Abx Refresher Flashcards

1
Q

What is an antibiotic?

A

A substance produced by micro organisms that selectively destroy or inhibit other micro organisms

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2
Q

Points about MRSA

A

Linked with abc misuse
Treatment based on C/S and severity of infection i.e. IV Vancomycin
Universal screening programmes for certain patients i.e. >65, elective surgery etc
Prevention methods - 5 day suppression with mupirocin +
chlorhexadine but > 5 days leads to mupirocin resistance
In U.K. It should be known as flucloxaccilin resistant

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3
Q

Points about CDIFF

A

Overuse of any abx can change gut environment
Most commonly associated with broad spectrum abx like cephalosporins and quinolones
Stop causative abx if symptomatic
Treat mild disease with oral metronidazole
Treat severe disease with oral vancomycin

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4
Q

Points about extended spectrum beta lactamase (ESBLs)

A
Gram -ve
Classic example is E.Coli
Resistant to conventional abx
Usually treated with carbapenems IV 
Routine screening not really done. Identification done through lab work after non response to multiple abx treatments
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5
Q

Which drugs work against MRSA but are last resort

A
Vancomycin
Doxycycline
Rifampicin 
Gentamicin 
Daptomycin
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6
Q

Points about Carbapenase Producing Enterobacteriase

A

Produce enterobeacteriacae
Carbapenases destroy carbapenams
Enteros produced are resistant to many abx
RFs : hospitalisation, ICU stay, abx exposure, severity of underlying illness
No current delocalisation strategy
Cause conditions with high mortality
Resistance is highly transmissible
Screen those that have been treated abroad or admitted to a U.K. Hospital with CPE

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7
Q

Points about Tazocin (Piperacillin/tazobactam)

A
Antipseudomonal penicillin
Broad spectrum
Tazobactam is a beta lactamase inhibitor
Some anaerobic cover
Less likely to cause CDIFF
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8
Q

Points about cephalosporins

A

1st gen: cefalexin, cefradine
2nd gen: cefaclor, cefuroxime
3rd gen: cefotaxime (BS), ceftazidime (NS)

Cephalosporins have a wide distribution
Poor CSF penetrance
Oral absorption is association with CDIFF

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9
Q

Points about carbapenems

A

Broad spectrum
Restricted to secondary care
Examples: imipenem/cilastin, meropenem, ertapenem

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10
Q

Points about tetracyclines

A

Tetracycline, oxytetracycline, lymecycline: used for acne
Doxycycline: used for chest infections and STDs

Avoid food and milk at the same time
Avoid in children and in pregnancy

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11
Q

Points about macrolides

A

Clarithromycin and erythromycin used for chest infections and SSTIs
Azithromycin used for STDs

Can cause stomach upset, rashes and liver damage
Inhibits CP450

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12
Q

Points about quinolones

A

Ciprofloxacin: restricted to specialities
Levofloxacin: 2nd line for RTIs

Broad spectrum
High use linked with HCAIs

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13
Q

Points about Imidazole’s

A

Metronidazole: used for anaerobic infections

Avoid with alcohol as it makes people feel sick (potentially deadly)
Good oral bioavailability
Nausea, metallic waste
Rarely peripheral neuropathy

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14
Q

Points about trimethoprim

A

Narrow spectrum
UTIs
Oral only
Beware in pregnancy

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15
Q

Points about nitrofurantoin

A

Narrow spectrum
UTIs
Oral only
Doesn’t work if catheter is in situ

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16
Q

Points about glycopeptides

A

Examples: vancomycin, teicoplanin

Gram +ve bacteria
IV only
Renal toxicity so monitor levels

17
Q

Points about aminoglycosides

A

Examples: gentamicin, amikacin

IV only
Gram both
Renal toxicity so monitor levels