Antibacterial drugs are very commonly used drugs, generally referring to drugs with bactericidal or bacteriostatic activities. Do you know wh
Antibacterial drugs are very commonly used drugs, generally referring to drugs with bactericidal or bacteriostatic activities. Do you know what they are? The following is the relevant content I have compiled for you, I hope it will be useful to you!
Germicides in breeding period: penicillins, cephalosporins, vancomycin, Tylenol and fluquinone.
Inactive fungicides: aminoglycosides and polymyxin.
Quick-acting bacteriostatic agents: tetracycline, chloramphenicol, macrolides, clindamycin.
Slow-acting bacteriostatic agents: sulfonamides.
Results of combined medication:
One+two: synergy one+three: antagonism?
Category II+Category III: Accumulation or Synergy Category I+Category IV: Accumulation?
Category III+Category IV: Cumulative Action Category II+Category IV: Cumulative Action?
Eight. Changes of bacterial drug resistance and its prevention;
Significance of drug resistance monitoring of common pathogens;
1. Antibiotics for clinical use.
2. Control the emergence of bacterial drug resistance.
Anti-infection faces the severity of bacterial resistance;
1. Staphylococcus aureus * * * methicillin-resistant Staphylococcus aureus * * and Staphylococcus epidermidis * * * MRSE * * are resistant to oxacillin.
2. Vancomycin-resistant Enterococcus ***MRE, VRE***.
3. Penicillin-resistant pneumococcus ***PRSP***.
4.g- bacilli extended-spectrum β -lactamases * * * ESBL * * and inducible enzymes
5. Vancomycin-resistant Staphylococcus ***VIRS***.
Drug resistance mechanism: producing inactivated enzyme; Changes in membrane permeability; The change of target position; Reverse pump mechanism.
The way of drug resistance: endogenous drug resistance: natural drug resistance;
Exogenous drug resistance: acquired drug resistance:
1* * chromosomal mutation;
2*** plasmid mediated.
Pressure selectivity of antibiotics: the use of β -lactam antibiotics can promote the production of β -lactamase by bacteria; Produce a large number of chromosomal β -lactamases; Producing plasmid-mediated beta-lactamase; Produce extended-spectrum variant beta-lactamase.
Drug resistance of pathogens from community respiratory tract infections has posed a serious threat. The main drug-resistant bacteria are:
1. Streptococcus pneumoniae: pbps ***PBP2b*** target site changes.
2. Haemophilus influenzae: producing β-lactamase.
Moraxella catarrhalis: β -lactamase producing.
The main pathogens of respiratory tract infection in community outpatient clinics:
Pathogens accounted for * * *% * * of the total isolates.
Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis, Staphylococcus aureus
Drug resistance rate of Streptococcus pneumoniae * * * PRSP * *;
PRSP was first cultivated in Sydney Hospital, Australia from 65438 to 0967. In 1970s, many countries discovered the existence of PRSP. And there is a serious drug-resistant "drug-resistant pneumococcus" DRSP. The incidence of drug resistance has increased rapidly since 1980s: Spain: 6% → 44%; France: 0.3% →12.4%; Mexico: 50%.
General provisions on the use of antibacterial drugs
1. Rational use of antibiotics
Choose appropriate antibiotics with clear indications, kill pathogenic bacteria with appropriate dosage and course of treatment, and control infection. At the same time, various corresponding measures are taken to enhance the immunity of patients, prevent adverse reactions, and especially avoid bacterial drug resistance.
2. Various aspects of irrational use of antibiotics:
Choose drugs that are ineffective and ineffective against pathogens or infections; Insufficient or excessive quantity; Continue to use drugs after the pathogenic bacteria develop drug resistance; Stop taking drugs prematurely or the infection has been controlled for many days without stopping taking drugs in time; No other effective drugs were used in the double infection of drug-resistant bacteria; Incorrect route of administration; Continue to take medicine when severe or allergic reactions occur; Improper combined use of antibiotics; Rely on the antibacterial effect of antibiotics and ignore the necessary surgical treatment; Preventive medication with no indication or weak indication; Ignore the efficiency/price ratio.
Three. Problems involved in rational drug use:
Indications of antibiotics and combination drugs; Pharmacokinetics and pharmacodynamics of antibiotics; Experience in anti-infective drugs; Dosage, course of treatment and administration method of antibiotics; Adverse reactions of antibiotics and their prevention: changes and prevention of bacterial drug resistance; The application of antibiotics under special circumstances and so on.
4. The basic principles of antibiotic application:
1. Early establishment of etiological diagnosis of infectious diseases.
2. Be familiar with the indications, antibacterial activity, pharmacokinetics and adverse reactions of the selected drugs.
3. According to the patient's physiology, pathology, immune status, rational drug use.
4. Rational use of commonly used antibiotics.
5. Choose the appropriate administration scheme, dosage and treatment course.
6. The application of antibiotics should be strictly controlled or avoided as far as possible under the following circumstances: preventive medication, medication in the face plate and mucosal area; The cause of virus infection or fever is unknown; Combined with antibacterial drugs.
7. Emphasize the importance of comprehensive management measures;
Verb (abbreviation of verb) Empirical application of antibiotics;
When the pathogen is unknown, it is very important to use antibiotics early for empirical anti-infection treatment. Choose broad-spectrum antibiotics and try to choose fungicides; Severe infections are often combined with drugs, and commonly used fungicides are β-lactams, aminoglycosides, fluoroquinolones, peptides and so on. In specific infections: sulfonamides, clindamycin, metronidazole and rifampicin are widely used. In the empirical application of antibiotics, we should judge the possible pathogenic bacteria according to clinical data and choose antibiotics. Different kinds of broad-spectrum antibacterial drugs have different antibacterial activities, so antibiotics should be selected according to indications, antibacterial activities and drug resistance changes.