Antibiotics BW 2 Flashcards
Todays outline
What are antibiotics?
How do they work?
What is MIC? Why is it important
What are the most important things to take away from MIC?
What is Antibiotic pharmacokinetics Pharmacodynamics
- E.g Time over MIC
For beta lactams? - TIme above the >MIC - Works best when over MIC - thus QID
Bioavaliability: IV are not inherently better than oral!
Should not give the following IV
1) IV associated with increased risk of infection
How do different antibiotics penetrate the site of infection?
What important considerations need to be taken for different infections sites (e.g CNS, Bioflims, Prostate)
What are common side effects to antibiotics?
(allergy) Get different types of allergy
Type 1: Immediate - IgE mediated and mast cells and basophils —-> Leading to anaphylaxis, angioedema, RASH
Beta-lactam allergy?
Patho?
When should you avoid? - Anaphylaxis/ SJS
Adverse effects of antibiotics:
Side effects (non immune mediated)
What are predicatable type a side effects?
Type B: more idiosyncratic- Happen in a smaller group of patients-
Adverse effects continued:
C diff
IV access related blood stream infections
Impact on patient microbiota
Different classes of antibiotics?
What are beta lactams?
What are the 3 major types?
What is their MOA?
- INhibit cell walls synthesis - by cross linking and inhibiting penicilling binding proteins (PBP)
Beta lactams -Pencillins
Beta lactams broad spectrum!
Beta lactams - Cephalosporins- Moderate and Broad spectrum
2nd generation
3rd generation:
Broad spectrum: Cephalosporin 4 th 5th
What are Beta-lactam carbapenenms? When are they used?
What are GLycopeptide? (Vanc, Teico,) GRAM positive activity! MRSA \
What are issues with Vancomycin?
When is it used? (gold standard fro MRSA)
What are aminoglycosides?
MOA?
Active against?
Side effects?
What are Fluoroquinolones?
MOA?
Common type?
Activity against?
(only oral agent active against pseudomonas)!
Try not to use it
What are Macrolides?
What are their activity against?
What are the different types?
Lincosamides?
What are they?
Name Two:
MOA?
Antibiotic resistance:
What are the mechanisms of antibiotic resistance? List 3
What are inactivating enzymes? (betalactamase)
How do they work?
What is ESBL?
How do we overcome them?
Resistance - Target modification
Efflux pumps resistance to antibiotics (mechanism)
What are the Mjaor multiresistant organisms of note?
MRSA?
VRE?
CRE NDM-1 ?
Principles of Antibiotic prescribing:
MIND ME;
Think when prescribing antibiotics:
M- microbiology
I
N
D
M
E
What is the aim of Prophylactic antibiotic therapy?
When is it indicated?
Aims to prevent infection when there is a significant clinicl risk of infection developing.
1) Restrict to indications for which there is evidence of efficacy
2) Base antimicrobials choice on likely pathogen
3) For most surgical prophylaxis indication
What is empirical antibiotic therapy?
What do you need to know?
What do you do when waiting for results?
How often should it be reviewed?
What is directed therapy? When can it be done?
What does it entail?
