Beta Lactam Antibiotics Flashcards

1
Q

Specifically, what enzyme do beta lactams block?

A

Block transpeptidase to prevent cell wall synthesis

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2
Q

3 mechanisms of bacterial resistance against beta lactam antibiotics

A
  1. Production of beta lactamases
  2. Alteration in structure of PBPs (like in MRSA) leading to lower binding affinity
  3. Alteration of outer membrane porins leading to decreased penetration
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3
Q

Natural Penicillins

A

Penicillin G
Benzathine penicillin G (IM, long acting)
Procaine penicillin G (IM)
Penicillin VK (oral)

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4
Q

Organisms susceptible to penicillin G or penicillin VK

A
Group streptococci
Viridians streptococci
Neisseria spp
Clostridium spp
Treponema pallidum
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5
Q

Pencillinase Resistant Penicillins

A

Nafcillin
Oxacillin
Methicillin
Dicloxacillin

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6
Q

What are penicillinase resistant penicillins used against?

A

MSSA

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7
Q

Aminopenicillins

A

Ampicillin (parenteral) and Amoxicillin (oral)

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8
Q

What are aminopenicillins developed for?

A

Increased activity against Gram negative aerobes

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9
Q

What are aminopenicillins good to use against?

A
Gram Negative
Proteus mirabilis
Some E coli
Salmonella
Shigella
BL- H. influenzae

Gram Positive
Enterococcus spp.
Listeria monocytogenes (!!!)

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10
Q

Carboxypenicillins

A

Ticarcillin (parenteral)

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11
Q

What were carboxypenicillins developed for?

A

Further increased Gram Negative activity

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12
Q

What are carboxypenicillins good against?

A

Pseudomonas aeruginosa

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13
Q

Ureidopenicillins

A

Piperacillin (parenteral)

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14
Q

Ureidopenicillins developed for?

A

Improved Gram positive activity while maintaining the strong Gram negative activity of carboxypenicillins

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15
Q

Ureidopenicillins used against?

A

Pseudomonas aeruginosa
Enterobacter spp.
Serratia marcescens
Some Klebsiella spp.

Good activity against anaerobes

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16
Q

Beta Lactamase inhibitors

A

Inhibit bacterial beta-lactamase
Often used in combination with antibiotics

Unasyn = ampicillin-sulbactam
Timentin = Ticarcillin-clavulanate
Zosyn = Piperacillin-tazobactam
Augmentin = Amoxicillin-clavulanate
17
Q

What are beta lactamase inhibitor combos good against?

A

Staph aureus
Bacteroides spp.
Haemophilus influenzae
Moraxella catarrhalis

Unasyn, Zosyn, Timentin good for polymicrobial infections