1. Antimicrobial Chemotherapy. Antibiotics. Drug Resistance of Bacteria Vinnitsa National Pirogov Memorial Medical University / Department of microbiology

2. Chemotherapy and chemotherapeutic agents Chemotherapy Chemotherapeutic agents Antibiotics Chemotherapeutic index

3. Development of chemotherapy  Paul Erlich found that dye Trypan Red was active against the trypanosome (causative agent of African sleeping sickness) in 1904  In 1910 P. Erlich discovered the arsenical compounds and one of their was active against the syphilis spirochete (later was called Salvarsan)  Cherhard Domagk discovered sulfonamides (red streptocide) that were effective for treatment of streptococci and staphylococci infections in 1935 (Nobel Prize in 1939)  In 1929 A.Fleming got penicillin, a first antibiotic  In 1939 penicillin was produced and purified by chemists H.Flory and E.Chain (A.Fleming, H.Flory and E.Chain received the Nobel Prize in 1945)  Selman Waksman announced in 1944 that he had found a new antibiotic streptomycin (he received Nobel Prize in 1952)

4. Chemotherapeutic Index (CTI) 

5. Classification of chemotherapeutic agents according to target (general microbial group they act against)  Antimicrobial drugs  Antiviral drugs  Antifungal drugs  Antiprotozoan drugs  Antitumoral drugs

6. Classification of chemotherapeutic agents Narrow-spectrum drugs Broad-spectrum drugs Specific-spectrum drugs (antituberculous, antiviral, etc.)

7. Classification of chemotherapeutic agents  Due to their total effect: With cidal action With static action  Due to their manufacture : Natural Semi synthetic Synthetic

8. Chemical classification of CTD  Heavy metal derivates  Sulfonamides  Diaminopyrimidins  Analogs of iso-nicotinic acid  Nitrofuran derivatives  Quinolones  Chinoxalines  Oxychinolones  Azoles  Metronidazole  Alkaloid preparations  Chinine derivate

9. Antibiotics  According to origin antibiotics are subdivided into next groups: Antibiotics produced by fungi. Antibiotics produced by actinomycetes. Antibiotics produced by bacteria Plant antibiotics (phytoncides) Animal antibiotics (lysozyme, interferons)

10. Mechanism of antibiotic action Cell wall synthesis inhibitors Protein synthesis inhibitors Cell membrane disruptors Nucleic acid synthesis inhibitors

11. Antibiotic action onto bacterial cell

12. Chemical antibiotics classification Penicillins Cephalosporins Carbapinems Monobactams Vancomycin Bacitracin Cycloserine Antitumoral antibiotics Aminoglycosides Tetracyclines Macrolides Chloramphenicol Linezolid Rifampin Polymyxin Polyenes

13. Chemical structure of β-lactams Carbapenem nucleus Monobactam nucleus Penicillin nucleusCephalosporin nucleus

14. B-lactams influence onto bacterial cell wall

15. Chemical structure of gentamicinChemical structure of a tetracycline Chemical structure of chloramphenicolChemical structure of lincomycin

16. Action of aminoglycosides onto protein synthesis

17. Determination of antimicrobial effectiveness of chemotherapeutic agents  Dilution susceptibility tests  Disk diffusion tests  E-tests  Accelerated tests

18. Broth dilution test

19. Disk diffusion test

20. Side effects of chemotherapy  Allergic response  Toxic effects  Disbacteriosis  Inhibition of immune system  Embryotoxic action  Formation of the drug resistance

21. Resistance to antimicrobial drugs  Natural  Acquired (mutation and genetic recombination)