Antimicrobial characteristics

Question 1

Pen V (po) and Pen G (iv)

Answer 1

=> Inhibits PBP and cell wall synthesis (-cidal)

• GP Streptococcus, Enterococcus, Listeria
• GN Niesseria, Treponema pallidum
• Oral anaerobes

Question 2

Cloxacillin

Answer 2

=> Stable beta-lactam ring

• GP streptococcus, S. aureus (not MRSA)

Question 3

Amoxicillin (po) Ampicillin (iv)

Answer 3

=> Extended-spectrum penicillins

• GP Streptococcus, Enterococcus, Listeria
• Increased GM- coverage to include E. coli, Proteus, and H. Flu in addition to Niesseria, treponema pallidum
• Covers oral anaerobes

Question 4

Amoxicillin-clavulanate (po)

Answer 4

Same coverage as amoxicillin (Streptococcus, Enterococcus, Listeria / E.coli, Proteus, H.flu, Niesseria, treponema / oral anaerobes), in addition to:

• S. aureus (not MRSA)
• increased E.coli and H.flu coverage
• increased anaerobe coverage (bacteroides)

Question 5

beta-lactamase inhibitors

Answer 5

Any penicillin with a b-lactamase inhibitor added on will cover anaerobes like bacteroides

Ex) amox-clav, pip-tazo

They will also increase coverage to GM+ organisms like S. aureus (not MRSA tho)

Question 6

Piperacillin (iv)

Answer 6

=> Extended-spectrum penicillin

Similar coverage to amoxicillin (Streptococcus, Enterococcus, Listeria / E.coli, Proteus, H.flu, Niesseria, treponema / oral anaerobes) in addition to:
- increased GM- coverage to include Citrobacter, Acinetobacter, PSEUDOMONAS, Enterobacter, Serratia

Question 7

Pipercillin-Tazobactam (iv)

Answer 7

Compared to Piperacillin (Streptococcus, Enterococcus, Listeria / E.coli, Proteus, H.flu, Niesseria, treponema / oral anaerobes) (GM- Citrobacter, Acinetobacter, Pseudomonas, Enterobacter, Serratia)

In addition to:

• S. aureus (NOT MRSA)
• anaerobes (bacteroides)

Question 8

List the 1st generation Cephalosporins

Answer 8

Cefadroxil (po)
Cephalexin (po)
Cefazolin (iv)

All have ‘a’ after their ‘f-sound’

Question 9

Spectrum of Cefadroxil, Cephalexin, Cefazolin

Answer 9

=>1st gen cephalosporins

• GP streptococcus, S. aureus (not MRSA)
• GN E.coli, Proteus, Klebsiella

Question 10

List the 2nd generation Cephalosporins

Answer 10

Cefaclor (po)
Cefprozil (po)
Cefuroxime (po, iv)

Cefoxitin (iv)

Question 11

Spectrum of Cefaclor, Cefprozil, Cefuroxime

Answer 11

=> all 2nd gen cephalosporins

• GP Streptococcus, S. pneumo, NO MORE S. aureus
• Increased GM- coverage to include Neissera, Moraxella, H.flu

Question 12

Cefoxitin

Answer 12

=> 2nd gen Cephalosporins

• GP Strept (incl. S. pneumoniae), NO MORE S. aureus
• add on GM- Neisseria, Moraxella, H. Flu
• anaerobes (bacteroides) => only 2nd gen with anaerobe coverage [fox = anaerobe]

Question 13

List the 3rd gen Cephs

Answer 13

Cefixime
Cefotaxime
Ceftriaxone
Ceftazidime
Ceftolazane-tazobactam

Question 14

List the carbapenems

Answer 14

Ertapenem
Meropenem
Imipenem-cilastatin

Question 15

Spectrum of Meropenem

Answer 15

• GP Streptococcus, S. aureus not MRSA,
• GN E.coli, Klebsiella, Citrobacter, Acinetobacter, Pseudomonas, Enterobacter, Serratia, ESBLs
• Anaerobes (oral, bacteroides)

Question 16

List the macrolides

Answer 16

• Erythromycin
• Clarithromycin
• Azithromycin (azolide)

Question 17

Spectrum of macrolides

Answer 17

=> they are static

• GP variable Streptococcus (not PRSP), variable S. aureus (not MRSA)
• GN H. fllu
• ATYPICALS (Mycoplasma, Legionella, Chlamydia)

Question 18

List the tetracyclines

Answer 18

Doxycycline (po)
Minocycline (po)
Tetracycline (po)
Tigecycline (IV)

Question 19

Spectrum of tetracyclines

Answer 19

=> bacteriostatic

• GP variable Strept, but good S. aureus (not MRSA)
• GN broad coverage! (No Pseudomonas)
• Atypicals (Mycoplasma, Legionella, Chlamydia)

Question 20

List the fluoroquinolones. Which are 2nd or 3rd gen?

Answer 20

Ciprofloxacin (po, iv) - 2nd gen
Norfloxacin (po) urinary - 2nd gen

Levofloxacin (po, iv) - 3rd gen
Moxifloxacin (po, iv) - 3rd gen

Question 21

Spectrum of 2nd gen FQs

Answer 21

=> Urinary FQ’s (Cipro, Norfloxacin)

• Gram+ bacteria acquire resistance during therapy!
• GN E.coli, Kelbsiella, Citrobacter, PSEUDOMAS, Enterobacter, Serratia
• Atypicals (Mycoplasma, Legionella, Chlamydia)

Norfloxacin does

Question 22

Spectrum of 3rd gen FQs

Answer 22

=> Respiratory FQs

• Similar to Cipro (Good GM-: E.coli, Klebsiella, Citrobacter, Pseudomonas, Enterobacter, Serratia)
• Good S. pneumoniae coverage!
• Moxiflocaxin covers anaerobes (bacteroides), but not pseudomonas

Question 23

List the aminoglycosides (AGs)

Answer 23

Amikacin
Gentamicin
Streptomycin (IM)
Tobramycin

All IV except Streptomycin

Question 24

Clindamycin spectrum

Answer 24

=> Bacteriostatic agent

• GP streptococcus, S. aureus including MRSA
• Anaerobes (both oral and bacteroides)

Question 25

Daptomycin spectrum

Answer 25

=> cidal agent! Gram positive coverage only

• GP streptococcus, S. aureus (including MRSA!), Enterococcus including VRE

Question 26

Linezolid spectrum

Answer 26

=> is static, available po and iv. GM+ only!

• GP streptococcus, S. aureus including MRSA, Enterococcus including VRE

Question 27

Metronidazole spectrum

Answer 27

=> spectrum ; used for C. Dif!!

• Anaerobes (oral and bacteroides)

Question 28

TMP/SMX spectrum

Answer 28

=> available po and iv

• GP S. aureus, including MRSA!
• GN E. coli, H. flu
• Pnemocystis

Question 29

Vancomycin spectrum

Answer 29

=> cidal, but works slowly. Only GP coverage!

• GP Streptococcus including PRSP, S. aureus including MRSA, CoNS, Enterococcus (not VRE)