Antibiotics

Question 1

Cephalosporins - 1st generation

Answer 1

Oral agents: cephalexin ( cefradin, cefadroxil )

Parental : cefazolin

Question 2

Cephalosporin 1st generation indications.

Answer 2

• mild urogenital, respiratory, bone, joint, skin infections. (Cephalexin, cefadroxil)
• perioperative prophylaxis (parenteral agents Cefazolin)

Question 3

Cephalosporins -2nd generation

Answer 3

Oral agents: cefaclor, cefuroxime axetil, cefprozil, loracarbef

Parental agents: cefamandole, cefonicid, cefuroxime, cefotiam, ceforanide

Cephamycins: cefoxitin, cefmetazole, cefotetan

Question 4

Cephalosporins - 2nd generation indications

Answer 4

Sinus, ear and respiratory infections caused by Hemophillus influenzae or Moraxella catarrhalis (cefamandole, cefuroxime, cefaclor)

Anaerobe bacteroides fragilis (cefotetan, cefoxitin)

Question 5

Name 3 b-lactamase inhibitors that are combined with Penicillins.

Answer 5

Clavulanic acid (with amoxicillin) oral use

Sulbactam (with ampicillin) oral / parental use

Tazobactam (with Piperacillin) - only parenterally

Question 6

Name at least 4 tetracyclines.

Answer 6

Tetracycline
Doxycycline
Minocycline
Demeclocycline
Tigecycline ( a glycycline)

Question 7

What is the first line treatment of gonorrhea ?

Answer 7

Single dose of intramuscular CEFTRIAXON

Question 8

CEFTRIAXON is active against …

Answer 8

Basically any serious hospital infections !

• empiric treatment for sepsis
  -community acquired & hospital acquired pneumonias
  -meningitis (CEFTRIAXON or cefotaxime)
  strep pneumo., h.influ, N. meningitidis - active against all the usual culprits
  -endocarditis caused by strep. Viridans & HACEK
  -gonorrhea : single dose of intramuscular ceftriaxon is used
  -lime Disease
  No MRSA coverage!!

Question 9

Which generation cephalosporin is especially useful against Pseudomonas?
And what is the name of the specific drug?

Answer 9

Third generation cephalosporins
especially : CEFTAZIDIME (pseudomonaaaazzz ceftaaaaaz)

Also 4th generation: Cefepime

Question 10

Adverse effects of Cephalosporins.

Answer 10

1. Allergy
   may elicits variety of hypersensitive reactions identical to those of penicillins (including anaphylaxis, fever, skin rashes, nephritis, hemolytic anemia, granulocytopenia)
2. Toxicity
   Interstitial nephritis, tubular necrosis