Antimicrobials Flashcards

1
Q

Macrolides: MOA

A

Binds to the 50s ribosomal subunit & prevents translation of bacterial proteins. Bacteriostatic.

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2
Q

Macrolides: Drug examples, organism against, side effects

A

ends in “mycin”
1. Clarithromycin: Good substitution for Streptococcus if allergic to penicillin
2. Azithromycin: Staph, Strept, GN enterococcus
3. Erythromycin
GI upset: vomiting, diarrhea. inflammation of biliary duct

*Generally good for Gram +ves & atypicals (i.e. Chlamydia trichomonas, legionnaires, Mycoplasma pneumonia, Streptococcus pneumonia, ?gonorrhea, MAI,

Clinical conditions: Chlamydia, gonorrhea, pneumonia, Legionnaires disease.

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3
Q

Aminoglycosides: Drug names, organisms against

A
ends in "cin" 
1. Gentamycin 
2. Tobramycin 
3. Amikacin 
GN aerobic bacilli (e. coli & company). Used preoperatively during GI surgery to prevent the spilling of the normal microflora into the peritoneal cavity.
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4
Q

TMP-SMX: Organisms against

A

Wide Gram +ve & Gram -ve coverage but no anaerobic coverage
1. GN bacilli
2. MRSA
TREE

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5
Q

ABs used against MRSA

A
  1. Vancomycin
  2. Linezolid
  3. Clindamycin
  4. TMP-SMX
  5. Tigecycline (tetracycline)
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6
Q

ABs used against VRE

A
  1. Ampicillin
  2. Imipenem
  3. Linezolid
  4. Piperacillin
  5. Fluoroquinolones
  6. Vancomycin
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7
Q

Linezolid: Organisms against

A

Gram POSITIVE cocci (VRE, MRSA)

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8
Q

Metronidazole

A
  1. Enteric anaerobes: Bacteroides, C. dificile below the diaphragm
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9
Q

Vancomycin: Mechanism & organisms against

A

Broad spectrum.
Gram POSITIVE cocci in hospital
MRSA, VRE

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10
Q

*Clindamycin: Organisms against

A
  1. Gram positive (staph, strept) even MRSA + anaerobes about the diaphragm
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11
Q

Respiratory tract infections

& associated microbes

A
  1. Otitis media
  2. Sinusitis
  3. Pharyngitis
  4. Bronchitis
  5. Pneumonia
  6. Group A Streptococcus
  7. Pneumococcus
  8. S. aureus
  9. Mycobacteria tuberculosis
  10. Neisseria Meningitis
  11. Hemophilus influenza
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12
Q

Genitourinary tract infections & associated microbes

A
  1. Vaginitis
  2. Urethritis
  3. Prostatitis
  4. Epididymitis
  5. Cervicitis
  6. UTI
  7. Pelvic inflammatory disease
  8. E. coli & company (enterobacteria)
  9. Neisseria gonorrhea
  10. S. aureus
  11. Group A beta-hemolytic streptococcus
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13
Q

Intra-abdominal infections & associated microbes

A
  1. Pyelonephritis (inflammation of the kidneys)
  2. Cystitis (inflammation of the bladder)
  3. Diverticulitis
  4. Pelvic inflammatory Disease
  5. Intra-abdominal abscess/peritonitis
  6. Cholecystitis
  7. Diabetic foot infection
  8. Gram negative aerobic bacilli: Yersinia, Shigella, Salmonella, Campylobacter, E. coli
  9. Enteric anaerobes
  10. Enterococci
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14
Q

CNS infections & associated microbes

A
  1. Encephalitis
  2. Meningitis

1.

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15
Q

Skin infections & associated microbes

A
  1. Cellulitis
  2. Impetigo
  3. Erysipelas
  4. Abscess/Carbuncle
  • Group A Beta-hemolytic Streptococcus (Streptococcus pyogenes)
  • S. aureus
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16
Q

Bugs that can cause pneumonia in infants/children & relative prevalence

A
  1. Respiratory syncytia virus: 35-60%
  2. Parainfluenza virus: 15-20%
  3. Influenza A: 5-8%
  4. Mycoplasma pneumoniae: 15-30%
  5. S. pneumoniae: 1-8%
  6. S. aureus: 1-5%
  7. H. influenzae: 1-5%
17
Q

Gram negative aerobic bacilli

A
  1. E. coli
  2. Enterobacter
  3. Pseudomonas aeruginosa
  4. H. Influenzae
  5. Legionella
  6. Klebsiella

Anaerobic is
Bacteroides fragilis
Bacteroides anthracis

18
Q

Nosocomial pneumonia

A
Gram -ve bacilli: E. coli, Enterobacter, Pseudomonas, Klebsiella. 
Then 
S. aureus: 5-30% 
S. pneumonia: 2-8% 
H. influenzae: 1-8% 
Legionella: 0-5%
19
Q

Pneumonia complications

A
  1. Lung abscess
  2. Empyema; pleural effusion
  3. Bacteremia; metastatic infection
20
Q

Pneumonia
Sx
Physical findings

A
  1. Constitutional: Fever, chills
  2. Resp: Cough, sputum, dyspnea, pleuritic chest pain
  3. Fever
  4. Tachypnea (RR>20/min)
  5. Crepitations/rales
  6. Bronchial breathing
  7. Chest X-ray: lobar consolidation?

*w/ respiratory viruses do a nasopharyngeal swab and PCR of DNA.

  • Further w/u is sputum, blood (plus CBC), pleural fluid, urine culture. Bronchoscopy, lung biopsy.
  • Culture, gram stain

***More work if suspect TB: serology, AFB gram stain,