Lincomycin clindamycin Pharmacokinetics p.o., "90% protein-bound (clindamycin) penetrate well into most tissue, including bone, but not csF (except toxoplasmic encephalitis) Metabolized in liver and excreted via bille and urine
Pharmacokinetics • p.o., ~ 90% protein-bound (Clindamycin) • penetrate well into most tissue, including bone, but not CSF (except toxoplasmic encephalitis). • Metabolized in liver and excreted via bile, and urine Lincomycin & Clindamycin
Lincomycin Clindamycin Clinical Uses severe anaerobic infection aerobic+ cocci infection(金葡菌骨髓炎) combination with pyrimethamine(乙氨嘧啶)for AIDS-related toxoplasmosis(弓形体病)&wth primaquine(伯氨喹) for pneumocystis carinii pneumonia(卡氏肺囊虫肺炎)
Clinical Uses • severe anaerobic infection • aerobic G+ cocci infection (金葡菌骨髓炎) • combination with pyrimethamine (乙氨嘧啶) for AIDS-related toxoplasmosis (弓形体病) & with primaquine (伯氨喹) for pneumocystis carinii pneumonia (卡氏肺囊虫肺炎). Lincomycin & Clindamycin
Lincomycin Clindamycin Adverse response: (gAstrointestinal effects nausea, vomiting abdominal pain diarrhea antibiotic-associated colitis is caused by toxigenic c difficile ( pseudomembranous colitis,;难辨梭状芽孢杄菌引起的伪膜性结肠 炎) Superinfection(二重感染): an infection following a previous infection, especially when caused by microorganisms that are resistant or have become resistant to the antibiotics used earlier (2)allergic reaction (impaired liver function(occasionally
Adverse response: (1)Gastrointestinal effects: • nausea, vomiting, abdominal pain, diarrhea • antibiotic-associated colitis is caused by toxigenic C difficile (pseudomembranous colitis, 难辨梭状芽孢杆菌引起的伪膜性结肠 炎). --Superinfection(二重感染)：an infection following a previous infection, especially when caused by microorganisms that are resistant or have become resistant to the antibiotics used earlier (2)allergic reaction (3)impaired liver function (occasionally) Lincomycin & Clindamycin
Vancomycins Vancomycin OH HN OH H3C Norvancomycin HO CH2OH Teicoplanin H HO、 Antibacterial activity(Narrow HH. spectrum) NHCH3 H H H bactericidal for G+ bacteria HaNC H3C HOOCH CH especially G*cocci, including MRSA&MRSE耐甲氧西林表皮葡 OH OH 萄球菌),C| ostridium difficile难 VANCOMYCIN 辨羧杆菌), Bacteroides fragilis( 脆弱拟杆菌,去甲万古)
Vancomycins - Vancomycin - Norvancomycin - Teicoplanin Antibacterial activity (Narrow spectrum) bactericidal for G+ bacteria (especially G+ ococci, including MRSA & MRSE耐甲氧西林表皮葡 萄球菌), Clostridium difficile (难 辨羧杆菌), Bacterooides fragilis ( 脆弱拟杆菌, 去甲万古)
Vancomycins Antibacterial mechanism Inhibiting cell wall synthesis by binding to the d-Ala-D-Ala terminus of nascent peptidoglycan pentapeptide
• Antibacterial Mechanism Inhibiting cell wall synthesis by binding to the D-Ala-D-Ala terminus of nascent peptidoglycan pentapeptide. Vancomycins