Antibiotics: Targets

Question 1

What is the drug of choice for treating syphilis?

Answer 1

Penicillin V (or G for i.v. administration)

Question 2

What are the drugs of choice for treating non-VRE enterococci / group D strep infections?

Answer 2

Ampicillin or Amoxicillin (broad spectrum penicillins / aminopenicillins)

Question 3

What is the first-line drug for a simple GAS pharyngitis (strep throat)?

Answer 3

Penicillin V (or G for i.v. administration)

Question 4

What drugs are best used to treat community-acquired abscesses and cellulitis (likely to involve S. aureus and group A strep)?

Answer 4

Very narrow spectrum / penicillinase-resistant penicillins and 1st generation cephalosporins

Question 5

What drugs are best used to treat acute sinusitis (likely to involve H. flu and Moraxella)?

Answer 5

Broad spectrum penicillins / aminopenicillins

Question 6

What drugs are best used to treat recurrent sinusitis, acute sinusitis in a COPD patient, and complicated abscesses or cellulitis (ex. foot ulcers with poor circulation)?

Answer 6

Penicillin + suicide inhibitors (amoxicillin-clavulunate, piperacillin-tazobactam) and 2nd generation cephalosporins

Question 7

What drugs cover the same Gram(+) organisms as aminopenicillins, but cover more Gram(-) organisms also?

Answer 7

Extended spectrum penicillins (piperacillin); 3rd and 4th generation cephalosporins are similar

Question 8

List 3 drugs/classes that you should think of when faced with infection of a chronic indwelling catheter or with Gram(-) sepsis.

Answer 8

Extended spectrum penicillins (piperacillin), 3rd generation cephalosporins (esp. ceftazadime), and aminoglycosides (first line for immediate Gram(-) treatment)

Question 9

What drug is mostly used in ICU patients who need broad coverage of all Gram(-) and Gram(+) organisms? What is one notable organism that it does NOT cover?

Answer 9

Imipenem (carbapenem): covers almost everything except MRSA

Question 10

If a patient presents to the hospital with Gram(-) pneumonia and renal dysfunction, what is a good drug to start them on?

Answer 10

Aztreonam (monobactam)

Question 11

What drug is useful for treating complicated Staph (MRSA), Enterococcus (ampicillin resistant), and C. difficile (metronidazole resistant) infections?

Answer 11

Vancomycin (glycopeptide)

Question 12

What 5 drug classes can be used to treat MRSA?

Answer 12

Glycopeptide, tetracycline, macrolides, clindamycin, linezolid

Question 13

Name 2 drugs used to treat VRSA.

Answer 13

Daptomycin, Linezolid

Question 14

Name 4 drug classes that are primarily used to treat Gram(-) infections: so they work on pseudomonas, but not on C. difficile

Answer 14

Monobactam, colistin, aminoglycosides, fluoroquinolones

Question 15

Which drug is best for a cystic fibrosis patient with resistant pseudomonas infection?

Answer 15

Colistin

Question 16

Which 2 drug classes are the best choice for treating intracellular pathogens like mycoplasma, chlamydia, legionella, and rickettsia?

Answer 16

Tetracyclines and macrolides

Question 17

Which drug is effective against all Gram(+) anaerobes except C. difficile?

Answer 17

Clindamycin (generally works “above the diaphragm”)

Question 18

Which drug is effective against all anaerobes, Gram(+) and (-), including C. difficile and H. pylori?

Answer 18

Metronidazole (generally works “below the diaphragm”)

Question 19

What is the first-line drug for treatment of uncomplicated UTI’s?

Answer 19

TMP-SMX (trimethoprim-sulfamethoxazole)

Question 20

If a UTI is unresponsive / resistant to TMP-SMX, what drugs should be given next?

Answer 20

Fluoroquinolones (ciprofloxacin and levofloxacin)

Question 21

What drug is good for treating pelvic inflammatory disease involving N. gonorrhea?

Answer 21

Ceftriaxone (3rd gen cephalosporin)

Question 22

What drug is good for treating pelvic inflammatory disease involving chlamydia?

Answer 22

Doxycycline (second choice: azithromycin)

Question 23

What drugs are best for immediate treatment of Gram(-) sepsis?

Answer 23

Aminoglycosides (gentamycin, tobramycin, streptomycin, etc.)

Question 24

You suspect a patient has C. difficile. What is the first drug you should try giving them? What is the second drug to think of if that fails?

Answer 24

Metronidazole; then vancomycin

Question 25

Which anti-TB drug also has efficacy against MSSA?

Answer 25

Rifampin