18. Metronidazole. Fidaxomicin. Rifaximin. Urinary antiseptics. Phosphomycin Flashcards

1
Q

Fidaxomicin

A

Protein synthesis inhibitor

  • ​Inhibits RNA polymerase - disruption of transcription
  • Bacteri​cidal
  • narrow , (G+) (c.difficile)
  • Oral
  • ——————————————————————————–G​I (nausea, vomiting)
  • hypersensitivity
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2
Q

Rifaximin
(​R​ifampicin​ group)

A
  • Interacting with DNA dependent ​RNA polymerase
  • semisynthetic, rifamycin-based non-systemic antibiotic.
  • G(+) (staphylo, strepto, enterococcus)
  • G(-) (m​oderate action​ against the intestine bacteria)
  • O​ral administration does no absorb from the GI!​!
  • H​epatic encephalopathy,
  • Prophylaxis before ​colorectal surgery​,
  • Acute(noninflammatory) Enteritis​(drug of choice),
  • C​olitis
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3
Q

Urinary antiseptics

A

Methenamine
Decomposes to formaldehyde in acidic pH
(toxic for bacteria)

  • oral
  • C​hronic suppressive therapy for UTI
  • G​I distresses
  • ——————————————————————————-Nitrofurantoin

Damages bacterial DNA- reduced to highly active intermediates

-uncomplicated lower UTI
(in pregnancy, in children, in case of resistance)
———————————————————————————G​I symptoms
-hypersensitivity pulmonary reaction

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4
Q

Phosphomycin

A

Cell wall synthesis inhibitor ​

(Inhibits the first step in formation of UDP-N-acetylmuramic acid)

  • Bacteri​cidal
  • G( +) and G (-) (ESBL E.coli), E.faecalis

-oral or parenteral
(no minimal 7 days administration - maintaining concentration in the urine)

  • GI symptoms
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5
Q

Metronidazole

A

-free radical metabolites disrupt bacterial DNA
(form free radicals) Bactericidal

  • Coverage of polymicrobial anaerobic infections (intra-abdominal infections)
  • activity against Entamoeba histolytica (liver abcess)
  • activity against giardia
  • treats vaginitis and cervicitis caused by protozoal infection(treat both patient and partner)
  • treats bacterial vaginosis caused by gardenella
  • substitute for amoxicillin in the triple therapy for helicobacter pylori infection in penicillin allergic patients
  • activity against anaerobic bacteria
    (bacteroides, prevotta, fusobacterium, clostridium)
  • treats pseudomembranous colitis caused by clostridium
  • Clindamycin above the diaphragm, metronidazole below
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