16. Clindamycin. Streptogramins. Oxazolidinones

Question 1

Clindamycin

Answer 1

bacterial 50s ribosomal subunit, inhibiting translocation

Bacteristatic

• Activity against staph and strep
• treats S.Pyogenes (GAS) and soft tissue infections (cellulitis)

Activity against MRSA

-Anaerobe activity

Lung stains with holes: excellent penetration into abscesses

treats oral infections and aspiration pneumonia caused by Bacteroides fragilis

activity against clostridium perfringens

topical clindamycin treats moderate to severe inflammatory acne

Uterus Machine: clindamycin plus gentamicin (gently cleaning the uterus) treats polymicrobial female genital tract infection.

Judo practitioner with Sai: gentamicin paired with clindamycin for broad coverage

-treats bacterial vaginosis from gardenella vaginallis

causes pseudomembranous colitis caused by C.Diff

Question 2

Streptogramins

Answer 2

Streptogramins A + B​

(A= ​Dalfopristin​ | B= Q​uinupristin​)

Protein synthesis inhibitor - bind to different sites on the S50 ribosome

By themselves, streptogramins A and B are bacteriostatic.

Together bacteri​cidal.

Given in mixture of 70:30 (A:B)

• A - disrupts elongation
• B - Releases incomplete peptide chains Long PAE

-G+ive cocci (also MDR strains)
-intracellular bacteria,
E.faecium and VRE

• ​IV
• Inhibits CYP3A4

-​Infusion related phlebitis,
hyperbilirubinemia,
Arthralgia-myalgia.

Question 3

Oxazolidinones

Answer 3

Linezolid

• binds reversibly to 50s ribosome, inhibiting peptide bond formation and halting translation
• activity against gram positive bacteria (staph, strep, enterococcus)
• MRSA activity
• treats nosocomial MRSA infections (hospital acquired pneumonia)
• activity against vancomycin resistant bacterial strains
• activity against vancomycin enterococcus

Broken plates: thrombocytopenia

Cut security camera wire: optic neuropathy ( and peripheral neuropathy)

-stocking-glove peripheral neuropathy

Happy face: serotonin syndrome

(weak inhibitor of MAOI, so can cause serotonin syndrome)