Mechanisms and Classification of Antibiotics (Antibiotics - Lecture 3)

[@StrongMed]

Errata: @9:00 Aminopenicillins are NOT penicillinase-resistant penicillins. @15:52 As pointed out by a viewer, there should be a negative sign next to MSSA (at least here in the United States) due to the high rates of penicillinase production in Staph aureus. For example, MSSA is ~20% sensitive to PCN among patients at both Stanford and San Francisco General, which is definitely low enough to be considered inadequate. This may be different in other parts of the world.

[@Thevince92]

Thank You

[@黃紹閔]

ps. in 14:40 MSSA is resistant to natural PCN

[@ysk249]

I've discovered this video in 2013 during the residency and I still believe this is the best lecture on antibiotics on KZbin to this date. The picture at 07:50 is very helpful for organizing different classes of antibiotics.

[@chau-kuenchan4730]

Hi! [I'm referring to 9:00/24:20.] Indeed, Aminopenicillins are NOT referred to as the penicillinase-resistant penicillins. They DO NOT resist beta-lactamases. I'm sorry to point it out, but some viewers may get the wrong message, which can be a serious issue. Apart from this, the lecture is good! Concise and clear!

[@StrongMed]

+Chau-kuen Chan Ugh. I can't believe that mistake has been there for almost 3 years... thanks for pointing it out. I've added an annotation correcting it.

[@N2CAGE]

I’m a pharmacist and your lecture has done a good reversion....,excellent 👏🏼

[@antoniopeixotoii9865]

I've never seen such a concise and effective approach to antibiotics, congratulations for your content sir!

[@pattyphelps2188]

I am a first year nursing student and this has helped more than you can know thank you so much

[@StrongMed]

Sounds good. Thanks for the feedback. After more videos get posted, I'll create some playlists for specific organ systems.

[@allthewaynatural6695]

This is helping me prepare for an interview I have coming up this week as a Supervisor in a Microbiology lab testing CRE INFECTIONS AND N. Gonorrhoeae surveillance project. Thank you for breaking it down in a clear way that is understandable. I found this to be a very helpful video to refer to.

[@doctor9963]

Carry on... Love from indian doctor

[@drarpitsaha9697]

I am resident of ICU from India...Sir,ur lectures of antibiotics really helps me lot..i n one word sir, u r awesome...thank u very much...thnx a lot for ur video

[@StrongMed]

Hari, I'm glad you are enjoying them. Regarding organizing the lectures into systems, do you mean the antibiotic lectures specifically, or all of them? If the former, I'm going to post some more videos in the next couple of days organized by type of pathogen (e.g. gram positives, negatives, anaerobes, etc...), and have a few supplemental lectures at the end of the antibiotic series on high-frequency sites of infection (e.g. lung, skin/soft tissue, GU tract, etc...)

[@genieocay612]

You are a very good teacher & doctor. You have exponentially help a lot of people over the world with your very clear and simplified lectures.

[@jonnyunited]

Thanks!

[@FabianRWhite]

Incredible lecture. Possibly the best one I've seen on antibiotics. Thank you.

[@lamerebill]

Thank you for your lectures and for including photos of the three scientists who won the Nobel Prize for antibiotics here, especially Chain. His kind, averted eyes seem so humble. I am glad he came to UK in 1933 and did not die in the camps like his mother and sister and undoubtedly like so many brilliant minds whose innovations we will never know.

[@StrongMed]

It's true that beta lactam antibiotics are generally bactericidal. They not only inhibit new cell wall formation, they also trigger autodigestion of previously formed peptidoglycans in the cell wall, which eventually leads to cell lysis. There are a couple of unsual circumstances when they act more bacteriostatic, but these are rare exceptions.

[@afarmboy76]

Thanks so much for these amazingly clear & succinct vids! I'm in the PA program at Stanford right now and can't thank you enough... really.

[@maudeisabelle1182]

Thanks so much! This series of lectures is so helpful. I was really looking for a good approach to learn antibiotics and have finally found it!

[@diveshpatel915]

This course is very important for me I appreciate your hard work sir keep it up sir thaku

[@c3811273]

Excellent presentation, well delivered, straight to the point, good voice and enthusiastic. Thank you

[@nishatanwar1590]

uitimate lecture ,everything is presented in a concise and crystal clear manner. It is easy to understand and all the important pont is covered without any excess.I give it 5 star.

[@rahisadik6345]

❤ very concised lecture.. Thanks a lot

[@dvmsharifi]

Dear Dr.Drericstrong Thanks a lot from your helpful video you have download it to KZbin and share it to all that the student can used it. I am A student bacteriology and this kind of video can help me a lot i am from Afghanistan but because in Afghanistan we dont have the master degree i have to continue in Iran so this can help me. thanks

[@joliescoldbeans29]

This was fantastic, thank you for making it. Coming to the end of 4th med school year, approaching exams, I've realised that I don't really understand how antibiotics relate to each other, and I therefore have trouble remembering when to use them. This was very useful for helping me organise all the names I keep hearing, thank you so much!

[@StrongMed]

Jolie Miller Glad you found it helpful. Loved the cover of I See Fire!

[@mauritiandoc2584]

Omgggggggggggggggg that's THE REASOn why am here

[@zeezeebo]

I'm becoming a better nurse by watching your videos. Pl keep uploading them. Thank you!!!

[@itsLannoh]

enjoying the lecture 11 years later😆Thanks alot

[@LD-tc4jp]

thanks for the concise & helpful review!

[@HariKishore87]

i appreciate ur efforts to help the medical students all over the world .......good work ..DrErck. it would be more useful if the lectures are system wise organised(like cvs , cns.. etc)

[@bn9891]

Thank you so much for these truly wonderful videos sir. Id really like to appreciate the immense effort you have taken to research and put together this data along with the great slides and animations

[@okothamsonwokorach9]

THANKS for educating the world. Personally I have benefitted a lot.

[@othoncezar]

Thanx for the video, it helped me to present my individual work in the Uni about antibiotics

[@Rhodah_Musonda]

I'm doing my presentation on antibiotics this wednesday,fingures crossed and I'm so glad i came upon this video cause I've been having trouble remembering them all (classes and mechanism of action and what note

[@shashikantreddy9376]

Amazing sir..thank you so much for nice tables

[@بلالغانم-ز6ز]

Thanks broooo i'd liked your style in learning&explication

[@hema11901]

اللهم علمنا ما ينفعنا وانفعنا بما علمتنا وذدنا علما يا كريم اللهم امين

[@tiffanyhyman5227]

Great Video, which helps me in my understanding of Antibiotics.

[@vishnuviswaroopan3693]

thank you ................incredible teaching

[@Testango]

i have no words to express my gratitude for You, Professor Strong!

[@ajeminadouglas6400]

This video really helped me to prepare for my microbiology quiz...........thanks alot

[@lehu8529]

22:35 What's the mechanism of synergy when using aminoglycosides in combination with beta-lactams or vancomycin?

[@MrTiwarygunda]

Faropenem available in oral form . What are its coverage that make it different from rest 3 of the..

[@StrongMed]

If it's the later, there are a couple of playlists on the main channel (e.g. antibiotics, EKGs, ABGs, cardiac auscultation, etc...). Hopefully, the playlists will seem more robust once I have posted more videos.

[@noornaushu4546]

so very thankful to you sir. enjoyed watching. please upload more videos of different types of drug classifications like antivirals, anticancer, etc

[@mutelarsorhougbe4606]

So good, thank you!

[@zkiller67]

Awesome Lecture! I spent time looking for videos and luckily I found this one. Thanks!

[@pratishsharma]

very nice presentation...thanks for such informative videos.

[@D007user]

Very nice information & It is the best review

[@howtomedicalvideos6597]

Great video, thank you

[@brianmi2380]

Thank you! That helped clear it up very well! Your videos have helped me a lot in my research.

[@sunitadantare4443]

Lecture 1and 2,where i will get these?

[@tessatharakan3568]

Superb..clear and concise...It would be very helpful if you have antiviral,antifungal,antiparasitic drug presentations too

[@StrongMed]

Thanks. An antifungal video is already in the works and hopefully will be posted soon. Antivirals and antiparasitic drugs will be a bit further down the road.

[@HafizahHoshni]

Awesomely informative and perfectly explained! Thank you so much! 😊😊 17/3/2019

[@StrongMed]

afarmboy76, I'm glad you've found them helpful. It's always great to hear from a fellow member of the Stanford community on here!

[@mohammedaltamimi4315]

Very Good

[@realmedicine9972]

Great lecture.find it really helpful .Antibiotic no doubt are miracle and life saving drugs but because we doctor sometime miss used over used and abused them bugs are becoming resistant.i am an antibiotic steward and i hope all of you are too.please upload a lecture on selection of appropriate antibiotic treatment with system based guideline it will be very helpful thanks in antecepation

[@danypetrix]

I love you videos !!!! easy to understand, thorough explanation !!! you made my day :) keep it up!!

[@alyssachevalier1988]

I am currently watching all of your lectures as part of my FNP coursework. They are excellent and very easy to follow! I am wondering if there is a link to just the powerpoints so I can download those for the useful tables and images. Thank you so much!

[@StrongMed]

kzbin.info/www/bejne/n3vMhnV8qNuXqsk

[@brianmi2380]

I have other sources saying beta-lactam antibiotics are bactericidal agents. Though they do interfere with cell wall synthesis and inhibit peptidoglycan polymerization, it is said the pressure differential and the weakened cell walls cause the bacteria to explode. So I am confused whether beta-lactam antibiotics are bacteriostatic or bactericidal.

[@ravipandey9215]

Thanx sir for your lectures...may god bless you...once again thanx

[@StrongMed]

Thanks! I hope u r enjoying the videos! For the most part, my slides are created in Powerpoint. Simple diagrams/illustrations are drawn right in Powerpoint, while I use Adobe Creative Suite for the most complicated stuff. Slides are exported from Powerpoint as jpgs & imported into Adobe Premiere, where it is synched with narration that I've recorded in Audacity. There are certainly quicker workflows that can produce something superficially similar, but I find this one affords more control.

[@nemodot]

Great review on the main antimicrobials. Thanks a lot.

[@geoffreykibuga7028]

An excellent presentation

[@aymanelsamany9829]

thanks dr eric , i cant wait ti finish the series

[@fairuzastevenson9896]

Thank you

[@clemencetshinga-mabudi4311]

I like the subject I just learned It, this week very good.

[@rhcorr]

This was actually very good

[@aswanikumar24]

very useful,,,GOD BLESS U SIR...

[@HariKishore87]

thank u for the reply .. a system at one place for example cvs playlist with content of some imp topics like ekg, heart failure,hypertension ...etc i know its not a one day work ...it would take some time to get in to shape as u already said...but i wanted to share my views as Ur subscriber..thank u doc !!

[@shelleyaurand4779]

This is sooooo extremely helpful! Thank you so much!!!

[@AnitaKumari-sc2dc]

very comprehensive n useful ...thank u ....

[@mukeshsuthar5207]

Awesome sir great information

[@MAlMahrous]

Thank you Eric. very useful talk.

[@mandmaq]

Great lecture. Thanks doc!

[@ierax29]

I'm quite curious to know why a large share of people never mention membrane-disrupting antibiotics, is there any particular reason for this ?

[@RicardoPerez-vt1sq]

Does the glycopeptide antibiotics as the vancomycin enter the group of the inhibitors of the cell wall??

[@xoxobeauty4341]

Thanks it helped with primary school project

[@avgjoeyd]

Thank you! Very helpful presentation.

[@lilitbabajanyan7783]

Thank you! A very good lecture!

[@ralph9563]

I have a question for you. Last week I had a tooth infection they gave me one bottle of Antibiotics for 10 days. Those are finished. Then this week I had to get same tooth extracted then they gave me another bottle to take so my gums can heal. Is it ok to take ANOTHER bottle after I just finished a bottle?

[@StrongMed]

+ralph9563 I can't offer specific medical advice here, but it's not uncommon to receive multiple courses of antibiotics right after one another, though, you should be sure to understand why that's being done. Possible explanations: the infection improved but hadn't resolved completely so the antibiotic duration needed to be extended; the original infection resolved but you developed another site of infection that needs to be treated separately; or the original antibiotic was ineffective against the infection (based upon either a lack of clinical response, or testing showing that the bacteria is resistant to the antibiotic). What can sometimes happen (which does NOT sound like is your case, but talk to your dentist if you are unsure) is that a doctor can keep throwing different antibiotics at a problem, to see none of them have any effect, only to learn weeks (or months) later that the problem isn't even infectious in origin.

[@ralph9563]

+Strong Medicine I think the Antibiotic did its job it's just the tooth couldn't be saved. But when I think about it both bottles are for 2 different reasons. The first bottle was so the infection won't get worst. The second bottle was for healing after the tooth has been extracted. Thanks for the info.

[@nellyhoffman6194]

Amazing lecture ! God blesss you !

[@claireplymouth3326]

Hi. What's your reference for the generations of Cephalosporins?

[@houzhienyong239]

Thank you for the wonderful video!

[@ATNye]

Thank you for the great lectures.

[@GAURAVKUMAR-mq9vl]

thanx man. u r just f***in genius. upload more videos nd abt antibiotic resistance

[@StrongMed]

Thanks for watching and for the feedback! Lecture 9 from this series is all about antibiotic resistance.

[@isabellagracacamara8650]

Thank you! The video was very helpful!

[@Wowhondor]

I am confused by aminoglycosides. In my book they are refereed to as bactericidal, yet they are said to inhibit protein synthesis. Can they be both? Also, I was told by my teacher that vancomycins are NOT aminoglycosides even though everywhere I look says that they are. Any idea?

[@Drhazaa]

thank you for this ppt. video

[@victoriaaginova3198]

Dear Eric! I like yours lectures very much. There are very clear and easy. Pictures and tables are great. I'm teacher of medicine microbiology from Russia. What books do you use? I would like to get links, if it possible. Thank you so much for these videos. It's really helpful for me. I would hope to cooperate with you. There are you from? With respect, Victoria

[@StrongMed]

Victoria, thanks for your feedback. I always love to hear from other educators! One of the reasons I chose to cover antibiotics relatively early in the life of this KZbin channel is because I was dissatisfied with the options already available that students had to learn the material. Existing textbooks or other videos were either not clinically relevant enough, or were too superficial. The resource for these videos was largely a combination of UpToDate (www.uptodate.com - paid subscription required), primary literature, guidelines from the Infectious Diseases Society of America (www.idsociety.org/IDSA_Practice_Guidelines/) and informal consultation with several ID docs here at Stanford University. I also referred to the Sanford Guide to Antimicrobial Therapy (www.sanfordguide.com/) for organism-specific or disease-specific antibiotic recommendations.

[@Zillybunny]

Hello Eric, I am writing a major essay on the topic of antibiotic resistant bacteria and would like to be able to source this. In order to be able to do this I would like to know which sources you have used for reliability :) //Lisa

[@StrongMed]

+Zillybunny The most used sources for the antibiotic series as a whole were the Sanford Guide to Antimicrobial Therapy (42nd ed. from 2012), numerous articles from www.UpToDate.com, personal knowledge, and informal conversations with infectious disease experts at my home institution (I understand that they are not very citable). Other resources include 50+ primary papers from the literature on specific issues/topics, which honestly would take a lot of time to dig up from my old, currently nonfunctional computer. In general, the videos are intended to be more of an educational tool than scholarly publications, so I usually don't document sources for information that I would consider a part of general medical knowledge (e.g. the resistance mechanisms seen with specific antibiotics, common side effect of antibiotics, classification of bacteria, etc...), and usually only carefully cite specific statistics or borrowed graphs/tables.

[@ВікаСабадош]

Excuse, but in video you say that cephalosporines do not influence enterococcus, but in Pharm. Encyclopedia we have the contrary...

[@abousetita]

Wonderful presentation How can l get handout of this lectures?

[@rajeshghanta99]

I missed this information all these days!!!!!!!!

[@shriswamiramanand]

veyr helpful..thank you.. espcially from 14:30..

[@mickhaelagill7691]

Hi! I'm currently in medical school and I love your video lectures. I just was wondering like an appropriate site you would suggest to do practice questions from. Your suggestion would truly be appreciated.

[@StrongMed]

I don't know where you are from, but here in the US, most students use a service called USMLE World (a.k.a. "uworld") for practice questions. Unfortunately, it's a subscription service and not cheap.

[@tariqhassan7306]

This is just fentastic..

[@KaraManning]

this video is fantastic thank you!

[@jittu2009]

great work keep it up

[@rehammahmoud3027]

very useful video thanks alot

[@mahagaja]

is possible to have this presentation in PDF files

[@noornoor440]

Do u use powerpoint program to create ur slides They are awesome ^_^

[@icefirexd]

Really helped me a lot

[@babyytt69]

Good work

[@habibullahbhi8092]

Jack Ryan ok