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I. Penicillins

Penicillin can be divided into: narrow-spectrum penicillin, penicillin-resistant penicillin, broad-spectrum penicillin against Enterobacter, and broad-spectrum penicillin against Pseudomonas aeruginosa.

Narrow-spectrum penicillin: penicillin G, procaine penicillin, benzathine penicillin, penicillin V, etc., mainly acting on penicillin of Gram-positive bacteria

Penicillin-resistant penicillin: oxacillin, cloxacillin, flucloxacillin, etc., antibacterial spectrum similar to narrow-spectrum penicillin, but the antibacterial effect is poor, sensitive to penicillin-resistant staphylococci due to enzyme production, but methicillin Staphylococcus aureus is resistant to this class of drugs.

Anti-Enterobacteriaceae broad-spectrum penicillin: ampicillin, amoxicillin, etc., have antibacterial activity against some Enterobacteriaceae bacteria.

Anti-Pseudomonas aeruginosa broad-spectrum penicillin: piperacillin, azlocillin, mezlocillin, ticarcillin, etc., has antibacterial activity against most Gram-negative bacilli including Pseudomonas aeruginosa.

 

II. Cephalosporins

The first generation of cephalosporin: mainly acts on aerobic Gram-positive cocci, only has a certain antibacterial activity against a few Gram-negative bacilli; commonly used injections are cefazolin, cefradine, etc. Oral preparations include cephradine, cephalexin and cefotaxime. Ampicillin and the like.

Second-generation cephalosporins: The activity against Gram-positive cocci is similar or slightly worse than that of the first generation, and also has antibacterial activity against some Gram-negative bacilli.
The injections include cefuroxime and cefotiam. The oral preparations include cefaclor, cefuroxime axetil and cefprozil.

The cephalosporins: cefoxitin, cefmetazole, cefminox, etc., the antibacterial spectrum and antibacterial effect are similar to the second generation cephalosporins, but the antibacterial activity against anaerobic bacteria such as Bacteroides fragilis is stronger than that of cephalosporins.

The third-generation cephalosporin has strong antibacterial activity against Gram-negative bacilli such as Enterobacteriaceae, and ceftazidime and cefoperazone also have strong antibacterial activity against Pseudomonas aeruginosa.
The injection varieties are cefotaxime, ceftriaxone, ceftazidime, cefoperazone and the like.
Oral varieties include cefixime and cefpodoxime, and oral varieties have no effect on Pseudomonas aeruginosa.

The fourth-generation cephalosporin: commonly used as cefepime, the effect on Enterobacteriaceae is similar to the third-generation cephalosporin, the effect on Pseudomonas aeruginosa is similar to that of ceftazidime, and the effect on Gram-positive cocci The third generation cephalosporin is slightly stronger.

 

III. Carbapenems

Carbapenems have strong antibacterial activity against various Gram-positive cocci, Gram-negative bacilli (including Pseudomonas aeruginosa, Acinetobacter spp.) and most anaerobic bacteria, and are highly stable to most β-lactamases. However, the antibacterial effects on methicillin-resistant Staphylococcus and Stenotrophomonas maltophilia are poor.

 

IV. Monocyclic β-lactams

The current variety is aztreonam. It has good antibacterial activity against aerobic Gram-negative bacteria such as Enterobacteriaceae bacteria and Pseudomonas aeruginosa, and has no antibacterial activity against aerobic Gram-positive bacteria and anaerobic bacteria. These drugs have low nephrotoxicity.

 

V. Aminoglycosides

Streptomycin, kanamycin: has good antibacterial activity against Enterobacteriaceae and Staphylococcus bacteria, but has no effect on Pseudomonas aeruginosa.

Gentamicin, tobramycin, netilmicin, amikacin, isepamicin, small nomitellin, etimicin: Gram-negative against Enterobacteriaceae and Pseudomonas aeruginosa Bacillus has strong antibacterial activity and also has a good effect on Staphylococcus.

 

VI. Lincosamide lincosamide

Lincomycin and clindamycin have good antibacterial activity against Gram-positive bacteria and anaerobic bacteria. Currently, bacteria such as Streptococcus pneumoniae have high resistance to them.

 

VII. Glycopeptides

Vancomycin, norvancomycin and teicoplanin: all glycopeptide antibacterials are active against Gram-positive bacteria, including methicillin-resistant Staphylococcus, Enterococcus, Listeria, and chain Cocci, Clostridium, and the like.

 

VIII. Fluoroquinolones

Levofloxacin and moxifloxacin: strong effect on intracellular pathogens or anaerobic bacteria such as Gram-positive cocci, Chlamydia, Mycoplasma, Legionella, etc., such as Streptococcus pneumoniae and Group A hemolytic streptococcus.

Ciprofloxacin and levofloxacin are mainly suitable for lower respiratory tract infections caused by Gram-negative bacilli such as Klebsiella pneumoniae, Enterobacter, and Pseudomonas.

 

IX. Macrolides

Macrolides: have antibacterial activity against Gram-positive bacteria, anaerobic bacteria, mycoplasma and chlamydia. The new macrolides such as azithromycin, clarithromycin, and roxithromycin have enhanced antimicrobial activity against Haemophilus influenzae, Mycoplasma pneumoniae, or Chlamydia pneumoniae.

 

X. Tetracycline

Tetracycline, chlortetracycline, doxycycline, metacycline and minocycline: broad-spectrum antibacterial activity against Staphylococcus, Streptococcus, Enterobacteriaceae (Escherichia coli, Klebsiella) ), Acinetobacter, Stenotrophomonas maltophilia, etc. have antibacterial activity and have good antibacterial activity against Brucella.

 

XI. Nitroimidazoles

Nitroimidazoles include metronidazole, tinidazole and ornidazole, and have high antibacterial activity against anaerobic bacteria such as Bacteroides, Fusobacterium, Prevobacterium, and Clostridium. Protozoa such as amoeba and Giardia lamblia also have good activity.

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