Antimicrobial Chemotherapy Flashcards by Sophie White

What is benzylpenicillin and penicillin V used for? (PENICILLIN CLASS)

Streptococci, Nisseria, Spirochetes Used for soft tissue, pneumococcal, meningococcal, gonorrhoea, syphilis infection

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What is amoxicillin used for?(PENICILLIN CLASS)

Broad spectrum but resistance is common UTI, RTI

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What is flucloxaxilin used for?(PENICILLIN CLASS)

Staphylococci Used for S. aureus infections

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What is co-amoxiclav used for?(PENICILLIN CLASS)

Broad spectrum including anaerobes UTI, RTI, Soft tissue infections, surgical wound infections

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What is a complication of using Co-amoxiclav?(PENICILLIN CLASS)

Clostridium Difficile

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What is piperacillin/tazobactam used for?(PENICILLIN CLASS)

Broad spectrum includes pseudomonas and anaerobes Neutropenic sepsis

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What is cefradine used for ? (Cephalosporins)

Broad spectrum. Resistance high. 1st line agent

UTI, Soft tissue infections

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What is cefuroxime used for? (CEPHALOSPORIN)

Broad spectrum,

UTI, RTI, Surgical Prophylaxis

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What is ceftriaxone or cefotaxime used for? (CEPHALOSPORIN)

Broad spectrum, especially good against GramNegative Bacilli. 2nd Line option.

Used for hospital infections such as bacteraemia, pneumonia, abdominal sepsis

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What are the risks of using ceftriaxone or cefotaxime?

Risk factor for MRSA, C Dif, VRE. Can only be used IV/IM

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What is ceftazidime used for? (CEPHALOSPORIN)

Broad spectrum. Good against Gram Negative bacilli. Also active against psudomonas

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What are risk factors for ceftazidime?

MRSA, C.Dif, VRE.

IV only

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What are ceftaroline or ceftobipirole used for? (CEPHALOSPORIN)

4th line agent used for broad spectrum. Anti MRSA.

Licensed skin and soft tissue infection. Endocarditis. Used if resistant to other treatment

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What is gentamicin used for? (AMINOGLYCOSIDE)

Gram negative bacilli

Serious gram negative infections such as bacteraemia, endocarditis, neutropenic sepsis

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What are the risks for using gentamicin? (AMINOGLYCOSIDE)

Renal and ototoxicity, disturbance of vestibular system

IV or IM only

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What is clarithromycin or erythromycin used for? (MACROLIDE)

Streptococci, staphylococci, mycoplasma, chlamydia or legionella.

Used in resp infection, soft tissue infection (if penicillin allergic), STD

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What is azithromycin used for? (MACROLIDE)

Gram negative organisms such as haemophilus or chalmydia

Mainly used in chlamydia

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What is ciprofloxacin used for? (Quiolones)

Gram negative bacilli including pseudomonas. Activity against staph and strep.

Complicated UTI, Complicated hospital acquired pneumonia, some GI infections

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What are the risks associated with ciprofloxacin use?

C Diff.
May affect growing cartilage
Can cause tendinitis or an aortic aneurysm rupture

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What is levofloxacin or moxifloxacin used for?

Enhanced activity against staph/strep. Active against pneumococcus, mycoplasma, chlamydia or legionella

2nd or 3rd line against pneumonia

What is vancomycin or teicoplain used for? (GLYCOPEPTIDE)

Gram POSITIVE organisms only

Used against C Dif, MRSA, Those with penicillin allergies

What is trimethoprim used for?

Gram negative bacilli

UTI, RTI, MRSA

What is co-trimoxazole used for?

Broad spectrum. Pneumocystis Jiroveci (fungus which causes pneumonia)

RTI, PCP

What is a side effect of co-trimoxazole?

Rashes

What is clindamycin used for?

Streptococci, staphylococci anaerobes Soft tissue infection and gangrene

What is tetracycline or doxycycline used for?

Streptococci, staphylococci, chlamydia, rickettsiae, brucella Q Fever, brucellosis, chlamydia,atypical pneumonia, MRSA

What is rifampicin used for?

Mycobacteria, meningococcus, staphylococci Used to treat TB, MRSA, Meningococcal prophylaxis, complicated staph infections.NEVER USE ON ITS OWN

What is ,meropenem used for?

Broad spectrum including anaerobes. Pseudomonas. Last resort Used for gram negative infections and neutropenic patients

What is metrondiazole used for?

Anaerobes or protozoa e.g giarida Surgical infections, giardiasis, ameobiasis, trichomonal infections

What is linezolid used for?

Gram positive bacteria only. Second line agent for MRSA, MSSA, VRE

What are the risks for Linezolid?

Bone marrow dysplasia and optic neuropathy

What is daptomycin used for?

Gram positive bacteria only 2nd line for MRSA, VRE, MSSA

What is tigecycline used for?

Very broad spectrum including MRSA, ESBL and anaerobes 3rd line treatment including intra-abdominal sepsis, soft tissue infections

What is tigecycline ineffective against?

Pseudomonas

What is empiric therapy?

Treatment without microbiology results

What is directed therapy?

Treatment based on microbiology results

What is primary prophylaxis?

Anti-malarial, immunosuppresed patients, pre-operative surgery, post exposure to HIV or meningitis

What is secondary prophylaxis?

Prevention of a second episode

What are the methods of diagnosing a patient?

Diagnosis of infection using clinical, laboratory results. Include a severity assessment

What patient characteristics should be take into consideration ?

Age, renal function, liver function, immunocompromised, pregnancy, known allergies

What antimicrobial selections can be taken into consideration when prescribing antibiotics?

Guideline or individualised therapy, what is the likely organism, empirical or result based therapy, bactericidal or bacteriostatic drug, single agent or combination, any adverse effects

What are the four mechanisms of antibiotic resistance?

Enzymatic inactivation of drug Modified targets for drugs Reduced permeability to drug Efflux of drug

What is chromosomally mediated resistance?

Mutation in gene coding for drug target or membrane transport system. BASIS FOR MULTI DRUG THERAPY

What are the steps in binary fission?

DNA replicates, cell elongates, cell divides in two and produces 2 identical bacteria

What is plasmid mediated resistance?

Plasmids are extra-chromosomal strands of DNA. They replicate independent of cell chromosomes and carry enzymes which degrade antibiotics/modify membrane transport systems. May carry 1 or more resistance gene

What is MRSA?

Methicillin-resistant Staphylococcus aureus Resistant to flucloxacillin Can cause invasive infections such as osteomyelitis, endocarditis

What is VRE?

Vancomycin resistant enterococci Can cause invasive disease such as endocarditis esp. in patients with prosthetic devices

What is ESBL?

Extended spectrum beta-lactamase Resistant to beta-lactam antibiotics, often cephalopsorins

What is CPE?

Carbapenem producing enterobacteriacae Multiply resistant bacteria and only sensitive to a few antibiotics of last resort