Natural penicillins 1. Are active against? And 2. Indicated for what condition?

1. Against STREPTOCOCCUS 2. Indicated for: strep throat: pharyngitis, tonsillitis

Penicillinase- resistant penicillins: 1 Active against? 2. Indicated for?

1. Streptococcus and staphylococcus 2. Cellulitis

Anti Bacterial Practice Points 🦠 Flashcards by Sarah E

Class of b-lactams

Penicillins
Cephalicosporins
Carbapenems

How well did you know this?

Not at all

Perfectly

Natural penicillins

Are active against?

And

Indicated for what condition?

Against STREPTOCOCCUS
Indicated for: strep throat: pharyngitis, tonsillitis

How well did you know this?

Not at all

Perfectly

Natural penicillins

Medication name

Phenoxymethylpenicillin

How well did you know this?

Not at all

Perfectly

Penicillinase- resistant penicillins:

1
Active against?

Indicated for?

Streptococcus and staphylococcus
Cellulitis

How well did you know this?

Not at all

Perfectly

Penicillinase resistant penicillins

Name medication

Flucloxacillin / dixloxacillin

*Oral or iv

How well did you know this?

Not at all

Perfectly

Aminopenicillins:

Active against?

Indicated for?

Strep
Few G-ve rods
(Influenza)

*broken down by B-lactamases

Indicated for = pneumonia

How well did you know this?

Not at all

Perfectly

Aminopenicillins

Medication name

Amoxicilkin

Ampicillin = iv

How well did you know this?

Not at all

Perfectly

Name

B-lactamase Inhibitors

Clavulanic acid
Tazobactam

Suicide Inhibitors
+
Increase gram -ve activity

How well did you know this?

Not at all

Perfectly

Penicillins and b-lacatamase Inhibitors:

Oral/iv amoxicillin + clauvanic acid = doesn’t cover pseudomonas

Iv Ticarcillin + clauvanic acid
Iv Piperacillin + tazobactam
= covers pseudomonas

How well did you know this?

Not at all

Perfectly

Cephalosporins:

1st generation
Name?
Coverage?

Cefalexin (oral)

Gram +ve (strep and straph) and some Gram -ve (e coli)

How well did you know this?

Not at all

Perfectly

Cephalosporins

2nd generation
Names

Cefaclor/cefuroxime (oral)

How well did you know this?

Not at all

Perfectly

Cephalorsporins

3rd generation

Names
Coverage?

Ceftriaxone / cefotaxime (iv)

Covers Gram +ve and Gram -ve

How well did you know this?

Not at all

Perfectly

Cephalosporins

4th generation
Name

Cefepime

How well did you know this?

Not at all

Perfectly

Which part of the B-lactam structure causes ALLERGIES?

Due to R1 ring

How well did you know this?

Not at all

Perfectly

If allergic to AMOXICILLIN,
what else should be avoided?

Avoid

Cefalexin or cefaclor

(1st and 2nd gen cephalosporin)

How well did you know this?

Not at all

Perfectly

What can ESBL inactivate?

All penicillins and cephalosporins

How well did you know this?

Not at all

Perfectly

Name Carbapenems 3

Imipenem
Meropenem
Ertapenem

How well did you know this?

Not at all

Perfectly

What does Carbapenems cover?

Gram +ve, Gram -v and anaerobes

Except MRSA

REVESERVED for bacteria with ESBL

Can use if allergic to penicillins + blactamase inhibitor combo

How well did you know this?

Not at all

Perfectly

MRSA is resistant to what?

Resistant to all B lactams

How well did you know this?

Not at all

Perfectly

MOA of Glycopeptides

Inhibit transpeptidase to crosslink peptidoglycan

Glycopeptides

Name 2

Coverage

Vancomycin (iv, oral)

Tecioplanin (iv)

Covers = G +ve Including MRSA

Glycopeptides

ADVERSE EFFECTS

-nephrotoxicity
-ototoxicity
-rash with eosinophilia
-Thrombocytopenia, neutropenia

What is the Redman syndrome?

When infusing VANCOMYCIN too quickly, not an allergic reaction

Vancomycin monitoring:

If on for more than 48 hours:

AUC/MIC ratio predicts?

Vancomycin efficacy

Quinolones Name 3

Norfloxacin Ciprofloxacin Moxifloxacin

Quinolones What does Ciprofloxacin/ norfloxacin cover?

Gram -ve + pseudomonas

Quinolones What is norfloxacin ALONE INDICATED FOR

Norfloxacin has low serum levels Used for UTI

Quinolones What does MOXIFLOXACIN cover

Gram +ve, Gram -ve, anaerobes, atypicals Less pseudomonas activity

Quinolones ADVERSE EFFECTS

-peripheral neuropathy: tingling, pins and needles -tendon damage

Aminoglycosides Name 3

Amikacin Gentamicin Tobramycin (inj)

Aminoglycosides Cover

Gram -ve rods Severe kidney infections

Aminoglycosides adverse reactions

Nephrotoxicity = reversible Ototoxicty

Anti folates Name 2

Sulfamethoxazole Trimethoprim

Anti folates Active against Indicated for

Gram -ve bacteria Used for UTIs Concentrates in urine,prostate, vaginal fluid

For anaerobic bacteria, 1. Nitroimidazoles Name 2

Metronidazole Tinidazole

For anaerobic bacteria, 1. Nitroimidazoles Are first line for which condition?

Necrotising gingivitis Can add other antimicrobials to get anaerobic cover => for aspiration pneumonia

For anaerobic bacteria, 1. Nitroimidazoles Important practice point?

Avoid alcohol during and 24 hrs after finishing course

For anaerobic bacteria, 2. Lincosamides Coverage?

Gram +v3 (some MRSA) + anaerobes (except c.difficile)

Why are LINCOSAMIDES great for allergies?

Can give if have Immediate hypersensitivity reactions to penicillins (superficial cellulitis)

Lincosamides Adverse reaction?

C.difficile associated disease!!! = Causes most severe antibiotics related Dirrhoea! = fatal (spores survive months)

What is Clostridium Difficile? How to treat?

Gram +ve anaerobe Treat = first line: Metronidazole If resistant to metronidazole, use Vancomycin orally

Macrolides (mycins) Name 4

Azithromycin Clarithromycin Erythromycin Roxithromycin

Macrolides Coverage

G +ve and G -ve Mainly aerobic g +ve And atypical bacteria (chlamydia) *can be used in penicillin/,cephlasporin allergies

Macrolides Interactions?

Clarithromycin, erythromycin = inhibit CYP3A4 Clarithromycin, erythromycin, azithromycin = inhibit p,gp Clarithromycin = inhibits OATP 1B1 ALL INCREASE QT INTERVAL.

What other effects do MACROLIDES have? Other than antibacterial

Immunomodulatory Anti inflammatory Used for Diffuse panbronchiolitis and cystic fibrosis

Tetracyclines Name 3

Tetracycline Minocycline Doxycycline

Tetracyclines Covers

Gram +ve and gram -ve Also atypical bacteria (chlamydia)

Tetracyclines Used to treat ?

Pneumonia, If atypical is suspected

Tetracyclines Councilling points

1. Do not take antacids, Fe, Ca, Zn within 2 hours = Decreases absorption = Binds to calcium deposits 2. Take with food 3. Remain upright after dose 30 mins = prevents gastric burns 4. Best taken in the morning 5. May increase sensitivity to light Use protective clothing and sunscreen