Medications for the Treatment of Infections

Antibiotic vs. Antibacterial Used interchangeably Origin of antibiotic includes any antimicrobial agent Antibacterial used to treat bacterial infection

Classification of Antibacterial Drugs Chemical structure Mechanism of action Bactericidal vs. Bacteriostatic Narrow spectrum Broad spectrum

Antibacterial Agents Classification according to mechanism of action

Antimicrobial Resistance Drug resistance

Penicillins the first  -lactam antibiotic Inhibits cell wall synthesis Bactericidal The spectrum of action: –Most of the Gram-positive bacteria and Gram-negative cocci Primary uses –Urinary tract infection –Respiratory tract infection –Infections of heart –syphilis

Cephalosporins  -lactam antibiotic Inhibits cell wall synthesis Bactericidal Both gram-positive and gram-negative activity Cephalosporins are classified in generations Primary uses –Respiratory tract –Urinary tract –Bacteremia –Skin and soft tissues

Carbapenems  -lactam antibiotic Inhibits cell wall synthesis Bactericidal Broad spectrum only Primary uses –Skin –Urinary tract –Intra-abdominal –Pelvic –Pneumonia

Tetracyclines Inhibits protein synthesis Bacteriostatic Broad spectrum Adverse effects –Epigastric burning, nausea, vomiting, diarrhea, photosensitivity Primary use –RMSF –Cholera –Lyme disease –Mycoplasma pneumoniae

Macrolides Inhibits protein synthesis Bacteriostatic Adverse effects –Epigastric irritation, nausea, vomiting Primary use –Respiratory tract –Genital –GI –Skin and soft tissue

Aminoglycosides Inhibits protein synthesis Gram (-) bacteria –Urinary and respiratory tract infections –Topical - skin, eyes, ears Narrow spectrum Adverse reactions –Ototoxicity –Nephrotoxicity

Fluoroquinolones Inhibit DNA synthesis Bactericidal Broad spectrum Primary use –Urinary tract –Respiratory tract –Prostate, GI –Bones, joints, soft tissues Adverse reactions –Nausea, vomiting, headache, dizziness

Glycopeptides Inhibit cell wall synthesis Gram positive cocci Critically ill or hypersensitivity to the β- lactams Last line of defense for cases of MRSA –Vancomycin Side effects –'Red man syndrome’ –Nephrotoxicity –Neutropenia and deafness Oral and intravenous

Topical Antibacterial Agents Use is mostly prophylactic –Can treat some superficial wound infections Topicals typically contain mixture of antibacterial agents “Trainer’s trick” caring for turf burn

Antifungals 2 types –Oral used for subcutaneous and systemic mycoses –Topical used for superficial mycoses Work by disrupting fungal membrane functions If using oral form to fight tenacious infection (under nail beds), may be advised to take prior to exercise –Perspiration distributes medication Often effects areas of high moisture

Antifungals Ointments work better than powders May be combined w/ a topical corticosteroid Types

Role of Athletic Trainer Educate regarding infections Educate regarding compliance Monitor for allergies Monitor for common adverse reactions Monitor for effectiveness