Antimicrobials & SSTIs Flashcards
Therapeutic balance of ID
Maximize ____ and minimize ___
Maximize bacterial killing, safety, and efficacy
Minimize toxicity & resistance
ecological adverse effects of antibiotic therapy, specifically selection of drug-resistant organisms and the unwanted development of colonization or infection with MDR organisms
collateral damage
collateral damage risks associated with cephalosporin
-subsequent infections with VRE
-extended spectrum B-lactamase producing K. pneumoniae
-B-lactam resistant Acinetobacter species
-C. diff
the lowest concentration of an antibiotic that completely inhibits the growth of a microorganism in vitro
MIC
the lowest concentration of the antibiotic which results in a 99.9% reduction in colony forming units in a given time
MBC
species that is
-gram + cocci
-clusters (catalase -)
-coagulase +
S. aureus
species that is
-gram + cocci
-clusters (catalase -)
-coagulase -
S. epidermidis
species that is
-gram + cocci
-pairs (catalase +)
-alpha
S. pneumoniae
species that is
-gram + cocci
-chains
-beta
Group A strep (S. pyogenes)
Group B strep (S. agalactiae)
Group C, G, F strep
species that is
-gram + cocci
-chains
-gamma
enterococcus species
E. faecalis
E. faecium
drugs for MSSA (S. aureus, 50%)
nafcillin, oxacillin, dicloxacillin
drugs for MRSA (S. aureus, 50%)
vancomycin, linezolid, daptomycin, Bactrim, clindamycin
drugs for MSSE (S. epidermidis, 20%)
nafcillin, oxacillin, dicloxacillin (same as MSSA)
drugs for MRSA (S. epidermidis, 80%)
vancomycin, linezolid, daptomycin, Bactrim, clindamycin (same as MRSA)
drugs for PCN (S) S. pneumoniae (90%)
penicillin G/V, nafcillin
drugs for PCN (R) S. pneumoniae (10%)
vancomycin, Bactrim
drugs for PCN (S) streptococcus
penicillin G/V, nafcillin (same as S. pneumoniae)
drugs for PCN (R) streptococcus
vancomycin, Bactrim (same as S. pneumoniae)
drug options for enterococcus species (E. faecalis, E. faecium)
- ampicillin +/- gentamicin
- vancomycin +/- gentamicin
- linezolid, daptomycin
drug for gram positive aerobe cocci
clindamycin
drug for gram positive aerobe bacilli
metronidazole
gram - cocci PEK species
Proteus mirabilus
Escherichia coli
Klebsiella pneumoniae
gram - cocci HEM species
Haemophilus influenzae
Enterobacteriaceae (salmonella, shigella)
Monexella catanthalis
gram - cocci SPACE species
Serratia marcesens
Pseudomonas aeruginosa
Acinetobacter baumannii
Citrobacter
Enterobacter
cephalosporins that cover PEK bacteria
cefazolin, cephalexin, cefadroxil
cephalosporins that cover PEKHEM bacteria
1) cefuroxime, cefaclor
2) cephamycins, cefoxitin, cefotetan cefmetazole
cephalosporins that cover PEKHEM S_ACE bacteria
1)Ceftriaxone, cefpodoxime proxetil
anti-pseudomonal: ceftazidime, cefoperazone
2) cefepime
3) ceftaroline
which cephalosporin is best for SPACE organisms
ceftazidime
which drugs are used for pseudomonas
combinations including:
-piperacillin/tazobactam
-carbapenems (meropenem, imipenem)
-ceftazidime
PKPD indices for antibiotic effect
Cmax:MIC
%T>MIC
AUC:MIC
which drugs follow:
-time dependent killing
-min/mod persistent effects
penicillins
cephalosporins
carbapenems
macrolides
oxazolidinones
what is the PKPD index that influences time dependent killing and min/mod persistent effects
%T/MIC
which drugs follow:
-concentration dependence
-prolonged persistent effects
aminoglycosides
quinolones