B-LACTAMSPENICILLINS | CARBAPENEMS | CEPHALOSPORINS | MONOBACTAMS | GLYCOPEPTIDES |
Tetracyclines – impairs the bactericidal effects of B-lactams PENICILLINSMOA | Bind to transpeptidases and block cross-linking of peptidoglycan residues resulting in weak cell walls and bacterial lysis in bacteria that are actively growing | PK | Excreted really
Penetration into the eye, prostate, and CNS is poor,
Absorption impaired by food-take 1-2 hrs before or after meal to prevent protein binding, acid inactivation
| AE | Hypersensitivity, anaphylaxis, super infections, diarrhea, convulsions (high dose, renal failure, epileptic pts) , hematolgic toxicities, nephritis, cation toxicity |
PENICILLINSPENICILLIN G | Unstable in acidic pH, given IV over IM
More active against gram-negative organisms (i.e., Neisseria) than penicillin V. | PENICILLIN V | More resistant to acid |
Penicillin G procaine and Penicillin G benzathine (i.m.) - formulated to delay absorption, resulting in prolonged blood and tissue concentrations. ANTI-STAPHYLOCOCCAL PENICILLINSMETHICILLIN | No longer used in US | NAFCILLIN | Excreted biliary | OXACILLIN | Excreted by kidney and biliary | DICLOXACILLIN | Excreted by kidney and biliary | CLOXACILLIN | Excreted by kidney and biliary |
Indications: MSSA, MSSE, Bone, joint, urinary tract, skin, endocarditis, meningitis | | AMINOPENICILLIN (EXTENDED-SPECTRUM)AMPICILLIN | UTI, sinusitis, otitis, lower respiratory tract infections | AMOXICILLIN |
Indications: Respiratory infections, UTI, skin, bacterial meningitis, septicemia, endocarditis, GI infections (typhoid fever, dysentery)
More expensive ANTI-PSEUDOMONAL (UREIDO-PENICILLIN)CARBENICILLIN | No longer used in US | PIPERACILLIN | Most potent | TICARCILLIN | PIPERACILLIN-TAZOBACTAM | TICARCILLIN-CLAVULANIC ACID |
Indications: Folliculitis, osteomyelitis, endocarditis, UTI, respiratory tract, wounds, bacteremia, CNS
Formulation of ticarcillin and piperacillin with β-lactamase inhibitors (formulation with clavulanic acid or tazobactum, respectively), extends the antimicrobial spectrum to include penicillinase-producing organisms NOTES PENICILLINSPROBENICID | Increases serum levels of penicillins | NAFCILLIN | Only one not excreted renally | AMOXICILLIN | Only one that doesn't undergo acid inactivation (absorption not impaired by food) |
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