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Use the drug that kills the bug!

Use the drug that kills the bug!. “best guess”. רבקה ברוקס מחלקת ילדים הר הצופים. BUGS: Gram positive cocci: rods: Gram negative Anaerobes “others”. DRUGS: β -latams: Aminoglycosides Azoles (metronidazole) Macrolides Others: Vancomycin Clindamycin Tetracycline

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Use the drug that kills the bug!

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  1. Use the drug that kills the bug! “best guess” רבקה ברוקס מחלקת ילדים הר הצופים

  2. BUGS: Gram positive cocci: rods: Gram negative Anaerobes “others” DRUGS: β-latams: Aminoglycosides Azoles (metronidazole) Macrolides Others: Vancomycin Clindamycin Tetracycline Chloramphenicol, quinolones, sulphonamides penicillines cephalosporines Strep A B P, staph diphth, anthrax, clost. Listeria gentamicin flagyl erythromycin

  3. BUGS: Staphylococcus auerus Pneumococcus Strep A DRUGS: β-latams Vancomycin Clindamycin Chloramphenicol על מה נדבר היום?

  4. מנגנוני פעולה של אנטיביוטיקה • פגיעה ביצירת דופן החיידק β lactams, vancomycin • פגיעה בממברנה Nystatin, fluconazole, colistin • פגיעה בסינתזת החלבונים Erythromycin, aminoglycosides (Gentamicin), Clindamycin Chloramphenicol, tetracycline, linezolid • פגיעה במטבוליזם חומצות נוקלאיות Metronidazole, quinolones, rifampicin, sulphonamides

  5. מנגנוני פעולה של אנטיביוטיקה - המשך Bacteriocidal β lactams, aminoglycosides, rifampicin Bacteriostatic Sulphonamides, Erythromycin, Clindamycin tetracyclines, chloramphenicol

  6. β lactams Penicillin Penicillins: 1. Narrow spectrum: : gram +(Strep A,B & P),meningo, anaer above diaph Cloxacillin(Orbenin):Staph aurus(β lactam pos = MSSA) 2. Broad spectrum: Ampicillin/Amoxycillin(Moxypen) above & some gram-: Haemoph (60%) 3. Clavulunic acid(Augmentin = C.A + Amoxycillin) above & beta lactamase (Haemoph 100%,Moraxela)& anaerobes Cephalosporines:Staph Strep gram - pseudomonas I (Cefazolin) II (Cefuroxime) III Ceftriaxone Ceftazidime beta-lactamase

  7. Pneumococcus X Β-lactamase penicillin PBP (Penicillin binding proteins) עמידות חלקית Penicillin high-dose PBP (Penicillin binding proteins) עמידות מלאה Vancomycin

  8. Vancomycin • Against cocci

  9. Strep A Tonsillitis, Pneumonia, Sinusitis impetigo Invasive Strep A "החיידק הטורף" Penicillin דופן Penicillin + Clindamycin exotoxins

  10. Clindamycin נגד: • Gram positive and anearobes (not against gram negative) יתרונות • נגד טוקסינים • חדירות מצוינת: אבצסים, עצמות וכד'

  11. β lactams Penicillin Penicillins: 1. Narrow spectrum: : gram + Strep (A,B & P), meningo, anaer above diaph Cloxacillin(Orbenin): Staph aurus - β lactam pos, MSSA 2. Broad spectrum: Ampicillin/Amoxycillin(Moxypen) above & some gram-: Haemoph, E.Coli 3. Clavulunic acid(Augmentin = C.A + Amoxycillin) above & beta lactamase & anaerobes Cephalosporines: Staph Strep gram - pseudomonas I (Cefazolin) II (Cefuroxime) III Ceftriaxone Ceftazidime beta-lactamase

  12. Staphylococcus aureus penicillin MSSA Β-lactamase Cloxacillin (=Methicillin) MRSA PBP (Penicillin binding proteins) Vancomycin

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