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FIM > 23. Intro to antibiotics > Flashcards

23. Intro to antibiotics Flashcards

1
Q

Which penicillin or cephalosporins has anti-pseudomonal activity?

A

Piperacillin-Tazobactam

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2
Q

What percentage of people have a history of penicillin allergy?

A

5%

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3
Q

Which penicillin is most suitable to treat a beta-lactamase producing E. coli urinary tract infection?

A

Co-amoxiclav

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4
Q

Which organism is always resistant to macrolides?

A

Pseudomonas augerosa

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5
Q

What are the functions of antibiotics?

A

Prophylaxis: medical or surgical
Treatment: empiric or targeted

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6
Q

What ways can antibiotics be classified?

A

Antibiotic family
Mechanism of action
Spectrum
Antimicrobial activity (bacteriostatic or bactericidal)

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7
Q

What is important for how effective bacteriostatic treatment is?

A

The host’s immune response

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8
Q

What specific infection is bacteriostatic antibiotics especially useful in?

A

Group A strep to prevent toxin production

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9
Q

What are bactericidal antibiotics especially useful in?

A

Immunosuppressed patients

Severe infections: BSI, meningitis, endocarditis

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10
Q

What are the methods of susceptibility testing?

A

Disk diffusion
MIC
Genotypic methods

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11
Q

What is the disadvantage in genotypic methods as a way of finding antibiotic susceptibility?

A

The gene might be present but not switched on

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12
Q

What is the general mechanism of action of beta lactams?

A

Inhibit cell wall synthesis

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13
Q

Name 4 penicillins

A

Benzylpenicillin
Ampicillin/amoxicillin
Flucloxacillin

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14
Q

What organisms does benzylpenicillin target?

A

Gram positive cocci (narrow spectrum)

Strep, staph and neisseria

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15
Q

What infections does benzylpenicillin treat?

A

Meningitis
Endocarditis
Cellulitis

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16
Q

Which penicillins are broad spectrum?

A

Ampicillin

Amoxicillin

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17
Q

What infections do ampicillin and amoxicillin treat?

A

UTIs

RTIs

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18
Q

What bacteria is flucloxacillin used for?

A

MSSA

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19
Q

Should cephalosporins be given to a patient with a penicillin allergy?

A

Can be given to a patient with a mild penicillin allergy

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20
Q

Name the classes of beta lactams

A

Penicillins
Cephalosporins
Carbapenems
Monobactams

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21
Q

Name a first generation cephalosporin

A

Cefaclor

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22
Q

What is cefaclor used to treat?

A

RTIs and UTIs cause by gram +

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23
Q

Name a second generation cephalosporin

A

Cefuroxime

24
Q

What is cefuroxime used to treat?

A

RTIs

Given as surgical prophylaxis

25
Q

Name a third generation cephalosporin

A

Ceftriaxone

26
Q

What is ceftriaxone used to treat?

A

Meningitis

27
Q

What is synergy?

A

Effect of two drugs in combination is greater than alone

28
Q

Are carbapenems narrow or broad spectrum?

A

Very broad

29
Q

What resistant organisms are carbapenems active against?

A

EBSL producers

30
Q

Name 2 carbapenems

A

Meropenem

Ertapenem

31
Q

What organisms are monobactams active against?

A

Gram -

32
Q

Name a monobactam

A

Aztreonam

33
Q

What is the mechanism of action of glycopeptides?

A

Inhibit cell wall synthesis of gram +

34
Q

What organisms are glycopeptides especially useful in treating?

A

MRSA

C. difficile

35
Q

Name 2 glycopeptides

A

Vancomycin

Teicoplanin

36
Q

What bacteria are aminoglycosides active against?

A

Gram - bacilli, staph aureus, mycobacteria, brucella, e.coli, pseudomonas
Inactive against anaerobes

37
Q

What infections are aminoglycosides used to treat?

A

Intra-abdominal

Infective endocarditis

38
Q

What are the possible toxic effects of aminoglycosides?

A

Nephrotoxicity

Ototoxicity

39
Q

Name an aminoglycoside

A

Gentamicin

Streptomycin for TB

40
Q

What is the mechanism of action of aminoglycosides?

A

Inhibit protein synthesis

41
Q

Name 3 macrolides

A

Clarithromycin
Erythromycin
Azithromycin

42
Q

What infections are treated with macrolides?

A

Atypical pneumonias: mycoplasma, coxiella, chlamydia, legionella

43
Q

What is the mechanism of action of macrolides?

A

Inhibit protein synthesis

44
Q

Are quinolones bacteriostatic or bactericidal?

A

Bactericidal: inhibit DNA gyrase

45
Q

Name 2 quinolones

A

Ciproflaxin

Levofloxacin

46
Q

What infections are treated with quinolones?

A

UTIs
Intra-abdominal
Caused by gram - bacilli

47
Q

Why are quinolones not often used?

A

Side effects include cartilage toxicity and tendon rupture

48
Q

Name a tetracycline

A

Doxycycline

49
Q

What bacteria are susceptible to tetracyclines?

A

Chlamydia
Rickettsia
Coxiella
Mycoplasma

50
Q

Why are tetracyclines contraindicated in pregnant women and children?

A

Stain growing teeth

51
Q

What is the general mechanism of action of tetracyclines?

A

Inhibit protein synthesis

52
Q

What types of microbes is metronidazole used to treat?

A

Anaerobic and protozoa

53
Q

What are the uses of metronidazole?

A

Prophylaxis in bowel surgery

Treat intra-abdominal infections

54
Q

What class of antibiotics are usually combined with metronidazole?

A

Cephalosporins

55
Q

What are the factors in choosing an antibiotic?

A 
Site of infection
Community or HCAI
Local resistance
Previous antibiotics
Previous lab results
Allergy
56
Q

What are the options for updating antibiotic treatment at 24-48 hours?

A 
Stop antibiotic
IV to oral
Change (more narrow or broad)
Continue
Outpatient Parenteral Antibiotic Therapy
57
Q

What is antibiotic stewardship?

A

Programmes and interventions to improve the use of antibiotics

FIM (44 decks)

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