Antibiotic choice

Question 1

Uses of penicillin

Answer 1

GAS
Syphillis
Confirmed penicillin sensitive pneumococcal infection
Meningococcal Infection (proved sensitive)

Question 2

Uses of amoxicillin

Answer 2

acute sinusitis, OM

pneumococcus, Hflu, Moraxella -> good for minor infections

Question 3

Use of ampicillin

Answer 3

Listeria meningitis

Question 4

Use of augmentin

Answer 4

Persistent minor infections

Question 5

Use unasyn

Answer 5

mixed infections -> doesn’t cover MRSA

Question 6

Use of Ticarcillin/Piperacillin

Answer 6

Pseudomonas (burns, neutropenic, hospital aquired pneumonia, CF, ventilator associated pneumonia)

Question 7

Why do you use higher doses of abx in persistent penumococcal infections

Answer 7

pneumococcus uses penecillin binding protein instead of beta-lactamases

Question 8

Use of Nafcillin and Oxacillin

Answer 8

Staph Aureus (meth sensitive)
cellulitis and endocarditis

Question 9

Use of PO Dicloxacillin

Answer 9

oral for Staph Aureus

Question 10

What bugs are not covered by cephalosporins?

Answer 10

Enterococcus

Anaerobes

Question 11

Use of 1st gen cephalosporin (cefazolin)

Answer 11

minor staph (outpatient cellulitis)
Pre-operative cellulitis prophalaxis

Question 12

Use of 2nd gen cephalosporin (Cefuroxime)

Answer 12

persistent minor infections (like augmentin)

Question 13

Use of 3rd generation cephalosporin (ceftriaxone, cefotaxime, cefdinir)

Answer 13

more gram negative coverage, good for meningitis

Question 14

Unique coverage of ceftazidime and cefepime

Answer 14

pseudomonas

Question 15

Use of IM ceftriaxone

Answer 15

gonorrhea

Question 16

When do cephalosporins promote resistance?

Answer 16

ESBL producing gram negative organisms: Klebsiells, Actinobacter, Enterobacter, Proteus, Pseudomonas, Serratia, E coli

Question 17

MOA of aminoglycosides

Answer 17

block protein synthesis at 30s ribosomal unit

Question 18

Use of aminoglycosides

Answer 18

gram negative infections

Question 19

Drug combo used in endocarditis

Answer 19

beta-lactams and aminoglycosides

Question 20

Two conditions when you can’t use aminoglycosides

Answer 20

penumonia and meningitis (poor penetration of meninges)

Question 21

Best drug in CA pneumonia

Answer 21

Erythromycin

Question 22

Pro of using azothromycin over erythromycin

Answer 22

fewer side effects, higher patient compliance

Question 23

MOA of macrolides

Answer 23

bind to 23s RNA of 50s ribosomal subunit

Question 24

AEs of macrolides

Answer 24

prolonged QT

Question 25

Use for Trimethoprim-Sulfamethoxazole

Answer 25

minor infections, both gram + and neg PCP pneumonia Non-serious soft tissue MRSA infections

Question 26

Best drug for uncomplicated UTIs

Answer 26

TMP-SFX

Question 27

Bugs that TMP-SFX doesn't cover

Answer 27

strep, psudomonas, anaerobes

Question 28

MOA of TMP-SFX

Answer 28

block nucelotide synthesis by inhibiting bacterial folate synthesis

Question 29

Use of Nitrofurantoin

Answer 29

UTI of E. coli with sulfa resistance | Pregnancy in UTI

Question 30

Bad side effect of Nitrofurantoin

Answer 30

can cause interstitial pulmonary fibrosis

Question 31

MOA of tetracyclines

Answer 31

Inhibit 30s ribosomal subunit

Question 32

Use for doxycycline

Answer 32

Chlamydia atypical pneumonia Rickettsial disease (RMSF)

Question 33

MOA of quinolones

Answer 33

Inhibit DNA gyrase and topoisomerases

Question 34

Use of Ciprofloxacin

Answer 34

prostatitis, complicated UTI, diabetic foot ulcer | not penumococcal

Question 35

Use of Levofloxacin

Answer 35

CA pneumonia, hospitalized pts with gram negative infection

Question 36

AE of quinolones

Answer 36

Achilles tendon rupture | blocks neuromuscular activity in Myasthenia Gravis

Question 37

MOA of clindamycin

Answer 37

lincosamide that blocks 50s ribosomal unit

Question 38

MOA of Metronidazole

Answer 38

promotes free radicals that damage bacterial DNA

Question 39

Use of clindomycin and metronidazole

Answer 39

anaerobic infections (intrabdominal or pelvic)

Question 40

Unique uses of metronidazole

Answer 40

C diff Trichomonas Giardia

Question 41

Diet consideration with metronidazole

Answer 41

don't use alcohol

Question 42

Use of clindomycin

Answer 42

MRSA | toxin related complications

Question 43

MOA of vancomycin

Answer 43

inhibits cell wall syntehsis and inhibits peptidoglycan synthesis

Question 44

Use of vancomycin

Answer 44

MRSA Staph epidermidis (indwelling catheter) Ampicillin resistant enterococcal infections

Question 45

Use of Aztreonam

Answer 45

serious gram negative infections | Can be used in penicillin allergic patients

Question 46

Use of carbapenams

Answer 46

only drugs effective against ESBL gram negatives

Question 47

Use of linezolid

Answer 47

gram positives (MRSA, VRE, Peniciilin resistant strep pneumo)

Question 48

Use of daptomycin

Answer 48

MRSA skin lesions | NOT MRSA pneumonia

Question 49

Drugs used for psuedomonas

Answer 49

``` Ticarcillin/Piperacillin Ceftazidime and Cefepime Cipro/Levofloxacin Vancomycin Carbapenams (if ESBL) ```

Question 50

Drugs for MRSA

Answer 50

TMP-SFX Clindomycin Linezolid Vancomycin