Antibiotics EXAM 2 Flashcards
Which pathogens are covered by Pen V, Pen K and Pen G (IV)?
Gram (+)
-Group B Strep
-Syphilis
Which drugs only cover MSSA?
Antistaphylococcal PNCs:
Nafcillin (IV)
Dicloxacillin (oral)
Oxacillin
Cephalexin (oral)
Cefazolin (IV)
When switching from Penicillins to Amoxicllin or Ampicillin which organs are covered in addition to Staph and Strep?
Enterococcus (and Staph and Strep)
friendly negatives (pan-sensitive gram neg)
E. coli, Klebsiellla, Proteus
When using Augmentin or Amp/Sulb which bugs are covered in addition to those of Amoxicillin and Ampicillin?
Gram (-) with ß-lactamase + anaerobes
Augmentin is a good choice for which type of infections, based on its coverage?
Breathing (respiratory tract): sinusitis, tonsillar abscess, bronchitis, pneumonia
Belly (GI): Colitis, Diverticulitis, infected gallbladder
Bites: human, dog, and cat bites
Which drug is a ß-lactam with a ß-lactamase inhibitor that also covers Pseudomonas?
Pip/tazo
What are the Antipseudomonals?
Pip/Tazo (Zosyn)
Cefepime (4th gen)
Meropenem
Levofloxacin, Ciprofloxacin
Aminoglycosides
When moving to early to later Cephalosporin gens, how does the coverage change?
more gram negatives as we go further down the generation, sometimes we give up gram pos coverage
Which organisms are covered by the First Gen Cephalosporins?
similar to Amoxicillin and Ampicillin
-Staph - MSSA
-Strep
-pan-sensitive gram negatives (E. coli, Klebsiella, Proteus)
BUT NO Entercoccus coverage
NO coverage against
Which of the Cephalosporins covers Enterococcus?
not sure?
What advantage does AmpC provide to organisms that produce it?
Which organism produces ampC ß-lactamase?
resistance to Penicillins and 1st to 3rd gen Cephalosporins
-Enterobacter
-Acinetobacter
-Citrobacter species
-some Klebsiella species
-some E. coli species
-Pseudomonas
Which Cephalosporin covers anaerobes?
Cefoxitin (2nd gen)
Which cephalosporin has a coverage profile similar to piperacillin/tazobactam?
Cefepime
add Flagyl for anerobe coverage
Pip/Tazo covers Pseudomonas and anaerobes
3rd gens have stability against…
ß-lactamase producing organism (similar to Augmentin)
-Ecoli
-Klebsiella
-M. cat
NO Enterococcus
Cefepime coverage
-MSSA
-Strep
-Enterococcal
-Gram-negatives
NO Anaerobes
Which organisms are covered by 5th generation Cephalosporins?
they cover organism that 3rd gens cover + MRSA
But NO Pseudomonas
5th gen example
-Ceftaroline
Coverage of Meropenem
-enterococcus
-staph (MSSA)
-strep
gram negatives
-pseudomonas
-anaerobes
Which organisms are not covered by ert(ape)nem but are covered by other carbapenems?
ape
Acinetobacter
Pseudomonas
Enterococcus
Carbapenems are often the drug of choice for which organism?
ESBL E. coli
ESBL Klebsiella
Which antibiotics cover Listeria?
-1st line: Ampicillin, Penicillin G
-Meropenem for meningitis listeria due to great CNS penetration
-Imipenem
When would Aztreonem (Monobactam) be a choice?
NAPLEX
true PNC allergy (anaphylactic PNC allergy)
it only has gram neg. coverage
-NO gram-positive, NO anaerobes
MOA of Fluroquniolones
DNA Gyrase inhibition
Which antibiotics cover MRSA?
Vancomycin
Clindamycin
Linezolid
Doxycycline
Bactrim
Daptomycin (not for pneumo)
What are the atypicals? Which part of the body do they typically infect?
- Mycoplasma pneumoniae
- Legionella
- Chlamydophila (Chlamydia) pneumoniae
infects the respiratory tract -> Pneumonia, URI, otitis media
Which antibiotics cover atypicals?
-Macrolides
-Tetracyclines (Doxycycline)
-FQ
What needs to be checked before starting Daptomycin?
check CK (creatine kinase) before starting and throughout the therapy
due to the risk of rhabdomyolysis
Main side effect of Linezolid
thrombocytopenia after 2 weeks
-> so can only use for 2 weeks
Which of the FQs primarily provide gram (+), and which one provides gram (-) coverage?
gram-positive coverage: MSSA, Strep pneumo, Enterococcus
-Moxifloxacin (it also has some gram (-) and anaerobe coverage)
gram-negative:
-Ciprofloxacin
some of both:
-Levofloxacin
Moxifloxacin doesn’t cover which gram-negatives?
Psueodomaona and UTI
it primarily covers gram-positives
Aminoglycosides cover only gram-_____
negatives including Pseudomonas
-may also be used for synergy for endocarditis added to ß-lactam
Which drugs are similar to Vancomycin with a longer half-life?
long-acting injectables with gram (+) coverage for 7-10 days
Dalbavancin
Oritavancin
-sometimes used for patients where we don’t want to send them home with IV access (abuse)
-maybe used to provide a single dose, and let the patient go home (don’t need to pay for hospitalization)
