Antimicrobial Chemotherapy Flashcards
Groups of antibiotics?
penicillins, cephalosporins, aminoglycoside, macrolide, quinolones, glycopeptide, others
penicillin used for streptococci, neisseria and spirochetes?
benzylpenicillin
main uses of benzylpenicillin
soft tissue, pneumococcal, meningococcal, gonorrhoea, syphilis
main uses of amoxicillin?
UTI,
RTI
main uses of flucloxacillin?
staphylococci
main uses of co-amoxiclav?
UTI,
RTI,
soft tissue infection,
surgical wound infection
main uses of piperacillin/ tazobactum?
neutropenic sepsis
risk factors or cephalosporins?
MRSA,
C.diff,
Vancomycin resistant enterococci
Main use of cefradine?
UTI,
soft tissue infection
Main use of cefuroxime?
UTI,
RTI,
surgical prophylaxis
Main use of ceftriaxone?
hospital infections,
gram -ve bacilli
Main use of ceftrazidime?
pseudomonal infections in hospital and CF
what special aboiut ceftaroline?
it’s anti-mrsa
Main use of ceftaroline?
licensed skin and soft tissue infection,
endocarditis resistant to other treatment
what kind of antibiotic is gentamicin?
aminoglycoside
what does gentamicin act against?
gram-ve bacilli
What are the main uses of gentamicin
serious gram-ve infections eg sepsis and septic shock
Gentamicin side effects?
renal toxicity,
ototoxicity
Name the macrolide antibiotics?
clarithromycin,
erythromycin,
azithromycin
activity for clarithromycin and erythromycin?
strptococci, staphylococci, mycoplasma, chlamydia, legionella
activity for azithromycin?
gram negative
main uses for clarithromycin and erythromycin?
resp infection,
soft tissue infection,
STD
activity for azithromycin?
chlamydia
Name the quinolone antibiotics?
ciprofloxacin,
levofloxacin
activity of ciprofloxacin
gram -ve bacilli,
pseudomonas,
staphylococci/ streptococci
main uses of ciprofloxacin
complicated uti,
complicated hospital pneumonia,
GI infections
activity of levofloxacin
enhanced activity against staphylococci/ strep, pneumococcus, mycoplasma, chlamydia, legionella
main use of levofloxacin
2nd or 3rd line agent against pneumonia
name the glycopeptide antibiotics
vancomycin,
teicoplanin
activity of glycopeptide anitibiotics
gram +ve only
main uses for glycopeptide antibiotics?
MRSA,
C.difficle,
allergic to penicillin
main use of trimethoprim
UTI,
resp infection,
MRSA
Main use of co-trimoxazole
resp infection,
PCP
Main use of clindamycin
soft tissue infection,
gangrene
Main use of tetracycline and doxycycline
q fever, brucellosis, chlamydia, atypical pneumonia, MRSA
Main use of rifampicin
TB,
MRSA,
complicated staph infections,
meningococcal prophylaxis
what does empiric antibiotic treatment mean?
prescribing without microbiology results
the 4 principles of prescribing?
indications for antimicrobials,
diagnosis,
patient characteristics,
antimicrobial selection
Sensitivity tests used to see antibiotic sensitivity?
Disk Defusion method,
Etest
How does the Etest for sensitivity work?
Zone of inhibition must be above the minimum inhibitory concentration
what are the 4 main mechanisms of resistance?
enzymatic inactivation of drug,
modified targets for drugs,
reduced permeability to drugs,
refflux of drug
what are the methods of resistance with regards to genetics?
chromosomally mediated,
plasmid mediated
Describe MRSA
penicillinase resistant penicillin,
can cause severe invasive infections
What is VRE?
vancomycin resistant enterococci,
gram +ve,
colonise in GI in patients with multiple antibiotic exposire,
can cause invasive disease
what is ESBL producing enterobacteraciae?
Extended spectrum beta-lactamase,
resistant to beta-lactam antibiotics
what is CPE?
Carbapenem producing enterobacteriacae,
can colonise in healthy gut,
multiply resistant bacteria
Factors influencing antibiotic resistance?
widespread antibiotic use,
patients surviving longer with more medical conditions and more hospital contact,
more invasive procedures and prosthetic devices,
increased bed pressure
what levels would you measure to detect resistance to antibiotic?
Minimum Inhibitory Concentration (MIC)
Reasons for failure of antibiotic therapy?
inadequate dose, route, non-compliance, bacteria walled off, foreign bodies, poor penetration
