Post on 02-Mar-2018
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7/26/2019 Antimkrba u Basil Gr (-) & Mek.krjnya
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Curriculum Vitae
N a m a : Prof. Dr. dr. Rozaimah Zain-Hamid, MS, SpFK
Pekerjaan : * Gr !e"ar #e$ap Depar$emen Farmako%o&i dan #erape$ik,
Fak%$a" Kedok$eran, 'S', Medan * S$af Pen&ajar Pro&ram S( !iomedik ) Pro&ram dmini"$ra"i
Ke+ijakan Ke"eha$an Pro&ram S Kedok$eran,
Seko%ah Pa"a"arjana, 'S', Medan
* /aki% Ke$a Komi"i Na"iona% 0$ika Pene%i$ian Ke"eha$an1KN0PK2, 3ndone"ia
Ri4a5a$ Pendidikan:
* Dok$er 1dr2, dari Fak%$a" Kedok$eran, 'S'. Medan
* Ma&i"$er Sain" 1MS2, 3%m Kedok$eran Da"ar 16!a"i Media% Siene"72,dari Fak%$a" Pa"a"arjana, 'ni8er"i$a" 3ndone"ia, 9akar$a
* Dok$or 1Ph.D2, Farmako%o&i K%inik 16%inia% Pharmao%o&572, dari 3n"$i$$e
of Po"$-&rada$ed S$die", 'ni8er"i$i Sain" Ma%a5"ia, Ma%a5"ia
* Spe"ia%i" Farmako%o&i K%inik 1Sp.FK2, dari De4an Peni%ai Kepakaran
Per"a$an Dok$er h%i Farmako%o&i K%inik 3ndone"ia 1P0RDFK32 P"a$,
9akar$a.
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R;Z3MH Z3N-HM3D
Depar$emen Farmako%o&i dan #erape$ik
Fak%$a" Kedok$eran
'ni8er"i$a" 3"%am Sma$era '$ara
ANTIMIKROBA UNTUK BASIL GRAM (-)
DANMEKANISME KERJANYA
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Pemi%ihan an$imikro+a "eara empirik
n$k infek"i +ak$eri Gram 1-2
Kman pa$o&en n$imikro+api%ihan 3
n$imikro+aa%$erna$if
o%iform:
E.coli,Klebsiella,Proteus
mino&%5o"ide
epha%o"porin&enera"i
#MP-SMZ,
Pn "p$rm %a"iprof%o
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Pemi%ihan an$imikro+a "eara empirik
n$k infek"i +ak$eri Gram 1-2
Kman pa$o&en n$imikro+api%ihan 3
n$imikro+aa%$erna$if
Salmonella #MP-SMZ,
iprof%o
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Pemi%ihan an$imikro+a "eara empirik
n$k infek"i +ak$eri Gram 1-2
Kman pa$o&en n$imikro+api%ihan 3
n$imikro+aa%$erna$if
Vibrio"p #e$ra5%ine,
#MP-SMZ
iprof%o
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Pemi%ihan an$imikro+a "eara empirik
n$k infek"i +ak$eri Gram 1-2
Kman pa$o&en n$imikro+a
pi%ihan 3
n$imikro+a
a%$erna$if
Pseudomonaspseudomallei
1me%iodo"i"2
Pseudomonas
mallei1&%ander"2
#e$ra5%ine h%7amphenio%
Zain-Hamid, R Depar$emen Farmako%o&i ) #erape$ik FK-'3S'.
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Pemi%ihan an$imikro+a "eara empirik
n$k infek"i +ak$eri Gram 1-2
Kman pa$o&en n$imikro+api%ihan 3
n$imikro+aa%$erna$if
Helicobacter"p Me$ronidazo%e mo
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n$imikro+a:!ak$eri Gram 1-2
Penii%%in, ampii%%in, amo
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n$imikro+a:!ak$eri Gram 1-2
Zain-Hamid, R Depar$emen Farmako%o&i ) #erape$ik FK-'3S'.
F%oro=ino%one
h%oramphenio%
0r5$hrom5in, %ari$hrom5in
Me$ronidazo%e
iprof%o
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N#3M3KR;!G;A;NGN P0N33AA3N
Zain-Hamid, R Depar$emen Farmako%o&i ) #erape$ik FK-'3S'.
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Penii%%in G 1+enz5%penii%%in2:
-k$ifi$a" $erhadap +ak$eri Gram 1>2-k$ifi$a" $erhadap +ak$eri Gram 1-2 BB
-
#idak "$a+i% $erhadap a"am-C E $erika$ pro$ein
-Dir"ak o%eh -%a$ama"e
Zain-Hamid R De ar$emen Farmako%o i ) #era e$ik FK-'3S'.
!e+erapa an$imikro+a&o%on&an penii%%in
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mpii%%in 1amino+enz5%penii%%in2:-k$ifi$a" $erhadap +ak$eri Gram 1>2-
Ae+ih ak$if $erhadap +ak$eri Gram 1-2-S$a+i% $erhadap a"am
-Dir"ak o%eh -%a$ama"e 1I pn G2
!e+erapa an$imikro+a&o%on&an penii%%in
mo
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Farmakokine$ik an$imikro+a&o%on&an penii%%in
+"orp"i ora%, +er-+eda( di$en$kan
o%eh "$a+i%i$a" kea"aman ) ika$an pro$ein
paren$era%
a+"orp"i epa$ ) %en&kap
Zain-Hamid R De ar$emen Farmako%o i ) #era e$ik FK-'3S'.
Di"$ri+"i %a" ke airan $+h ) jarin&an
3ka$an pro$ein JJ o
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Farmakokine$ik an$imikro+a&o%on&an penii%%in
Zain-Hamid R De ar$emen Farmako%o i ) #era e$ik FK-'3S'.
0k"kre"i
&inja%1 E me%a%i "ekre"i $+%ar )
L E me%a%i fi%$ra"i &%omer%"2
pro+eneid men&ham+a$ "ekre"i $+%ar
pn kadar pn da%am darah )memperpanjan& 4ak$ parhn5a
Aon&-a$in& penii%%in:-proaine pn G
-+enza$hine pn
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Spek$rm an$imikro+a&o%on&an penii%%in
Zain-Hamid R De ar$emen Farmako%o i ) #era e$ik FK-'3S'.
Narro4 "p$rm:-Pn @ ) G
-re"i"$en $erhadap
-%a$ama"e:
1;
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!road "pe$rm:
-ar+enii%%in, piperi%%in, $iari%%in
-re"i"$en $erhadap-%a$ama"e:
1 $iari%%in > %a8%ani aid2
Spek$rm an$imikro+a
&o%on&an penii%%in
Zain-Hamid R De ar$emen Farmako%o i ) #era e$ik FK-'3S'.
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Mekani"me kerja an$imikro+a&o%on&an penii%%in
L. !erika$an P!P" "e+a&ai re"ep$or
Zain-Hamid, R Depar$emen Farmako%o&i ) #erape$ik FK-'3S'.
. k$i8a"i enzim a$o%i$ik pada dindin& "e%
kema$ian "e% +ak$eri
(. Men&ham+a$ $ran"pep$ida"i pep$ido&%5an
men&ham+a$ "in$e"a dindin& "e%
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Mekani"me $erjadin5a re"i"$en"i$erhadap penii%%in
L. !ak$eri men&ha"i%kan -%a$ama"e
Zain-Hamid, R Depar$emen Farmako%o&i ) #erape$ik FK-'3S'.
. Permea+i%i$a" me%a%i %api"an $er%ar
+ak$eri 1- 2
(. Re"ep$or P!P 5an& "pe"ifik
o+a$ 1 - 2
O. Ga&a%n5a ak$i8a"i enzim a$o%i$ik
. Dindin& "e% +ak$eri 1-2
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0fek "ampin& an$imikro+a&o%on&an penii%%in
L.Reak"i hiper"en"i$i8i$a":S5ok anafi%a
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#ok"i"i$a" an$imikro+a&o%on&an penii%%in
Do"i" +e"ar penii%%in:Gan&&an "a%ran erna, na"ea, 8omi$", diare
1$er$ama ampii%%in ) amo
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N#3M3KR;!
G;A;NGN 0PHA;SP;R3N
Zain-Hamid, R Depar$emen Farmako%o&i ) #erape$ik FK-'3S'.
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!e+erapa an$imikro+a&o%on&an epha%o"porin
Gen L.
- efadro
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Farmakokine$ik an$imikro+a&o%on&an epha%o"porin
+"orp"i pem+erian ora% +er-+eda(:
1epha%e
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Farmakokine$ik an$imikro+a&o%on&an epha%o"porin
Pro+eneid men&ham+a$ "ekre"i $+%arpn kadar eph7"porin da%am darah )
0k"kre"i
&inja%1me%a%i fi%$ra"i &%omer%" ) "ekre"i $+%ar2
K%iren" rea$inine ( -O m%Qmeni$
1LQ( do"i"2
K%iren" rea$inine B ( m%Qmeni$1LQ do"i"2
Zain-Hamid, R Depar$emen Farmako%o&i ) #erape$ik FK-'3S'
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Spek$rm an$imikro+a&o%on&an epha%o"porin
Zain-Hamid R De ar$emen Farmako%o i ) #era e$ik FK-'3S'.
Genera"i L:-San&a$ ak$if n$k o" &ram 1>2,
kea%i en$eroo"
Genera"i (:-JJ amph dari &enera"i L +ak$eri &ram 1-2
Genera"i :
-Spek$rm %e+ih %a" dari &enera"i L ) (-dapa$ di&nakan n$k +ak$eri &ram 1-2 )
p"edomona"
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k$i8i$a" epha%o"porin &en.
!a"i% &ram 1-2H. inluen!aeKlebsiella
Enterobacter
ProteusSerratiaS.pneumoniae
". gonorrhoeae". meningitidisP.aeruginosaS.aureus
efo$a
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Mekani"me kerja an$imikro+a&o%on&an epha%o"porin
L. !erika$an P!P" "e+a&ai re"ep$or
Zain-Hamid, R Depar$emen Farmako%o&i ) #erape$ik FK-'3S'.
. k$i8a"i enzim a$o%i$ik pada dindin& "e%
kema$ian "e% +ak$eri
(. Men&ham+a$ $ran"pep$ida"i pep$ido&%5an
men&ham+a$ "in$e"a dindin& "e%
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Mekani"me $erjadin5a re"i"$en"i$erhadap epha%o"porin
L. Pene$ra"i o+a$ BBB
Zain-Hamid, R Depar$emen Farmako%o&i ) #erape$ik FK-'3S'.
. De&rada"i o+a$ o%eh -%a$ama"e
(. Re"ep$or P!P 5an& "pe"ifik
o+a$ 1 - 2
. Mn%n5a -%a$ama"e 5an& kha"
O. Ga&a%n5a ak$i8a"i enzim a$o%i$ik
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0fek "ampin& an$imikro+a&o%on&an epha%o"porin
L.Reak"i hiper"en"i$i8i$a":S5ok anafi%a
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#ok"i"i$a" an$imikro+a&o%on&an epha%o"porin
L.#ok"i"i$a" $erhadap &inja%
Zain-Hamid, R Depar$emen Farmako%o&i ) #erape$ik FK-'3S'.
(. Hipopro$rom+inemia
perdarahan1efamando%e, mo
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N#3M3KR;!
G;A;NGN #0#RA3N0
Zain-Hamid, R Depar$emen Farmako%o&i ) #erape$ik FK-'3S'.
! + $i ik +
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!e+erapa an$imikro+a&o%on&an $e$ra5%ine
Kerja "in&ka$:
- $e$ra5%ine
- o
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Farmakokine$ik an$imikro+a&o%on&an $e$ra5%ine
+"orp"i :
pem+erian ora% +er-+eda(
+"orp"i $er$ama pada "" ha%" +a&ian a$a"
+"orp"i $er&an&& ika$an den&an ka$ion
+er8a%en"i ( 1a(>, M&(>, Fe(>2, %>
da%am "", an$a"ida ) pH a%ka%i"2
Zain-Hamid, R Depar$emen Farmako%o&i ) #erape$ik FK-'3S'.
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Farmakokine$ik an$imikro+a&o%on&an $e$ra5%ine
Di"$ri+"i:
E $erika$ pada pro$ein p%a"ma$erdi"$ri+"i %a" ke +er+a&ai jarin&an dan
airan $+h, kea%i ke airan ere+ro"pina%
kadar JJ
air ma$a ) "a%i8a 1mino5%ine2dapa$ me%a%i "a4ar p%a"en$a ) S3
1+erika$an den&an a &i&i ) $%an& fe$"2
Zain-Hamid, R Depar$emen Farmako%o&i ) #erape$ik FK-'3S'
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Farmakokine$ik an$imikro+a&o%on&an $e$ra5%ine
0k"kre"i :
$er$ama me%a%i emped )fi%$ra"i &%omer%" &inja%
do
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Spek$rm an$imikro+a&o%on&an $e$ra5%ine
Pro$o$ipe an$imikro+a 6+road "pe$rm6
!ak$erio"$a$ik n$k +ak$eri &ram 1>2 ) 1-2,
+ak$eri anaero+, rike$$"ia, h%am5diae,
m5op%a"ma, pro$ozoa: ame+a
Zain-Hamid, R Depar$emen Farmako%o&i ) #erape$ik FK-'3S'
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Mekani"me kerja an$imikro+a&o%on&an $e$ra5%ine
!erika$an den&an re"ep$or
pada ni$ S ri+o"om )men&ham+a$ ika$an aminoa5%-$RN
den&an $empa$ ika$ann5a pada ri+o"om
men&ham+a$ "in$e"a pro$ein1a"am amino2
Zain-Hamid, R Depar$emen Farmako%o&i ) #erape$ik FK-'3S'
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Mekani"me $erjadin5a re"i"$en"i$erhadap $e$ra5%ine
Mekani"me $ran"por$ ak$if me%in$a"imem+ran "e% +ak$eri 1 - 2
!ak$eri 5an& re"i"$en $erhadap$e$ra5%ine, mennjkkan permea+i%i$a"
5an& pa"if $erhadap $e$ra5%ine 1 - 2
Re"i"$en"i di $ran"mi"i o%eh p%a"mid
Zain-Hamid, R Depar$emen Farmako%o&i ) #erape$ik FK-'3S'
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0fek "ampin& Q $ok"i"i$a" $e$ra5%ine
Gan&&an "a%ran erna:
na"ea, 8omi$", diare,men&&an&& f%ora norma% ""
Men&a%ami depo"i"i di $%an& ) &i&i:1per+ahan 4arna &i&i 5an& "edan& $m+h,
deformi$a" $%an&2
Sindroma Fanoni1+erkai$an den&an pen&&naan o+a$ kada%4ar"a2
a"ido"i" $+%ar rena%i", amino aidria,
a%+minria ) hipoka%emiaZain-Hamid, R Depar$emen Farmako%o&i ) #erape$ik FK-'3S'
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0fek "ampin& Q $ok"i"i$a" $e$ra5%ine
Hepa$o$ok"ik )7ho%e"$a$i jandie7
Dia+e$e" in"ipid" nefro&enik1deme%o5%ine2
Reak"i 8e"$i+%ar 1mino5%ine2
Fo$o "en"i$i8i$a"1deme%o5%ine2
Pemanjan&an 4ak$ pem+ekan darah
Zain-Hamid, R Depar$emen Farmako%o&i ) #erape$ik FK-'3S'
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N#3M3KR;!
G;A;NGN M3N;GA;S3D0
Zain-Hamid, R Depar$emen Farmako%o&i ) #erape$ik FK-'3S'.
!e+erapa an$imikro+a
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!e+erapa an$imikro+a&o%on&an amino&%5o"ide
"$rep$om5in&en$amiin
$o+ram5inamikain
ne$i%miin
kanam5inneom5in
"pe$inom5in
Zain-Hamid, R Depar$emen Farmako%o&i ) #erape$ik FK-'3S'.
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Farmakokine$ik an$imikro+a&o%on&an amino&%5o"ide
+"orp"i :
pem+erian ora% a+"orp"i "an&a$ +rk
Di"$ri+"i :
L E +erika$an den&an pro$ein p%a"ma
0k"kre"i :
$er$ama me%a%i fi%$ra"i &%omer%"
Zain-Hamid, R Depar$emen Farmako%o&i ) #erape$ik FK-'3S'.
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Mekani"me kerja an$imikro+a&o%on&an amino&%5o"ide
3ka$an ionik - permkaan "e% +ak$eri
Pen&am+i%an o+a$ "eara ak$ifke da%am "i$op%a"ma +ak$eri
!erika$an den&an re"ep$orpada ni$ S ri+o"om
men&ham+a$ "in$e"a pro$ein1a"am amino2
Zain-Hamid, R Depar$emen Farmako%o&i ) #erape$ik FK-'3S'
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Mekani"me $erjadin5a re"i"$en"i$erhadap amino&%5o"ide
3nak$i8a"i enzim 6p%a"mid media$ed7
;+a$ &a&a% mempene$ra"i amp%op +ak$eri
Si"$em $ran"por$ 5an& 6ener&5 dependen$7
1 - 2
6Ri+o"oma% re"i"$ane7
Zain-Hamid, R Depar$emen Farmako%o&i ) #erape$ik FK-'3S'
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0fek "ampin& Q $ok"i"i$a" amino&%5o"ide
Nefro$ok"ik ) o$o$ok"ik
1o$o$ok"i$a" +er"ifa$ mene$ap2
Zain-Hamid, R Depar$emen Farmako%o&i ) #erape$ik FK-'3S'
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N#3M3KR;!
G;A;NGN HA;RMPH0N3;A
Chl h i l
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Dii"o%a"i dari Streptom$ces %ene!uelae
Kri"$a% $ak +er4arna +era"a pahi$
San&a$ %ar$ da%am a%koho%,
kran& %ar$ da%am air
#e$ap mem+erikan ak$i8i$a" an$i+ak$eri
"e%ama +e+erapa +%an,+i%a di"impan da%am %emari pendin&in )
+i%a di%indn&i dari aha5a1pada "h kamar2
Zain-Hamid R De ar$emen Farmako%o i ) #era e$ik FK-'3S'.
Chloramphenicol
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!ak$erio"$a$ik pada JJ mikroor&ani"me
!ak$eri"id den&an kadar
pada +ak$eri aero+ik1S. pneumoniae, ". meningitidis, H. inluen!ae &
Zain-Hamid R De ar$emen Farmako%o i ) #era e$ik FK-'3S'.
Chloramphenicol
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Spek$rm h%oramphenio%
Zain-Hamid R De ar$emen Farmako%o i ) #era e$ik FK-'3S'.
n$i+io$ik "pek$rm %a"
1!ak$eri Gram 1>2 Gram 1-2 aero+ anaero+2
Chlam$dia, '$coplasma, (ic)ettsiae, *reponema,
E.coli, K. pneuminiae, Proteus mirabilis,
Salmonella, Shigella
!ak$eri 5an& re"i"$en :Serratia, Proteus rettgeri, P.aeruginosa
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Farmakokine$ik h%oramphenio%
+"orp"i:1ora%2 "a%ran erna, +aik
Zain-Hamid, R Depar$emen Farmako%o&i ) #erape$ik FK-'3S'.
Di"$ri+"i:
Aa" ke airan $+h )
+er"ifa$ %ipofi%ik
"a4ar darah o$akDapa$ me%in$a"i"a4ar p%a"en$a
Di "irk%a"i, ika$an pro$ein E
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Farmakokine$ik h%oramphenio%
Me$a+o%i"me :
Se+a&ian +e"ar +er%an&"n& di hepar,
1me%a%i kon5&a"i 5an& %en&kap
den&an &%koronida2
Zain-Hamid, R Depar$emen Farmako%o&i ) #erape$ik FK-'3S'.
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Zain-Hamid R De ar$emen Farmako%o i ) #era e$ik FK-'3S'.
0k"kre"i:
Diek"kre"i ke da%am S3
Farmakokine$ik h%oramphenio%
Pada &an&&an fn&"i &inja%,
$idak diper%kan pen5e"aian do"i"
Pada &a&a% hepar do"i"
F k ki ik h% h i %
7/26/2019 Antimkrba u Basil Gr (-) & Mek.krjnya
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Zain-Hamid R De ar$emen Farmako%o i ) #era e$ik FK-'3S'.
0k"kre"i:
#LQ( : ? jamDiek"kre"i me%a%i rin
? L E da%am +en$k ak$if
1me%a%i fi%$ra"i &%omer%"
BB me%a%i emped2
? E da%am +en$k $idak ak$if
1me%a%i "ekre"i $+%ar &inja%2
Farmakokine$ik h%oramphenio%
7/26/2019 Antimkrba u Basil Gr (-) & Mek.krjnya
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Mekani"me kerja h%oramphenio%
!erika$an den&an "+ni$ OSdari TS ri+o"ome men&ham+a$ ak$i8i$a"
enzim pep$id5% $ran"fera"e
Zain-Hamid, R Depar$emen Farmako%o&i ) #erape$ik FK-'3S'.
Sin$e"a pro$ein
Men&ham+a$ "in$e"a pro$ein mi$okondria
pada "e% "m"m $%an& mama%ia
7/26/2019 Antimkrba u Basil Gr (-) & Mek.krjnya
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0fek "ampin& h%oramphenio%
L. nemia ap%a"$ik 5an& $idak+erh+n&an den&an do"i"
Zain-Hamid, R Depar$emen Farmako%o&i ) #erape$ik FK-'3S'.
Perdarahan fa$a%
Pan"i$openia den&an ap%a"$ik Q h5pop%a"$ik
"m"m $%an&
7/26/2019 Antimkrba u Basil Gr (-) & Mek.krjnya
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0fek "ampin& h%oramphenio%
(. Penekanan "m"m $%an& 5an&+erh+n&an den&an do"i"
Zain-Hamid, R Depar$emen Farmako%o&i ) #erape$ik FK-'3S'.
nemia pro&re"if
den&an kadar ferm 5an& $in&&i )re$ik%o"i$ BB
0f k i h% h i %
7/26/2019 Antimkrba u Basil Gr (-) & Mek.krjnya
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0fek "ampin& h%oramphenio%
. Gra5 "5ndrome:komp%ika"i pada +a5i prema$raki+a$ &a&a%n5a kon5&a"i o+a$
Zain-Hamid, R Depar$emen Farmako%o&i ) #erape$ik FK-'3S'.
# U JJJ ) akm%a"i o+a$
Per+ahan 4arna k%i$, pem+e"aran a+domen,
5ano"i", ke%emahan o$o$, mn$ah,
pernapa"an 5an& $ak $era$r, hipo$ermi,
ko%ap" "irk%a"i 5an& +eraki+a$ fa$a%
0f k i h% h i %
7/26/2019 Antimkrba u Basil Gr (-) & Mek.krjnya
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0fek "ampin& h%oramphenio%
. Sperinfek"i +ak$eri+S. aureus, P.aeruginosa, C.albicans&
Zain-Hamid, R Depar$emen Farmako%o&i ) #erape$ik FK-'3S'.
Ham+a$an JJJ f%ora norma% di ""
O. Gan&&an "a%ran erna ma%, mn$ah,
&an&&an pen&eapan, "$oma$i$i", &%o""i$i".Diare non-"pe"ifik aki+a$
ko%i$i" p"edomem+rano"a o%eh C.diicile
0f k i h% h i %
7/26/2019 Antimkrba u Basil Gr (-) & Mek.krjnya
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0fek "ampin& h%oramphenio%
O. Si"$em "araf
Zain-Hamid, R Depar$emen Farmako%o&i ) #erape$ik FK-'3S'.
Neri$i" perifer ) neropa$i op$a%mik
1pem+erian jan&ka %ama2
$ropi "araf op$ik" ) ke+$aan
3 $ k i + $ d h% h i %
7/26/2019 Antimkrba u Basil Gr (-) & Mek.krjnya
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3n$erak"i o+a$ den&an h%oramphenio%
Memperpanjan& #LQ( ) kadar
Zain-Hamid, R Depar$emen Farmako%o&i ) #erape$ik FK-'3S'.
Phen5$oin, $o%+$amide,
h%orpropamide, 4arfarin
h%7amphenio%men&ham+a$ ak$i8i$a" enzim miro"om ha$i
Mekani"me $erjadin5a re"i"$en"i
7/26/2019 Antimkrba u Basil Gr (-) & Mek.krjnya
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Mekani"me $erjadin5a re"i"$en"i$erhadap h%oramphenio%
Di$ran"fer me%a%i p%a"mid aki+a$diha"i%kann5a enzim
h%oramphenio% ae$5%$ran"fera"e
e$5%a"i &&" h5dro
7/26/2019 Antimkrba u Basil Gr (-) & Mek.krjnya
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N#3M3KR;!
G;A;NGN MR;A3D0
7/26/2019 Antimkrba u Basil Gr (-) & Mek.krjnya
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0r5$hrom5in
zi$hrom5in
%ari$hrom5in
Zain-Hamid R De ar$emen Farmako%o i ) #era e$ik FK-'3S'.
!e+erapa an$imikro+a&o%on&an maro%ide
7/26/2019 Antimkrba u Basil Gr (-) & Mek.krjnya
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n$imikro+a &o%on&an makro%ide
#idak %ar$ da%am air ) +era"a pahi$
Diinak$ifa"i o%eh a"am1"aa$ ini +en$k "in$e$ikn5a %e+ih $ahan a"am2
Zain-Hamid R De ar$emen Farmako%o i ) #era e$ik FK-'3S'.
Erythromycin
7/26/2019 Antimkrba u Basil Gr (-) & Mek.krjnya
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Profi% farmakokine$ik
an$imikro+a &o%on&an makro%ide
;+a$ #LQ( !ioa8ai%. 3ka$an 0%imina"i 1jam2 ora% pro$ein $ama
0r5$hrom5in L, L- O E T( E emped
zi$hrom5in - C E O E emped
%ari$hrom5in O- T O E V.. emped
Zain-Hamid, R Depar$emen Farmako%o&i ) #erape$ik FK-'3S'.
7/26/2019 Antimkrba u Basil Gr (-) & Mek.krjnya
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Farmakokine$ik er5$hrom5in
+"orp"i :
k$if da%am "a"ana a%ka%i"
1ak$i8i$a" an$imikro+ia%
pH B T.2
Dir"ak o%eh a"am %am+n&
16en$eri oa$ed72
!en$k "$eara$ ) e"$er: $ahan a"am
;ra% a+"orp"i di in$e"$inm JJJ
Zain-Hamid, R Depar$emen Farmako%o&i ) #erape$ik FK-'3S'.
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Di"$ri+"i:
#erdi"$ri+"i %a" ke +er+a&ai jarin&an,1kea%i ke jarin&an o$ak ) airan ere+ro"pina%2
Dapa$ me%in$a"i "a4ar p%a"en$a
Zain-Hamid, R Depar$emen Farmako%o&i ) #erape$ik FK-'3S'
Farmakokine$ik er5$hrom5in
F k ki $ik $h i
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0k"kre"i:
#er$ama me%a%i emped
1kadarn5a O W J darah2
Men&a%ami "irk%a"i en$erohepa$ik
O E diek"re"i me%a%i rin
# U : L- jam pada rena% 5an& +aik1# U azi$hrom5in ) %ari$hrom5in J er5$hrom5in2
Zain-Hamid, R Depar$emen Farmako%o&i ) #erape$ik FK-'3S'
Farmakokine$ik er5$hrom5in
S k$ $h i
7/26/2019 Antimkrba u Basil Gr (-) & Mek.krjnya
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Spek$rm er5$hrom5in
!ak$erio"$a$ik n$k JJJ+ak$eri &ram 1>2,
5an&re"i"$en $erhadap penii%%in
+Pneumococcus, Streptococcus, Staph$lococcus,Cor$nebacteria&
!ak$eri 5an& j&a peka:
'$coplasma, Legionella, Chlam$dia trachomatis,
Helicobacter, '$cobacterium )ansasii,
'$cobacterium scrouloceum
Zain-Hamid, R Depar$emen Farmako%o&i ) #erape$ik FK-'3S'
7/26/2019 Antimkrba u Basil Gr (-) & Mek.krjnya
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Mempene$ra"i den&an epa$
mem+ran +ak$eri ) +erika$an
den&an (S "+ni$ OS ri+o"om
Zain-Hamid, R Depar$emen Farmako%o&i ) #erape$ik FK-'3S'
Mekani"me kerja er5$hrom5in
Ham+a$an "in$e"a pro$ein
Mekani"me $erjadin5a re"i"$en"i
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Mekani"me $erjadin5a re"i"$en"i$erhadap er5$hrom5in
Me$h5%a"i re"ep$or rRN pada ni$ OS
ri+o"om di +a4ah kon$ro% p%a"mid
Re"i"$en"i "i%an& $erhadap %inom5in
Zain-Hamid, R Depar$emen Farmako%o&i ) #erape$ik FK-'3S'.
Pada kman o%iform: $ran"mi"i me%a%i
p%a"mid e"$era"e men&hidro%i"a inin
%ak$on maro%ide
0fek "ampin& er5$hrom5in
7/26/2019 Antimkrba u Basil Gr (-) & Mek.krjnya
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0fek "ampin& er5$hrom5in
L. Gan&&an "a%ran erna:1norek"ia, ma%, mn$ah, di"pep"ia,
iri$a"i %am+n&, diare2
Zain-Hamid, R Depar$emen Farmako%o&i ) #erape$ik FK-'3S'.
(. #ok"i"i$a" hepar:Kh""n5a er5$hrom5in e"$o%a$e
Hepa$i$i" ko%e"$a$ik
1demam, ik$er", &an&&an fn&"i hepar2
. Reak"i a%er&i:1demam, eo"inofi%ia, ram k%i$2
3n$erak"i o+a$ den&an er5$hrom5in
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3n$erak"i o+a$ den&an er5$hrom5in
L. 0fek an$ikoa&%an ora% ) di&o