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200 SEcTioN ii Microbiology ` microbiology—aNtimicrobials Microbiology ` microbiology—aNtimicrobials
Echinocandins Anidulafungin, caspofungin, micafungin.
mecHaNism Inhibit cell wall synthesis by inhibiting synthesis of β-glucan.
cliNical Use Invasive aspergillosis, Candida.
aDVerse eFFects GI upset, flushing (by histamine release).
Griseofulvin
mecHaNism Interferes with microtubule function; disrupts mitosis. Deposits in keratin-containing tissues (eg,
nails).
cliNical Use Oral treatment of superficial infections; inhibits growth of dermatophytes (tinea, ringworm).
aDVerse eFFects Teratogenic, carcinogenic, confusion, headaches, disulfiram-like reaction, cytochrome P-450 and
warfarin metabolism.
Antiprotozoal therapy Pyrimethamine (toxoplasmosis), suramin and melarsoprol (Trypanosoma brucei), nifurtimox
(T cruzi), sodium stibogluconate (leishmaniasis).
+
Anti-mite/louse Permethrin (inhibits Na channel deactivation neuronal membrane depolarization), malathion
therapy (acetylcholinesterase inhibitor), topical +/− oral ivermectin. Used to treat scabies (Sarcoptes
scabiei) and lice (Pediculus and Pthirus).
Chloroquine
mecHaNism Blocks detoxification of heme into hemozoin. Heme accumulates and is toxic to plasmodia.
cliNical Use Treatment of plasmodial species other than P falciparum (frequency of resistance in P falciparum
is too high). Resistance due to membrane pump that intracellular concentration of drug. Treat
P falciparum with artemether/lumefantrine or atovaquone/proguanil. For life-threatening malaria,
use quinidine in US (quinine elsewhere) or artesunate.
aDVerse eFFects Retinopathy; pruritus (especially in dark-skinned individuals).
2+
Antihelminthic Pyrantel pamoate, Ivermectin, Mebendazole (microtubule inhibitor), Praziquantel ( Ca
therapy permeability, vacuolization), Diethylcarbamazine. Helminths get PIMP’D.
FAS1_2019_03-Microbiology.indd 200 11/14/19 12:22 PM
