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Transcript
THERAPY FOR ANAEROBIC INFECTIONS Tissue necrosis and abscess formation are often seen in anaerobic infections. Drainage and debridement together with an antibiotic are often used. THERAPY FOR ANAEROBIC INFECTIONS For infections above the diaphragmpenicillin G is often used. Infections below the diaphragmclindamycin, metronidazole or chloramphenicol. Anaerobic CNS infectionschloramphenicol or metronidazole. THERAPY FOR ANAEROBIC INFECTIONS For some infections combinations of antibiotics are needed to cover both anaerobic and aerobic organisms. THERAPY FOR ANAEROBIC INFECTIONS The treatment of anaerobic infections must be individualized taking into account the site, type, extent , and severity of the infection as well as the patients’ condition. METRONIDAZOLE Nitroimidazole derivative. Introduced in 1959 as an antiparasitic agent. Unique agent having activity vs both bacterial and parasitic infections. ANTIBACTERIAL ACTIVITY Bactericidal against most gram negative and gram-positive anaerobes including Bacteroides, Prevotella and Clostridia. PHARMACOKINETICS Rapidly and completely absorbed from the GI tract. IV for serious bacterial infections. Widely distributed throughout the body including the CNS. PHARMACOKINETICS Metabolized by the liver. Renal excretion is the major route of elimination from the body (mostly as metabolites). THERAPEUTIC INDICATIONS Drug of choice for trichomoniasis, amebiasis and giardiasis THERAPEUTIC INDICATIONS For anaerobic infections it is the drug of choice or an alternative to clindamycin, certain beta-lactams and chloramphenicol. Many of these are mixed aerobic anaerobic infections so it must be combined with aerobic agents. THERAPEUTIC INDICATIONS Endocarditis caused by B.fragilis. Meningitis or brain abscess caused by B.fragilis. Prophylaxis in surgical operations where risk is high. B.fragilis infections resistant to other drugs. THERAPEUTIC INDICATIONS Intra-abdominal infections. Anaerobic infections of the bone, joints or soft tissue. THERAPEUTIC INDICATIONS Antibiotic associated pseudomembranous colitis (AAPMC). CONTRAINDICATIONS AND PRECAUTIONS Pregnancy. DRUG INTERACTIONS Alcohol. Warfarin.