Penicillins (cell wall synthesis inhibitors)

Penicillins

• beta lactation antibiotics/ beta lactation ring in structure

• Bactericidal

Beta lactation antibiotic resistance

• staphylococcus aureus

• Penicillinases (enzyme that breaks down the beta lactation ring) → ineffective

• Beta lactase inhibitors → bind to beta lactase’s → inactivates them

Narrow spectrum beta lactase’s susceptible medications

Penicillins G, Penicillin V

Broad spectrum beta lactase susceptible medications

Amoxicillin, ampicillin

Extended spectrum penicillins

Peperacillin, tiracillin

Very narrow spectrum beta lactase resistant medications

Methicillin, oxacillin, nafcillin, cloxacillin, dicloxacillin

Narrow spectrum beta lactase susceptible medications - effective agaisnt

• gram positive bacteria (streptococcus progenies)

• Gram negative bacteria (neisseria meningitidis)

• Spirochetes (treponema pallidum/ borrelia burgdorferi)

Broad spectrum beta lactamase susceptible medications effective against -

Hemophilia influenza, morazella catarrhalis, H. Pylori, salmonella, shigella, listeria

• category B pregnancy- no risk found (amoxicillin antibiotic of choice in pregnant women)

Extended spectrum penicillins

Piperacillin and ticarcillin

• effective against pseudomonas aeurginosa

• Susceptible to beta lactamases

Very narrow spectrum beta lactamase resistance medications effective agaisnt

Gram positive bacteria ( staphylococcus aureus)

No effective agaisnt; enterococcus, MRSA, gram negative bacteria

MRSA

• treat MRSA with glycoprotein antibiotics (vancomycin and teicoplanin)

Penicillin side effects

• GI upset (diarrhea)

• Taste disturbance

• Allergy (5-10% of patients have a reaction); cross reactivity

General antibiotic side effects

• superinfections by more resilient organisms

• Yeast infections from antibiotics destroying native flora

• Jarvis’s- Herxheimer reaction: fevers, chills, muscle pain, and flushing