Blue - Antibiotics

Question 1

What organisms are considered part of the normal skin flora?

Answer 1

• S. aureus
• S. epidermis
• Micrococcus luteus
• Corynebacterium diptheriae
• Proprionibacterium acnes

Question 2

What is the difference between bacteriostatic and bactericidal antibiotics?

Answer 2

• Bacteriostatic: prevents growth of bacteria

- Bactericidal: kills bacteria

Question 3

What antibiotics are considered static?

Answer 3

• Clindamycin
• Chloramphenicol
• Macrolides
• TMP/SMX
• Tetracyclines

Question 4

When is antibiotic prophylaxis recommended?

Answer 4

• All clean-contaminated procedures

- No more than 1 hour pre-op

Question 5

What antibiotic should be used for endocarditis prophylaxis?

Answer 5

Oral/respiratory/esophageal:

• amoxil 2g PO 1hr pre-op
• PO clinda/keflex, azithro/clarithro
• IV clinda, anced

GU/GI

• Amp +/- gent /iv 30min pre-op–>+Gent if: prosthetic valve, previous IE, complex cyanotic congenital heart disease, surgically constructed systemic to pulmonary shunts or conduits
• IV Vancouver +/- gen

Question 6

What procedures should you provide PPX Abs for?

Answer 6

• Oral procedures that may cause bleeding or incision of mucosa
• Rigid bronchoscopy
• I&D of infection
• Cysto with urethral dilatation
• Endo of upper urinary tract
• Urinary catheterization in presence of infection
• Vaginal hysterectomy
• Vaginal delivery in presence of infection
• GI procedures involving incision or resection of mucosa
• Endoscopic manipulation

Question 7

What does antibiotic bowel prep consist of?

Answer 7

Neomycin + erythromycin: 19, 18, and 9 hours pre-op + IV Abx

Question 8

Where do anaerobes most commonly reside?

Answer 8

GI tract

Question 9

What antibiotics cover anaerobes?

Answer 9

• Flagyl
• Clindamycin
• Imipenem
• Chloramphenicol
• Penicillin + beta-lactamase inhibitor (tic/clav, amp/salbactam, pip-tazo)
• 2nd generation cephalosporin (cefoxitin, cefotetan)
• Some 3rd generation cephalosporins /ceftizoxime)

Question 10

What are some common anaerobes

Answer 10

• Bacteroides (mouth, vagina, colon)
• Clostridium
• Fusbacterium
• Peptrostreptococcus
• Actinomyces

Question 11

What are the common obligate aerobes?

Answer 11

• Pseudomonas

- Acineobacter

Question 12

What antibiotics cover obligate aerobes?

Answer 12

• Ceftazidime
• Imipenem, meropenem
• Ciprofloxacin
• Aminoglycoside
• Aztreonam
• Acylureidopenicillin

Question 13

What is the antibiotic choice for enterococcus?

Answer 13

• Amp + gent

- Vanco

Question 14

What infections are commonly cause by enterococci?

Answer 14

• UTI
• Biliary tract
• Subacute endocarditis