Bugs & drugs (Antibiotics)

Question 1

Penicillin treats?

Answer 1

Mostly Gram + organisms (S. pneumo, S. pyogenes, Actinomyces).. Also N. meningitidis, & syphilis

Question 2

Oxacillin, Nafcillin, Dicloxacillin treat?

Answer 2

S. aureus (except MRSA) *Naf treats Staph

Question 3

Ampicillin/Amoxicillin treat?

Answer 3

HELPSS kill enterococci: H. influenza, E. coli, Lysteria monocytogenes, Proteus mirabilis, Salmonella, Shigella, enterococci (use with clavulinic acid)

Question 4

Ticarcillin, piperacillin treat?

Answer 4

Pseudomonas (use with clavulinic acid)

Question 5

Beta lactamase inhibitors? Use?

Answer 5

CAST: Clavulanic Acid, Sulbactam, Tazobactam. Added to Pcn to protect it from destruction by beta lactamases

Question 6

Organisms typically NOT covered by Cephalosporins are?

Answer 6

LAME: Listeria, Atypicals (Mycoplasma, Chlamydia), MRSA, Enterococci (Exception: ceftriaxone covers MRSA)

Question 7

1st generation Cephalosporins?

Answer 7

Cefazolin, Cephalexin

Question 8

What do the 1st gen Cephs treat?

Answer 8

PEcK: Proteus mirabilis, E. coli, Klebsiella pneumoniae

Question 9

What is used prior to surgery to prevent S. aureus wound infections?

Answer 9

Cefazolin *Be Cef before you zole in to surgery??

Question 10

2nd gen Cephs?

Answer 10

Cefoxitin, Cefaclor, Cefuroxime

Question 11

2nd gen Cephs treat?

Answer 11

HEN PecKS: H. influenzae, Enterobacter aerogenes, Neisseria spp, Proteus mirabilis, E. coli, Klebsiella pneumo, Serratia marcenscens

Question 12

3rd gen Cephs?

Answer 12

Ceftriaxone, Cefotaxime, Ceftazidime

Question 13

3rd gen Cephs treat?

Answer 13

Serious Gram - infections
Ceftriaxone: meningitis & gonorrhea
Ceftazidime: Pseudomonas

Question 14

4th gen Ceph? What does it treat?

Answer 14

Cefepime. Pseudomonas

Question 15

What do you give to someone with Pcn allergy or renal insufficiency who cannot tolerate AMGs?

Answer 15

Aztreonam (treats Gram- rods only)

Question 16

Name the carbapenems. What is special about one of them?

Answer 16

Imipenem & Meropenem. Must give cilastatin with imipenem to prevent inactivation of drug in renal tubules

Question 17

What do the carbapenems treat?

Answer 17

Gram+ cocci, Gram- rods, and anaerobes. However, limited in use due to significant AEs (seizures)

Question 18

Vancomycin treats?

Answer 18

Serious Gram+ infections: MRSA, enterococci, C. diff

Question 19

Name the AMGs

Answer 19

GNATS: Gentamicin, Neomycin, Amikacin, Tobramycin, Streptomycin

Question 20

AMGs treat?

Answer 20

Severe Gram- rod infections. Cannot treat anaerobes cuz need O2 for uptake. Neomycin for bowel surgery

Question 21

Doxycycline treats?

Answer 21

Borrelia burgdorferi, M. pneumoniae, & intracellular bugs (Rickettsia, Chlamydia)

Question 22

Demeclocycline treats?

Answer 22

SIADH.. it is an ADH antagonist & is rarely used as an antibiotic

Question 23

The macrolides (Azithromycin, Clarithromycin, Erythromycin) treat?

Answer 23

Atypical pneumonias (Mycoplasma, Chlamydia, Legionella), STDs (Chlamydia) and Gram+ cocci (Streptococcal infections for pts allergic to Pcn)

Question 24

Chloramphenicol treats?

Answer 24

Meningitis (H. influenza, Neisseria meningitidis, Strep pneumo). Used sparingly in US cuz of toxicities (anemia & gray baby syndrome)

Question 25

Clindamycin treats?

Answer 25

Anaerobic infections above diaphragm (aspiration pneumonia with Bacteriodes fragilis or C. perf & oral infections with mouth anaerobes like Actinomyces)

Question 26

The sulfonamides (Sulfamethoxazole, sulfisoxazole, sulfadiazine) treat?

Answer 26

Gram+, Gram-, Nocardia, Chlamydia. Can use SMX for simple UTI

Question 27

Trimethoprim treats?

Answer 27

Used in combo with SMX (TMP-SMX) for UTIs, Shigella, Salmonella, Pneumocystis jirovecii (treatment and prophylaxis)

Question 28

Fluoroquinolones (the “floxacins”) treat?

Answer 28

Gram- rods of urinary & GI tract (Pseudomonas), Neisseria, and some Gram+ organisms

Question 29

Metronidazole treats?

Answer 29

GET GAP: Giardia, Entamoeba, Trichomonas, Gardnerella vaginalis, Anaerobes (Bacteriodes, D. diff), & H. Pylori (along with a PPI and clarithromycin.. “triple therapy”)