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Infectious Disease and Medical Microbiology > Beta-lactams > Flashcards

Beta-lactams Flashcards

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USMLE® Step 1 flashcards Biology 101 flashcards
0
Q

Mechanism of action of beta-lactams

A

Inhibition of bacterial cell wall synthesis. Bind and inactivate penicillin binding proteins. Prevents cross-linking and activates bacterial cell’s autolytic system leads to cell death.

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1
Q

The following 3 classes of antibiotics are beta-lactams

A
  1. Penicillins
  2. Cephalosporins
  3. Carbapenems
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2
Q

What do bacteria produce to counter beta-lactams?

A

Beta-lactamases

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3
Q

Clavulanic acid and tazobactam are 2 examples of what?

A

Beta-lactamase inhibitors

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4
Q

The penicillins include: (7)

A
  1. Penicillin V (PO)
  2. Penicillin G (IV)
  3. Amoxicillin (PO)
  4. Ampicillin (IV)
  5. Cloxacillin (PO/IV)
  6. Piperacillin (IV)
  7. Ticarcillin (IV)
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5
Q

Spectrum and indications for Penicillin V (PO) and Penicillin G (IV)

A
  1. Streptococci

2. Bacterial pharyngitis and endocarditis (IV)

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6
Q

Spectrum and indications for Amoxicillin (PO) and Ampicillin (IV)

A
  1. Streptococci and Enterococcus faecalis

2. Otitis media, community acquired pneumonia (CAP), enterococcal infections

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7
Q

Spectrum and indications for Cloxacillin PO/IV

A
  1. MSSA
  2. IV = bacteremia, endocarditis, bone/joint infections
  3. PO = STTI
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8
Q

Spectrum and indications for Amoxicillin/clavulanate PO

A

Spectrum = Gram +ve, Gram -ve, and anaerobes

Indications = polymicrobial infections (bite wounds, diabetic foot ulcer)

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9
Q

Spectrum and indications for Piperacillin/tazobactam IV

A

Spectrum: Gram +ve, Gram -ve, Pseudomonas aeruginosa, anaerobes

Indications: Febrile neutropenia, intraabdominal, polymicrobial infections, sepsis unknown source

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10
Q

Spectrum and indications for Ticarcillin/clavulanate IV

A

Spectrum: Gram +ve, Gram -ve, Pseudomonas aeruginosa, anaerobes

Indications: Febrile neutropenia, intraabdominal, polymicrobial infections, sepsis unknown source

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11
Q

The following drugs are considered Cephalosporins (10)

A
  1. Cephalexin PO (1st)
  2. Cefazolin IV (1st)
  3. Cefuroxime IV (2nd)
  4. Cefuroxime axetil PO (2nd)
  5. Cefprozil PO (2nd)
  6. Cefotaxime (3rd)
  7. Ceftriaxone IV (3rd)
  8. Cefixime PO (3rd)
  9. Ceftazidime IV (3rd)
  10. Cefepime IV (4th)
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12
Q

Spectrum and indications for Cephalexin PO (1st)

A

Spectrum: S. aureus (MSSA) and beta hemolytic Streptococci

Indications: SSTI

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13
Q

Spectrum and indications for Cefazolin IV (1st)

A

Spectrum: MSSA, Streptococci, E. coli, Proteus mirabilis, Klebsiella

Indications: SSTI, bone/joint, surgical prophylaxis

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14
Q

Spectrum and indications for Cefuroxime IV, Cefuroxime axetil PO, and Cefprozil PO (2nd)

A

Spectrum: S. pneumoniae (if penicillin susceptible), H. influenzae, M. cattarrhalis

Indications: CA respiratory infections (NOT first line)

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15
Q

Spectrum and indications for Cefotaxime and Ceftriaxone IV (3rd)

A

Spectrum: Streptococci, penicillin I/R S. pneumoniae, Gram -ve

Indications: Urosepsis, endocarditis, SSTI, meningitis

16
Q

Spectrum and indications for Cefixime PO (3rd)

A

Spectrum: Streptococci (if penicillin susceptible), Gram -ve

Indications: UTI, gonorrhea

17
Q

Spectrum and indications for Ceftazidime IV (3rd)

A

Spectrum: Pseudomonas aeruginosa

Indications: Combined with aminoglycosides for severe Pseudomonas infections

18
Q

Spectrum and indications for Cefepime IV (4th)

A

Spectrum: Gram +ve, penicillin I/R S. pneumoniae, MSSA, Gram -ve, Pseudomonas aeruginosa

Indications: Combined with aminoglycosides for Pseudomonas infections, febrile neutropenia, polymicrobial infections

19
Q

Cephalosporins in general have no activity against the following: (2)

A
  1. Enterococci

2. MRSA

20
Q

The following are considered Carbapenems (3)

A
  1. Ertapenem IV
  2. Meropenem IV
  3. Imipenem IV
21
Q

Spectrum and indications for Ertapenem IV

A

Spectrum: Gram +ve, Gram -ve, Extended Spectrum Beta-Lactamase (ESBL)/AmpC producers, anaerobes

Indications: Outpatient Rx of polymicrobial infections or multidrug resistant organisms

22
Q

Spectrum and indications for Meropenem IV

A

Spectrum: Gram +ve, Gram -ve, ESBL/AmpC producers, Pseudomonas, anaerobes

Indications: Post-trauma or neurosurgical meningitis, polymicrobial infections (with suspected multidrug resistant organisms)

23
Q

Spectrum and indications for Imipenem IV

A

Spectrum: Gram +ve, Enterococcus faecalis, Gram -ve, ESBL/AmpC producers, Pseudomonas, anaerobes

Indications: Intraabdominal, polymicrobial infections (with suspected multidrug resistant organisms)

24
Q

Carbapenems are first line for community acquired infections, True or False?

A

FALSE.

25
Q

Carbapenems are reserved for serious infections with known/suspected colonization/infection with multidrug resistant pathogens, True or False?

A

TRUE

26
Q

Carbapenems have NO activity against what?

A

MRSA

Infectious Disease and Medical Microbiology (23 decks)

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