CASE 1 Penicillin gram Some gram Neisseria Treponema

CASE 1

Penicillin gram+ Some gram- (Neisseria) Treponema pallidum (ωχρό τρεπόνημα) Beta-lactams: Penicillins, cephalosporins, monobactams, carbapenems, b-lactamase inhibitors.

Penicillins • Pneumococcus, enterococcus, N. meningitidis, syphilis, listeria, leptospirosis, αναερόβια στόματος • Penicillin G, penicillin V (p. o. ), procaine penicillin, benzathine penicillin. • Benzathine penicillin (Penadur): μακράς δράσης (κάθε 2 -4 εβδομάδες) σε σύφιλη, λοιμώδη ενδοκαρδίτιδα, πρόληψη υποτροπής οξέος ρευματικού πυρετού • Συνεργική δράση με τις αμινογλυκοσίδες • Penicillin V (Ospen)

Tazobactam Sulbactam

CASE 1 (cont)

VRE, VISA, VRSA

Τα ελάχιστα επίπεδα πρέπει να είναι τουλάχιστον 10 mg/L και τα μέγιστα 30 mg/L. - Clostridium difficile - MRSA: Methicillin Resistant Staphylococcus Aureus

Penicillinase

Vancomycin Methicillin/Oxacillin (MSSA) Penicillin MRSA Penicillinase

Teicoplanin, Linezolid, Daptomycine, Tigecycline Vancomycin Methicillin/Oxacillin (MSSA) Penicillin VRSA, VISA, VRE MRSA Penicillinase

CASE 2 Amoxicillin/Clavulanate για 7 ημέρες

MACROLIDE SPECTRUM -erythromycin-sensitive S. pneumoniae -Haemophilus spp, Moraxella catarrhalis Atypical pneumonia pathogens -Legionella pneumophila -Chlamydia pneumoniae -Mycoplasma pneumoniae Gram-negative bacteria -Escherichia coli -Salmonella spp -Yersinia enterocolitica -Shigella spp -Campylobacter jejuni -Vibrio cholerae -Neisseria gonorrhoeae -Helicobacter pylori.

CASE 2 (modified) Πρόσφατη λοίμωξη υπό Amoxicillin/clavulanate πριν 2 μήνες

CASE 3

Πολυανθεκτικότητα - Μultidrug resistance (MDR) Πανανθεκτικότητα - Panresistance Enterococcus faecium Staphylococcus aureus (MRSA) Klebsiella pneumoniae Acinetobacter baumannii Pseudomonas aeruginosa Enterobacteriaceae (Salmonella, Escherichia coli, Yersinia, Shigella)

Tygecycline, Colistin, Aztreonam Carbapenemes: Meropenem, Imipenem, ertapenem Cephalosporins III: Ceftriaxone, Ceftazidime, Cefotaxime Aminopenicillins, cephalosporins Carbapenemase (KPC) Extended Spectrum Beta Lactamases (ESBL) Β-lactamase

Αντιψευδομοναδικά • Aminoglycosides (gentamicin, amikacin, tobramycin) • Quinolones (ciprofloxacin, levofloxacin, moxifloxacin) • Cephalosporins (ceftazidime, cefepime, αλλά όχι cefuroxime, ceftriaxone, cefotaxime) • Antipseudomonal penicillins: carboxypenicillins (piperacillin, ticarcillin) • Carbapenems (meropenem, imipenem, αλλά όχι ertapenem) • Polymyxins (colistin) • Monobactams (aztreonam)

NUCLEOSIDE/NUCLEOTIDE ANALOGUES

Nucleoside analog reverse-transcriptase inhibitors Zidovudine Didanosine Zalcitabine Stavudine Lamivudine (Zeffix) (HBV) Abacavir Emtricitabine Entecavir (Baraclude) Apricitabine Acyclovir / Valacyclovir / famcyclovir * (δραστικότητα έναντι HSV 1, HSV 2, VZV) Nucleotide analog reverse-transcriptase inhibitors Tenofovir (Viread) Adefovir (Hepsera) Non-nucleoside reverse-transcriptase inhibitors Efavirenz Nevirapine Delavirdine Etravirine Rilpivirine

Integrase inhibitor: Raltegravir

Protease inhibitors

Protease inhibitors HIV/AIDS: Saquinavir, rotnavir, indinavir, nelfinavir, etc. ) Hepatitis C: Boceprevir Hepatitis C: Telaprevir

-Interferon α HBV, HCV - +polyethyleneglycol (PEG) peginterferon

Polyenes Azoles Echinocandines Amphotericin B Nystatin Imidazoles Bifonazole Butoconazole Clotrimazole Econazole Fenticonazole Isoconazole Ketoconazole Miconazole Omoconazole Oxiconazole Sertaconazole Sulconazole Tioconazole Triazoles Albaconazole Fluconazole Isavuconazole Itraconazole Posaconazole Ravuconazole Terconazole Voriconazole Thiazoles Abafungin Anidulafungin Caspofungin Micafungin

Azoles Imidazoles Bifonazole Butoconazole Clotrimazole Econazole Fenticonazole Isoconazole Ketoconazole Miconazole Omoconazole Oxiconazole Sertaconazole Sulconazole Tioconazole Triazoles Albaconazole Fluconazole (Fungustatin) Isavuconazole Itraconazole Posaconazole Ravuconazole Terconazole Voriconazole (V-fend) Thiazoles Abafungin Γενικά η βιοδιαθεσιμότητά τους δεν είναι ιδιαίτερα πρoβλέψιμη και απαιτείται παρακολούθηση των θεραπευτικών επιπέδων