Antibiotics Flashcards
Beta lactams
Name and target
Penicillins - flucloxaxillin, benzylpenicillin, tazocin, amoxicillin
Carbapenems - meropenem
Cephs (2nd Gen) - cefuroxime
Cephs (3rd Gen) - ceftriaxone, cefotaxime
Cephs (4th Gen) - cefepime
Target: bacterial cell wall
Glycopeptides
Name and target
Vancomycin/Teicoplanin
Target bacterial cell wall - peptidoglycan links
Require monitoring of levels in Renal Impairment
Flucloxacillin
Sensitivity and use
MSSA +++, Streps +
Used for skin infections/soft tissue, OE, endocarditis
Benzylpenicillin
Sensitivity and use
Streptococcus, some enterococci
Used for skin/soft tissues, RTIs, OM, endocarditis, meningococcal diseae
Amoxicillin
Sensitivity and use
Streptococci, some enterococci
Used for CAP and OM, UTIs
Co-amoxiclav (augmentin)
Sensitivity and use
Staphs/ Streps, E.coli, Haemophilis, some enterococci
Used for cystitis, pyelonephritis, cellulitis, osteomyelitis, GUI, abdo infection
Tazocin
Sensitivity and use
Broad spec
Used for HAP, complicated UTIs, intra-abdominal infections, complicated skin/soft tissue infections (sepsis)
Meropenem
Sensitivity and use
Staphs & streps, haemophilus and e.coli, pseudomonas spp.
Used for complicated infections
Cephalosporins
Use
Often used in polymicrobial, some GPC most GNB
3rd Gen - pseudomonas
4th Gen - mixed
5th Gen - MRSA
Vancomycin, Teicoplanin
Sensitivity and use
Almost all GP (except VRE), some anaerobes
Used in severe infections and sepsis/MRSA
Aminoglycosides
Name and target
Gentamicin/Amikacin/Streptomycin/Neomycin
Targets 30S ribosome
Gentamicin
Sensitivity and use
Mostly E.coli/coliforms, pseudomonas spp
used in severe GN infections and some GP
- inactive against anaerobes
Sepsis, biliary infection, acute pyelonephritis, HAP
Must be given parenterally due to low lipid solubility
Measure 1 hour (peak dose) and trough (pre-dose)
Tetracyclines
Name and target
Doxycycline - targets 30S ribosome
Doxycycline
Sensitivity and use
Mix of GP and GN
Used for some UTIs, RTIs, STDs (chlamydia)
Lincosamides
Name and target
Clindamycin - targets 50S ribosome
Clindamycin
Sensitivity and use
BS, serious anaerobe infections, most GP
Used in place of penicillins, dental infections, tonsillitis
Macrolides
Name and target
Erythromycin, clarithromycin, azithromycin (GN)
Targets 50S ribosome
Erythromycin
Sensitivity and use
Staphs and streps, E.coli, Haemophilus, atypical pneumonias (legionella, mycoplasma)
Used for RTIs, ear infection, skin/soft tissue infection
Chloramphenicol
Sensitivity and use
Broad spec
Used for bacterial conjunctivitis
Fluoroquinolones
Name and target
Ciprofloxacin
Target DNA gyrase enzyme
Ciprofloxacin
Sensitivity and use
Most GN
Used for URTI, UTI, abdo infections, traveller’s diarrhoea
Metronidazole
Sensitivity
Anaerobes - bacteroides
Co-trimoxazole
Uses
Bacterial UTIs
Nitrofurantoin
Sensitivity and use
Enterococci, E.coli/coliforms
Used for UTIs
Penicillins
Side effects
Anaphylaxis, CNS toxicity in OD, GI upset, abx assoc-colitis, interstitial nephritis
Carbapenems
Side effects
Anaphylaxis, abx assoc-colitis, seizures, hepatotoxicity, headaches, NVD
Cephalosporins
Side effects
Anaphylaxis, CNS toxicity, seizures, abx assoc-colitis
Glycopeptides
Side effects
Anaphylaxis, red man syndrome, nephrotoxic, ototoxic, infusion site reaction, blood disorders, SJS, TEN
Aminoglycosides (Gentamicin)
Side effects
Nephrotoxic, ototoxic
Tetracycline
Side effects
NV&D, oesophageal irritation, ulceration, dysphagia, photosensitivity, discoloured enamel (children), intracranial HTN
Metronidazole
Side effects
GI upset, taste disturbane, disulfaram type reaction with alcohol
Trimethoprim
Side effects
Teratogenic in T1/3, hyperkalaemia
Ciprofloxacin
Side effects
NV&D, tendonitis, photosensitivity, SJS, TEN
Lincosamides
Side effects
C.diff, abdo discomfort, oesophagitis, taste disturbance, SJS, TEN
Macrolide
Side effects
NV+D, phlebitis, QT prolongation, myaesthena-type syndrome
Flucloxacillin side effects
Delayed cholestatic jaundice/hepatitis
Common Gentamicin combos
with metronidazole (anaerobes) or penicillin (gram positives)
Safe in pregnancy
Penicillins, Clindamycin, Erythromycin
Must avoid in pregnancy
Tetracyclines, Co-trimoxazole (late), Nitrofurantoin (early)
Quinolones caution for practical prescribing
Lowers seizure threshold
What to prescribe for CURB65 score of 2 vs 3+
CURB65 = 2 --> Coamoxiclav CURB65 = 3/+ --> Coamoxiclav + clarithromycin