Abx Overview 2

Question 1

ADE:

• CNS effects (confusion & seizures)

Broad Spectrum:

• PRSP (penicillin resistant strep pneumoniae)
• Gram neg rods
• Pseudomonas

Answer 1

Carbapenems : Imipenem - cilastatin

Question 2

Have a broad spectrum of activity, but CNS adverse effects

Answer 2

Carbapenems

Question 3

What does PRSP stand for?

Answer 3

Penicillin Resistant Strep Pneumoniae

Question 4

• No cross allergenicity w/ beta lactams
• Active only against gram neg bacteria

Answer 4

• Monobactam (beta-Lactam) : Aztreonam

Question 5

Activity Spectrum

• Covers MRSA and PRSP (gram positive activity)

PK:

• Parenteral for systemic infections
• Oral ____ for C. difficile collitis (CANNOT GIVE IV)

Toxicity:

• Red neck / Red Man Syndrome (erythematous rash on face and upper body)

Answer 5

Glycopeptides : Vancomycin

Question 6

Toxicities:

-Red-neck/ Red man syndrome

Answer 6

Glycopeptides: Vancomycin

Question 7

In what form do we give Vancomycin to treat C. diff?

Answer 7

Oral, not IV

Question 8

Toxicities:

• myopathy (monitor CPK weekly)

Activity Spectrum:

• Endocarditis
• Sepsis
• Off-labeled uses
  
  • Osteomyelitis
  • Prosthetic Joint infections
• MSSA and MRSA

Answer 8

Daptomycin (Lipopeptide)

Question 9

Unique toxicity of Daptomycin

Answer 9

Myopathy (moniter CPK weekly)

Question 10

• Endocarditis
• Sepsis
• Osteomyelitis (off label use)
• Prosthetic joint infections (off label use)
• MSSA and MRSA

Answer 10

Daptomycin

Question 11

New update by AAP:

Answer 11

Doxycycline can now be used in children of all ages for 21 days or less

Question 12

ADE:

• Hepatic dysfunction
• QT elongation
• CYP450 inhibition (not azithromycin)

Activity Spectrum:

• CAP
• Pertussis
• Corynebacteria
  
  • Diptheria
• Chlamydial

Answer 12

Macrolides : Azithromycin

Question 13

ADE:

• Can cause C. difficile colitis

Answer 13

Lincosamides : Clindamycin

Question 14

ADE:

• Dose related Anemia
• Gray baby syndrome

Activity Spectrum:

• Serious infections due to organisms resistant to less toxic abx
• Many vancomycin resistant enterococci

Answer 14

Chloramphenicol : available OTC

Question 15

ADE:

• Dose related anemia
• Neuropathy
• Optic neuritis
• Serotonin syndrome w/ SSRIs

Activity Spectrum:

• MRSA
• PRSP
• VRE strains****

Answer 15

Oxazolidinone : Linezolid

Question 16

ADE:

• Nephrotoxicity (reversible)
• Ototoxicity (irreversible –> deafness)
• Neuromuscular blockade

Activity Spectrum:

• Often used in combination w/ beta-lactams

Answer 16

Aminoglycosides : Gentamicin

Question 17

Mechanism sulfonamide and trimethoprim:

• ______?

Mechanism fluoroquinolones:

• _______?

Answer 17

• Blockade of folic acid synthesis
• Interferes w/ bacterial DNA synthesis by inhibiting DNA gyrase

Question 18

Sulfonamides w/ Trimethoprim results in what?

Answer 18

Synergistic inhibition of folic acid synthesis

Question 19

Activity Spectrum:

• UTI
• MSSA or MRSA skin/soft tissue infections

**Dosing is based on which component?

Answer 19

Sulfonamides w/ Trimethoprim (Trimethoprim-sulfamethoxazole)

• Based on trimethoprim component

Question 20

What do Quinolones do?

Answer 20

Inhibit DNA replication via binding to DNA gyrase and topoisomerase IV

Question 21

Which quinolones are used for UTIs?

Answer 21

Ciprofloxacin and Ofloxacin

Question 22

Which quinolones are used for respiratory infection?

Answer 22

• Levofloxacin
• Gemfloxacin
• Moxifloxacin

Question 23

ADEs:

• CNS effects (dizziness/headaches)
• Tendinitis (avoid in young children/pregnancy)
• Peripheral neuropathy
• Neuromuscular blocking activity
• QTc prolongation

Interaction:

• Oral absorption impaired by cations-Calcium, magnesium, aluminum

Answer 23

Quinolones

Question 24

Inhibitory or Killing effects of 2 or more antimicrobials used together significantly greater than expected from their effects when used individually.

Answer 24

Synergism

Question 25

• Provide info about local resistance patterns
• Can be used to determine empiric tx options

Answer 25

Antibiogram