antibiotics? What are antibiotics? Definition: chemicals produced by one microorganism to kill or inhibit the growth of other microorganisms Now included the semi-synthetic antibiotics Effective against bacteria Antibacterial drugs largest group of antibiotics General terms used to include other microbes are antimicrobial drugs or antimicrobials Difference between disinfectants/antiseptics and antimicrobial drugs

3. Antibiotic spectrum Antibiotic spectrum Broad vs. narrow spectrum antibiotics Benefits and problems with each

5. Microbes that produce antibiotics: Microbes that produce antibiotics: Bacteria: Bacillus and Streptomyces Fungi: Cephalosporium and Penicillium

7. How do antibiotics work? How do antibiotics work? 1. must kill pathogen and not kill host 2. fewest sides effects in host; highest toxicity in pathogen 3. exploit differences between the pathogen and the host

9. Modes of action of the antibiotics: Modes of action of the antibiotics: 1. Inhibition of cell wall synthesis cell wall is weakened by these when cell is growing ex. penicillin(s) and cephalosporins low toxicity to humans

11. Modes of action of the antibiotics: Modes of action of the antibiotics: 2. Inhibition of protein synthesis binding to 70S ribosome differences between 70S and 80S ribosomes ex. chloramphenicol, erythromycin, streptomycin, tetracyclines host mitochondria may also be affected

13. Modes of action of the antibiotics: Modes of action of the antibiotics: 3. Increase permeability of plasma membrane ex. polymyxin B used topically can have high toxicity in humans

15. Modes of action of the antibiotics: Modes of action of the antibiotics: 4. Inhibit synthesis of RNA/DNA can be very toxic ex. quinolones DNA

17. Modes of action of the antibiotics: Modes of action of the antibiotics: 5. Inhibition of metabolic pathways ex. sulfanilamide folic acid pathway low toxicity because of the absence of this pathway in humans

19. Antagonism vs. synergism of 2 or more antibiotics Antagonism vs. synergism of 2 or more antibiotics Antagonism: Ex. Tetracycline penicillin (Why?) Synergism: Ex. TMP-SMZ (SMX) trimethoprim and sulfamethoxazole

20. Prophylaxis preventative use of antibiotics Prophylaxis preventative use of antibiotics Ex. of their use: 1. before surgery i.e. appendix removal 2. before dental work in heart patients 3. in AIDS patients to prevent many infections

21. Factors affecting antimicrobial activity in vivo Factors affecting antimicrobial activity in vivo 1. In the environment A. metabolic state of pathogen Ex. Mycobacterium tuberculosis B. distribution of drug is different in different tissues Ex. blood/brain barrier and necrotic tissue C. location of pathogen Ex. Chlamydia inside host cells D. interfering substances Ex. low pH in stomach; binding to proteins in body, etc.

22. Factors affecting antimicrobial activity in vivo Factors affecting antimicrobial activity in vivo 2. Concentration of antibiotics in body A. absorption, inactivation, excretion B. distribution of the drug systemic vs. local vs. topical C. variability dosing flutuations, how long antibiotic lasts in the body.

23. Antiviral drugs Antiviral drugs Nucleotide analogs (look similar to the bases + sugars of DNA) Ex. AZT looks like thymine; acyclovir looks like guanine Enzyme inhibitors Ex. reverse transcriptase inhibitor important in controlling HIV infection Interferons naturally produced by our immune systemsEx. alpha, beta, and gamma; prevents further infection

25. Antifungal drugs Antifungal drugs Targets for antifungal drugs??? Possible side effects??? Ex. amphotericin B and imidazole affect sterol production Griseofulvin binds to keratin in skin cells, treats skin fungal infections

26. Antibiotic resistance (also called drug resistance) Antibiotic resistance (also called drug resistance) What is happening? As microbes are exposed to drugs, the ones with defenses against them survive

27. Microbial defense mechanisms against antibiotics Microbial defense mechanisms against antibiotics 1. Change receptor for drug 2. Bind to drug and inactivate it, ex. penicillinase ( - lactamase) 3. Change target site, ex. change ribosome structure 4. Change metabolic pathway 5. MDR pump multi-drug resistance pump

28. How does drug resistance develop in different microbes? How does drug resistance develop in different microbes? Antibiotics overprescribed and not regulated Many countries do not require a prescription Improper dosage Antibacterial soaps/surfaces, etc. Antibiotics in animals (used as our food source) People insisting on receiving antibiotics, even for viral infections Nosocomial infections and the chronically infected

31. Antibiotic sensitivity tests Antibiotic sensitivity tests Kirby-Bauer test zones of inhibition Minimal inhibitory concentration test

35. The End