antimicrobials Flashcards
what does penicillin cover
strep pyogenes
n.meningitdis
what does flucloxacillin cover
MSSA
what does amoxicillin cover
h.influenzae
strep pnumoniae
enterococcus
what does co-amoxiclav cover
all of amoxicillin plus
s.aureus
gram positive coci anaerobe
some gram negatives
what does tazocin cover
strep
enterococcus faecalis
gram negatives
pseudomonas aeruginosa
what does temocillin cover
ESBL
what does cefazolin cover
gram positives inc. s aureus and strep
what does cefuroxime cover
gram positives
some gram negatives
what does ceftriaxone cover
meningococci
gram negative and positive
carbapenem coverage
broadest spec of bl
-gram positives and gram negatives
what works against carbapenems
cpe cabapenemase produces enterobacteriacea
what is gentamicin for
gram negative cover
but also s.aureus
and enterococci
what are glycopeptides for
MRSA
what is ciprofloxacin for
- gram negatives and
- atypical pneumonia
- TB
- some s.aureus
what is clarithromycin for 5
gram positives and
atypical organisms and
mycobacteria avium intracellulare
h.pylori and lyme disease
what is clindamycin for4
gram positives
anaerobes
pneumocytis jiroveci
malaria
what is tetracycline for 3
chlaymdia trachomatis and psittaci and pneum
mycoplasma pneumoniae
what is doxycycline for
-used for RTI
h.influenzae
s.aureus-mild mrsa
m.catarrhalis
E.coli
klebsiella pneumonia
what is tigecycline for
MRSA VRE
what is trimethoprim for
gram positives and gram negatives
-uti’s
what is metronidazole for
anaerobes and parasites
what is linezolid for
gram positive MRSA and VRE
what is daptomycin for
gram positive s.aureus and VRE
adverse for penicillin
- allergy
- cholestasis: co-amoxiclav
- hepatitis: flucoxacillin
- interstitial nephritis
- antibiotic assoc. diarrhoea
antibiotics of choice more or less in pregnancy
penicillins
gentamicin adverse
nephrotoxic
ototoxic
worsens myasthenia gravis
vancomycin adverse
nephrotoxic
ototoxic
red man syndrome
quinolones adverse
- diarrhoea, n&v
- reduced seizure threshold so ci epilepsy
- tendon rupture in children and arthropathy
- qt prolongation
macrolides adverse
- gi upset
- hepatotoxicity
- rash
- qt prolongation
- thrombophlebitis
- increased risk myositis with statins
lincosamide adverse
diarrhoea rash hepatotoxicity leucopenia thrombocytopenia risk c.diff infection
tetracycline adverse
- N&v
- oesophageal irritation
- photosensitivity in lupus
- deposited in growing bones and teeth avoid <12
- hepatotoxic
- renal impair
trimethoprim adverse
- steven Johnson syndrome
- n&v
- suppression of haematopoiesis
- increase serum creatinine-but false kidney failure as just reduces secretion
- teratogenic 1st semester of pregnancy
- avoid with other folate drugs
antibiotics that are harmful in pregnancy and why
- trimethoprim 1st trimester anti folate-spina bifida
- nitrofurantoin: at term haemolysis
- quinolones: arthropathy
- gentamicin: ototoxic to foetus
- piperacillin
metronidazole adverse
-metallic tast
-N&V
-peripheral neuropathy
-disulfarim like reaction with alcohol
headache and dizzy
-cerebellular toxicity
linezolid adverse
bone marrow suppression
optic neuropathy
daptomycin adverse
myositis
rhabomyolysis
hep b treatment
interferon alpha and tenofovir injections
hep c treatment
interferon and ribavirin daa's simepravir=protease daclatasvir= ns5a sofobuvir-ns5b
hiv treatment
retroantiviral drugs eg ziovudine
triple therapy
influenza treatment remember route
neuraminidase inhibitors
- oseltamivir oral
- zanamivir inhalation
herpes virus treatment
aciclovir: dna polyermase inhibitor oral
ganciclovir: nucleoside analogue
endocarditis treatment
beta lactam +/- aminoglycoside
proven MSSA treatment
flucoxacillin oral-iv depend on severity
proven MRSA treatment
vancomycin IV as can only be used oral for gut infections
meningitis bacterial treatment 3
ceftriaxone IV
dexamethasone IV
and if >50, pregnant or immunocompromised or on steroids also amoxicillin IV
viral encephalitis treatment
aciclovir IV
cerebral abscess treatment
ceftriaxone IV
and metronidazole oral
prophylactic orthopaedics treatment
and post op wound infection
co-amoxiclav or clindamycin
oral for prophylaxis
mild=flucox oral or clarithro oral
pen allergy=vancomycin
severe=co-amoxcilav iv
pen allergy= ceftriaxone IV and metronidazole oral
osteomyelitis treatmet
flucox or vanomycin
iv
neutropaenia treament
beta lactam and aminoglycoside
pseudomonas infection treatment
piperacillin or ciprofloxacin
esbl treatment
temocillin
cellulitis treatment
mild infection flucoxacillin oral or pen allergy = doxycycline oral or clarithromycin oral
for severe switch to IV and same as mild for pen allergy
necrotising fasciitis treatment 5
fine bears can gather much
flucoxacillin benzylpenicillin clarithromycin gentamicin metronidazole IV all
CAP penicillin allergy treatment for CURB2
doxycycline or clarithromycin oral
CAP penicillin allergy treatment for CURB 3-5
ciprofloxacin oral
and vancomycin iv
CAP 0-1 treatment
amoxicillin oral
or doxycycline oral
CAP 2 treatment
amoxicillin iv and clarithromycin oral
CAP 3-5 treatment
co-amoxiclav IV and clarithromycin iv
CURB65 meaning
confused <8 urea >7 rr >30 blood p <90 or <60 diastolic >65
severity marker for HAP
temp <36 or >38 hr >90 rr>20 wcc <4 or >12 organ dysfunction
HAP treatment if early onset in hospital <5 days
treat as CAP because means come from community
HAP treatment if >5 days and severity marker of 0-1
doxycycline for 5 days oral
HAP treatment if >5 days 2 and greater severity
amoxicillin IV and gentamicin IV
penicillin allergy for HAP
vancomycin IV and gentamicin IV
HAP for mrsa
vancomycin IV and gentamicin IV
risk of giving both vancomycin and gentamicin
both can cause renal damage
aspiration pneumonia treatment
amoxicillin IV and metronidazole oral
aspiration pneumonia with allergy
doxycycline oral
or
co-trimoxazole oral and metronidazole oral
type of bacteria that cause hap, cap and aspirate
aspirate: aerobes and anaerobes
hap: gram positive and negatives
cap: typicals and atypicals
asplenic prophylactic treatment
lifelong phx penicillin
c.diff treatment
- metronidazole oral if no severity markers
- vancomycin oral if one severity marker
- 1st relapse fidaxomicin
triple therapy for abdo infections and for pen allergy
amoxicillin iv (switch to vancomycin if pen allergy)
gentamicin
metronidazole oral
spontaneous bacterial peritonitis treatment
amoxicillin iv
temocillin
metronidazole oral
h.pylori treatment
omeprazole oral
amoxicillin oral
clarithromycin or metronidazole oral
uti treatment for cystitis
and for pyelonephritis and route
cystitis
trimethoprim or nitrofurantoin for 3 days women and 7 days men both oral
pyelonephritis
-gentamicin iv and amoxicillin IV
antibiotics that cover atypical organisms
clarithromycin
ciprofloxacin
antibiotics that cover gram negatives 6
tazocin ceftriaxone carbapenems-but only used in severe infections quinolones-ciprofloxacin amingolycosides-gentamicin trimethoprim for UTI
antibiotics that cover MRSA
vancomycin
tigecycline or doxycyline only for mild mrsa
trimethoprim
antibiotics for COPD exacerbations
doxycyline oral
antibiotics for chlamydia
tetracycline
antibiotic for VRE
tigecycline
gastroenteritis in children treatment
none unless sensitivity comes back
gastroenteritis caused by ameobiasis treatment
metronidazole oral
gastroenteritis caused by campylobacter treatment
erythromycin oral
giardiasis gastroenteritis treatment
metronidazole or
albenazole oral
treatment of legionella pneumonia
needs antibiotics that have intracellular activities including levofloxacin or clarithromycin
specific treatment of H.influenzae pneumonia
depends if beta lactamase producer or not co-amoxiclav
p.aeruginosa pneumonia treatment
ciprofloxacin or piperacillin
enteric fever treatment-salmonella
ceftriaxone
treatment of rickettsial
doxycycline
pneumocystis jiroveci treatment
co-trimoxazole IV
