Antibiotics

Question 1

Penicillin

Answer 1

B-Lactam 
PO, IV, IM
Resistance via penicillinase
Gram +
-Group A strep
-S. pneumoniae (when sensitive)
-Treponema pallidum (syphillis)

Question 2

Anti-staph Penicillins

Answer 2

B-Lactam
PO,IV
Resistance via altered PBP=MRSA
Good for MSSA, skin and soft tissue infections, bloodstream infections, pneumonia
-Cloxacillin

Question 3

Amino Penicillins

Answer 3

B-Lactam
PO, IV
Treats more gram + and some gram -, entercoccus, and listeria (ampicillin)
Resistance via B-lactamase (+B-lactamase inhibitor)
-Amoxicillin(+ clavulanate)
-Ampicillin
-Piperacillin(+tazobactam)

Question 4

1st Gen Cephalosporins

Answer 4

B-Lactam
Gram +
-Cephalexin (PO)
-Cefazolin (IV)

Question 5

2nd Gen Cephalosporins

Answer 5

B-Lactam
Gram +, haemophilus influenzae
-Cefuroxime (PO)

Question 6

3rd Gen Cephalosporins

Answer 6

Gram +,-, pseudomonas

• Cefixime (PO)
• Ceftriaxone (IV)
• Ceftazidime (IV)

Question 7

4th Gen Cephalosporins

Answer 7

-Cefepime (IV)

Question 8

5th Gen

Answer 8

Gram +/-,

• Ceftaroline (MRSA)
• Ceftolozane-tazobactam (Pseudomonas, ESBL)

Question 9

Carbapenems

Answer 9

• Ertapenem
• Meropenem
• Imipenem

Question 10

B-Lactams

Answer 10

Work on bacteria with a cell wall. They work by interfering with cell wall synthesis. Resistance occurs via B-lactamase, PBP, porin channel alteration,efflux pump

Question 11

Fluoroquinolones

Answer 11

Prevent DNA replication. Resistance occurs via efflux pumps, alteration of target DNA enzyme, and membrane porins

Question 12

Flouroquinolones

Answer 12

Covers Atypical causes of pneumonia!!
Not recomended for uncomplicated UTI
Moxifloxacin doesn’t get into the bladder
Not for people <16y/o
Prolongs QTc
Chronic use can lead to tendonitis
-Ciprofloxacin
-Levofloxacin
-Moxifloxacin

Question 13

Macrolides

Answer 13

Prevent Protein translation by binding to 50s subunit
Resistant via efflux pumps and ribosomal alteration
Also prolongs QTc
-Clarithromycin
-Azithromycin
-Daptomycin (inactivated by lung surfactants)

Question 14

Tetracyclines

Answer 14

Binds to 30s subunit preventing translation
Adverse effects - tooth discolouration, erosive esophagitis, photosensitivity
Not for pregnant women or children <8
Resistant via efflux pumps, alteration of ribosomal target
-Doxycycline
-Tetracycline
-Minocycline

Question 15

MRSA Treatment

Answer 15

PO: TMP-SMX, linezolid, doxycycline (+/- Clindamycin)
IV: Vancomycin, Daptomycin, Ceftaroline

Question 16

ESBL Treatment

Answer 16

Carbapenems

Question 17

Drugs for pseudomonas

Answer 17

PO: Ciprofloxacin
IV: Pip-tazo, ceftazidime, cefepime, meropenem, imipenem

Question 18

Treatment for CAP (healthy outpatient)

Answer 18

Amoxicillin or Doxycycline (must be >8 y/o to give a tetra-cycline)

Question 19

Treatment for CAP (outpatient w/ comorbidities)

Answer 19

Haemophilus influenza is more likely and has B-lactamase so we add a B-lactamase inhibitor
-Amoxicillin/clavulanate + Azithromycin or doxycycline (to cover atypical causes)

Question 20

Treatment for CAP (severe; admitted to hospital)

Answer 20

Ceftriaxone + Azithromycin (to cover atypical)

Question 21

Treatment for HAP/VAP

Answer 21

Likely to have increased resistance

• Piperacillin-tazobactam
• meropenem/imipenem
• cefepime/ceftazidime
• ciprofloxacin/levofloxacin

+/- vancomycin or linezolid (to cover MRSA)