Abx Refresher Flashcards
What is an antibiotic?
A substance produced by micro organisms that selectively destroy or inhibit other micro organisms
Points about MRSA
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
Points about CDIFF
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
Points about extended spectrum beta lactamase (ESBLs)
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
Which drugs work against MRSA but are last resort
Vancomycin Doxycycline Rifampicin Gentamicin Daptomycin
Points about Carbapenase Producing Enterobacteriase
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
Points about Tazocin (Piperacillin/tazobactam)
Antipseudomonal penicillin Broad spectrum Tazobactam is a beta lactamase inhibitor Some anaerobic cover Less likely to cause CDIFF
Points about cephalosporins
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
Points about carbapenems
Broad spectrum
Restricted to secondary care
Examples: imipenem/cilastin, meropenem, ertapenem
Points about tetracyclines
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
Points about macrolides
Clarithromycin and erythromycin used for chest infections and SSTIs
Azithromycin used for STDs
Can cause stomach upset, rashes and liver damage
Inhibits CP450
Points about quinolones
Ciprofloxacin: restricted to specialities
Levofloxacin: 2nd line for RTIs
Broad spectrum
High use linked with HCAIs
Points about Imidazole’s
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
Points about trimethoprim
Narrow spectrum
UTIs
Oral only
Beware in pregnancy
Points about nitrofurantoin
Narrow spectrum
UTIs
Oral only
Doesn’t work if catheter is in situ