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Antimikroba

BAD things or GOOD things??


The Facts!!!!
can produce desirable and undesirable responses
within the host.

Example:
normal bacteria in the gastrointestinal tract have
beneficial effects, assisting in the production of
vitamins and the breakdown of foods
The Facts!!!!
can produce desirable and undesirable responses
within the host.

Example:
Pathogenic organisms enter the body through oral
ingestion, inhalation, trauma, surgical procedures, or
any body opening, the result is an unwanted host-
pathogen response, termed an infection.
Defenisi
Antimikroba Obat pembasmi mikroba
dapat berasal dr bahan alam termasuk
mikroorganisme maupun hasil sintesis

Antibiotika Zat/senyawa yg dihasilkan


o/berbagai jenis mikroba terutama fungi yang
dpt menekan mikroba yg lain
Kapan suatu senyawa dikatakan
antimikroba????

Dihasilkan o/ organisme hidup atau hasil


sintesis, yg memiliki indeks terapi tinggi pada
dosis yang sangat rendah
Eradication Ability
Plasma Concentration of Drugs
Site of Infection
Combination
Bacterial Resistance
Broad & Narrow
Eradication Ability
Bactericidal
or Bacteriostatic

CFU = Coloning Forming Unit


Plasma Concentration of Drugs
Concentration-Dependent killing
Duration-Dependent

MIC
(Minumum Inhibit Concentration)
Site of Infection
Enter CSF When Do Not Enter CSF
Readily Enter CSF Inflammation Adequately to Treat
Present Infection
Chloramphenicol Penicillin G Cefazolin
Sulfonamides Ampicillin Cefoxitin
Trimethoprim Piperacillin Erythromycin
Rifampin Oxacillin Clindamycin
Metronidazole Nafcillin Tetracycline
Cefuroxime Gentamicin
Cefotaxime Tobramycin
Ceftriaxone Amikacin
Ceftazidime
Aztreonam
Ciprofloxacin
Vancomycin
Meropenem
Cefepime
Combination
Why???
To treat a life-threatening infection
To treat a polymicrobial infection
Empiric therapy when no one agent is active against potential
pathogens
To achieve synergy (obtain enhanced antibacterial activity)
To prevent the emergence of resistant bacteria
To permit the use of a lower dose of one of the antimicrobial
agents
Bacterial Resistance

A. Bacterial conjugation between 2 bacteria


B. Transduction with a virus
C. Pickup DNA from the environment
Bacterial Resistance

The major mechanisms of bacterial resistance


to antibiotics. These mechanisms include
A. altered receptors or targets to which the
drug cannot bind (altered PBP)
B. enhanced destruction or inactivation of
drug (-Lactamase)
C. synthesis of resistant metabolic pathways
(tetrahydrofolic acid in thymidine
synthesis)
D. a decrease in the concentration of drug
that reaches the receptors (by altered rates
of entry or removal of drug) (tetracyclin,
quinolones)
1. Berdasarkan struktur kimia
2. Berdasarkan aksi utamanya
3. Berdasarkan spektrum aktivitasnya
4. Berdasarkan tempat kerjanya
5. Berdasarkan mekanisme kerjanya
1. Antibiotik -Laktam (penisilin, sefalosporin, dan
-laktam nonklasik)
2. Turunan amfenikol
3. Turunan polipeptida
4. Aminoglikosida
5. Antibiotik makrolida
6. Antibiotik kuinolon
7. Linkosamida
8. Antibiotik polien
9. Turunan ansamisin
10. Turunan antrasiklin
Pembagian AM berdasarkan spektrum
1. AM dengan spektrum luas, efektif baik trhd gram
positif maupun gram negatif (tetrasiklin, amfenikol,
aminoglikosida, makrolida, rifampisin, turunan
penisilin (ampisilin, amoksisilin, bakampisilin,
karbanesilin, hetasilin, pivampisilin, sulbenisilin, dan
tirkasilin), dan sebagian besar turunan sefalosporin)
2. AM yang aktivitasnya lebih dominan terhadap gram
positif (basitrasin, eritromisin, sebagian besar turunan
penisilin sprt benzilpenisilin, penisilin G prokain,
penisilin V, fenetilisin K, metisilin Na, turunan
linkosamida, asam fusidat, dan beberapa turunan
sefalosporin.
3. AB yang aktivitasnya lebih dominan terhadap
bakteri gram negatif (kolkistin, polimiksin B sulfat,
dan sulfomisin)
4. AB yang aktivitasnya lebih dominan thdp
Mycobacteriae (antituberkulosis), (streptomisin,
kanamisin, sikloserin, rifampisin, viomisin, dan
kapreomisin
5. AB yang aktif terhadap jamur (antijamur),
(griseofulvin, dan antibiotik polien seperti
nistatin, amfoterisin B, dan kandisidin
6. AB yang aktif terhadap neoplasma (antikanker),
(aktinomisin, bleomisin, daunorubisin, mitomisin,
dan mitramisin
Pembagian AM berdasarkan tempat Kerja

Menghambat sintesis
Dinding peptidoglikan
Sel Ex: gol Betalaktam

Mengganggu keutuhan
Membran membran sel
sel Ex: nistatin
Pembagian AM berdasarkan tempat Kerja

Menghambat
Asam sintesis DNA, mRNA
nukleat Ex: Rifampisin

Menghambat
Ribosom sintesis protein
Ex: kloramfenikol
THaNk U
&
See u next weeK