Antibiotics Flashcards
Define stewardship
- identifying the small group of people that require antibiotics
What are the 4 c’s to avoid
- co-amoxiclav
- cephalosporins (ceftriaxone)
- clindamycin (macrolide)
- ciprofloxacin (fluoroquinolone)
Why are the 4 c’s avoided
- increased c . diff risk
Name a cephalsporin
- ceftriaxone
Where are anaerobic organisms found?
- mouth
- teeth
- throat
Where are gram negative bacteria found?
- Gastrointestinal
General antibiotic side effects
- nausea
- vomiting
- diarrhoea
- rashes
- candida
Flucoxacillin and co-amoxacillin side effect
- cholestatic jaundice
Vancomycin side effect
- red man syndrome
Tetracycline side effect
- photosensitivity
What may affect tetracycline and quinolone absorption?
- calcium
Broad spectrum antibiotics given to a patient on warfarin may cause?
- increased INR
What must be avoided when on metrondiazole
- alcohol
What drugs a B lactams found in?
- penicillin
- cephaloporins
- carbapenems
- aztreonam
Commonest CNS infection bug?
- s. pneumonia
- ceftriazone
Commonest lung infection bug and treatment
- s.pneumonia (amoxicillin, doxycycline)
H.influenzae lung infection treatment
- co - amoxiclav
- amoxicillin
1st line for a c.diff gut infection?
- oral vancomycin
What does the gram negatives have on their cell wall that gram positive don’t?
- lipopolysaccharide
- can cause shock
Name a gram negative cocci
- neisseria
Gram neg bacilli examples
- pseudomonas
- e.coli
- klebsiella
- salmonella
What are coliform
- always present in gi tract
- e.coli and similar
What is atypical bacteria?
- less common bugs
- not strep
Hospitalised patients more susceptible to ____ bacteria
- gram negative
Chronic lung disease now infection, what bugs?
- pseudomonas (CF patient)
- pneumococcus
- influenza
What bug peaks every 4 years
- mycoplasma
Bug associated with lamb season and sheep farming
- coxiella
Treatment for haemophilus influenzae?
- amoxicillin
H. influenzae is what category of bug?
- gram negative coccobacilli
How are atypical pneumonias treated?
- not strep
- treated with doxycycline
- legionella = quinolones, clarithromycin
How is legionella treated?
- quinolones
- clarithromycin
What antibiotic coverage is lost in ESBLs
- penicillin
- cephalosporins
- aztreonam
What must be monitored when giving gentamicin?
- renal function
Corynebacterium is seen in what condition and what is it categoriesed as?
- seen in diptheria
- gram positive bacilli
Name some gram positive bacilli?
- corynebacterium
- clostridium
- listeria
- bacillus
Alpha haemolytic means?
- partial haemolysis
- green
- pneumonia
- viridian’s
Beta haemolytic means
- complete haemolysis
- s.pyogens
- group b strep (agalctiae)
Group B strep example. and when is it seen?
- s. agalactiae
- pregnancy
- neonate
Treatment of enterococci?
- iv amoxicilllin
- vancomycin
What route should antibiotics be given in sepsis?
- IV
- except for sepsis due to c.diff in which oral vancomycin is given
Treatment for a staphylococci infection?
- flucoxacillin
What infections are gram positive bacilli seen?
- intra abdo infection
- skin and soft tissue
- prosthetic material
- meningitis/encephalitis
- PWID
What is the typical organism in Pneumonia?
- s. pneumonia
Name some atypical pneumonia bugs?
- mycoplasma
- legionella
- chamydophila
- psittaci
Immunosuppressed patients are more susceptible to what pneumonias
- jiroveci
- aspergillus
- TB
What do vaccines aim to target for s.pneumonia?
- the virulence factors
Cystic fibrosis patient with pneumonia?
- pseudomonas aeruginosa
What is the difficulty at diagnosing fungal infections?
- hard to culture and sample
How is aspergillosis diagnosed?
- broncho-alveolar lavage
- galactomman as a marker
- septate hyhae on microscope
Commonest strain of aspergillosis?
- fumigatus
Who is most susceptible to an aspergillosis infection?
- immunocompromised
- transplant patients
- chemotherapy
