Other Antimicrobial Drugs

For both the clinician and patient, an allergic reaction elicited by a p-lactam antibiotic is probably considered the archetypal drug allergy but a range of other antibiotics, both naturally occurring and semisynthetic, and a number of other antimicrobials of varied origin and nature also 

Baldo and N.H. Pham, Drug Allergy Clinical Aspects, Diagnosis, Mechanisms, Structure-Activity Relationships, DOI 10.1007/978-l-4614-7261-2 6, Springer Sdence+Business Media, LLC 2013 

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However, it should never be nsed for infections that can readily be treated with other antimicrobial drugs. Synonyms of this drng are levomycetin, amindan, aqnamycetin, Chloromycetin, ophthoclor, opnlets, lenkomycin, and many others. 

Trimethoprim (a weak base) concentrates in prostatic fluid and in vaginal fluid, which are more acidic than plasma. Therefore, it has more antibacterial activity in prostatic and vaginal fluids than many other antimicrobial drugs. 

For treatment of systemic fungal disease, amphotericin B is given by slow intravenous infusion at a dosage of 0.5-1 mg/kg/d. It is usually continued to a defined total dose (eg, 1-2 g), rather than a defined time span, as used with other antimicrobial drugs. 

Although the first antibiotics reported to cause pseudomembranous colitis were lincomycin and clindamycin, the disease was later described with all other antimicrobial drugs, even topically applied (149). Vancomycin (150) and metronidazole (151), which may be used as specific treatments, have also been implicated. 

Answer B. Erythromycin is eliminated largely via biliary excretion, and decreases in renal function do not usually require a dosage reduction unless creatinine clearance <10 mL/min, All of the other antimicrobial drugs listed are eliminated by the kidney, at rates proportional to creatinine clearance, so major dose reductions would be needed in patients with renal dysfunction to avoid toxicity. 

Historically, the development of antiviral drugs has been slow when compared with the development of other antimicrobial drugs. This was probably because the majority of viral infections are eliminated by the host s immune system. With the advent of the HIV and acquired immunodeficiency syndrome (AIDS) that follows infection with HIV, many new antiviral drugs have been introduced since the end of the 1990s. As more is known about how viruses replicate inside cells and how they affect cell function, then no doubt more antiviral dmgs will be developed. 

THERAPEUTIC USES Therapy with chloramphenicol must be limited to infections for which its benefits outweigh the risks of the potential toxicities. When other antimicrobial drugs that are equally effective and potentially less toxic are available, they should be used instead of chloramphenicol. 

Mechanisms Mupirocin is a fermentation product of Pseudomonas fluorescens and is unrelated to any other antimicrobial drug. It acts on gram-positive cocci and inhibits protein synthesis by specifically binding to isoleucyl-tRNA synthetase. 

The excellent improvement of this fever-responsive dysimmune neuropathy patient suggests that perhaps we should always treat dysimmune patients by combining anti-dysimmune and antiviral (or other antimicrobial) drugs, or one drug that does both. This concept is a putative model for future "combined anti-dysimmune plus anti-microbial therapy." And in each dysimmune patient we should always be searching for tracks of a relevant microbe."... 

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