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Infection > Antimicrobial Chemotherapy > Flashcards

Antimicrobial Chemotherapy Flashcards

1
Q

Give examples of penicilins that are commonly used

A

Amoxicilin, flucloxacilin, co-amoxiclav, benzylpenicillin/penicillin V and piperacillin/tazobactam

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2
Q

What are the main uses of benzylpenicillin/penicillin V?

A

Soft tissue, pneumococcal, meningococcal, gonorrhoea and syphilis

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3
Q

What are the main uses of amoxicilin?

A

UTI and RTI

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4
Q

What is the main use of flucloxacilin?

A

S. aureus

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5
Q

What are the main uses of co-amoxiclav?

A

UTI, RTI, soft tissue infections and surgical wound infections

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6
Q

What is the main use of piperacillin/tazobactam?

A

Neutropenic sepsis (IV)

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7
Q

Give examples of commonly used cephalosporins

A

Cefradine (1st), cefuroxime (2nd), ceftriaxone/cefotaxime (3rd), ceftazidime (3rd) and ceftaroline/ceftobipirole (4th) - anti MRSA

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8
Q

What are the main uses of cefradine?

A

UTIs and soft tissue infection

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9
Q

What are the main uses of cefuroxime?

A

UTI, RTI and surgical prophylaxis

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10
Q

What are the main uses of ceftriaxone/ cefotaxime?

A

Hospital infections e.g. bacteraemia, pneumonia and abdo sepsis

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11
Q

What are the main uses of ceftazidime?

A

Pseudomonal infections in hospital and in cystic fibrosis

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12
Q

What are the main uses of ceftaroline/ ceftobipirole?

A

Skin and soft tissue infections (+ IE resistant to other treatment)

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13
Q

What is the most common aminoglycoside and what is it used for?

A
  • Gentamicin

- Serious gram negative infections e.g. bacteraemia, endocarditis and neutropenic sepsis

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14
Q

Give examples of commonly used macrolides

A

Clarithromycin, erythromycin and azithromycin

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15
Q

What are the main uses of clarithromycin and erythromycin?

A

Resp infection, soft tissue infection (if penicillin allergic) and STDs

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16
Q

What is the main use of azthromycin?

A

Chlamydia

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17
Q

Give examples of commonly used quinolones?

A

Ciprofloxacin, levofloxacin and moxifloxacin

18
Q

What are the main uses of ciprofloxacin?

A

Complicated UTI, complicated hospital pneumonia and some GI infections

19
Q

What is the main use of levofloxacin/moxifloxacin?

A

2nd or 3rd line agent for pneumonia

20
Q

Give examples of commonly used glycopeptides

A

Vancomycin and teicoplanin

21
Q

What are the main uses of vancomycin and teicoplanin?

A

MRSA, alternative to penicillin (allergy) and C. diff (oral)

22
Q

What are the 4 main mechanisms of bacterial resistance?

A
  • Enzymatic inactivation of the drug
  • Modified targets for drugs
  • Reduced permeability to drug
  • Efflux of drug
23
Q

Describe how binary fission works

A
  • DNA replicates
  • Cell elongates
  • Divides in 2
  • Creates 2 identical bacteria
24
Q

How can plasma mediated resistance occur?

A

Conjugation - transfer resistance gene to other species

25
Q

List the medically important resistant organisms

A

MRSA, VRE, ESBL, CPE and clostridium difficile

26
Q

Which infections can MRSA cause?

A

Severe invasive infections e.g. osteomyelitis and endocarditis

27
Q

What is VRE resistant to and what infection can it cause?

A
  • Vancomycin

- Endocardities: esp. in patients with prosthetic devices

28
Q

Which antibiotics are ESBL resistant to?

A

Beta lactam antibiotics - cephalosporins

29
Q

Which factors influence antibiotic resistance?

A
  • Antibiotic use by medical professions, vets, farming etc.
  • Patients surviving longer with more medical conditions and hospital contact
  • More invasive procedures and prosthetic devices
  • Increased bed pressure encouraging spread of resistant organisms
30
Q

What are the reasons for failure of antibiotic therapy?

A
  • Inadequate dose/route
  • Non-compliance
  • Bacterial walled off in abscess cavity
  • Foreign bodies e.g. surgical implants/prosthesis
  • Poor penetration of drug to site of infection
31
Q

Which antibiotics have good biofilm activity?

A

Rifampicin, daptomycin and ceftobiprole

32
Q

List the points of the antibiotic stewardship

A
  • Using the right antibiotic for the right indication for the right duration of time
  • Use only if suspected/proven bacterial infection
  • Review prescriptions and stop ASAP
  • Limit use of broad spectrum blind antibiotic therapy to seriously ill patients
33
Q

When should IV antibiotics be switched to oral?

A
  • Able to swallow and tolerate fluids
  • Temp 36-38 for at least 48hrs
  • Heart rate <100 for 12 hrs
  • WCC: 4-12x10^6L
34
Q

Which health conditions would mean you wouldn’t switch IV antibiotics to oral?

A

Endocarditis, meningitis, staph aureus bacteraemia, immunosuppression, bone/joint infection, deep abscess, CF and prosthetic infection

35
Q

What may antivirals be used for?

A

Prophylaxis, pre-emptive therapy, overt disease and suppressive therapy

36
Q

Which antivirals can be used for HSV and VZV?

A

Aciclovir, valaciclovir, famciclovir and foscarnet

37
Q

How does aciclovir work?

A

It is converted to ACV-TP which competitively inhibits and inactivates HSV-specific DNA polymerase (prevents further viral DNA synthesis without interrupting the cell)

38
Q

When would antivirals be used to treat CMV?

A

HIV patients, CMV retinitis, colitis. transplant patients, pneumonitis and neonates with symptomatic congenital CMV infection

39
Q

Which antivirals can be used to treat chronic hepatitis B?

A
  • Tenofovir
  • Adefovir
  • Entecavir
  • Larnivudine
  • Emtricitabine
  • Telbivudine
40
Q

Which antivirals can be use to treat chronic hepatitis C?

A

Pegylated interferon alpha and ribavirin +/- telaprevir or boceprevir

Infection (15 decks)

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