Carbapenem, Glycopeptide & Oxazlidione Antibiotics

Question 1

Carbapenem

Answer 1

meropenem , Irvemon (Ivrance)

Mechanism of action:
Bactericidal, inhibits cell wall mucopeptide synthesis

Clinical application:
Excellent anaerobic coverage
Gram-positive cocci
gram-negative bacteria

UTI = ecoli with ESBL
Pneumonia
intra-abdominal infections
skin and soft tissue infections

Avoid use :
Atypicals no coverage

Side effects :
Elevated LFT, leukopenia, seizures

Question 2

Glycopeptides and Lipoglycopeptides

Answer 2

Vancomycin : ( Glycopeptide)
binds to bacterial cell wall peptides
disrupts peptidoglycan polymerization

Clinical application:
gram-positive organisms , cocci, and bacilli
covers MRSA , MRSE & ambicillin resistant entercocci
Oral dosing for C diff
IV doseing bacteremia, endocarditis

Avoid use:
MSSA and gram-negative organisms

Side effects:
ototoxicity and nephrotoxicity
red man syndrome and DRESS ( spares mucous membranes / simular to SJS)
thrombocytopenia and neutropenia

Question 3

Lipoglycopeptide

Answer 3

Daptomycin

Mechanisms of action:
anchors to bacterial cell walls depolarize membranes
bactericidal

Clinical application:
gram-positive coverage
covers vancomycin-resistant strains
bacteremia
endocarditis

Avoid use :
pneumonia: Dapto binds to surfactant, which make it useless

Side effects
C diff, superinfection, thrombocytopenia, rhabdomyolysis

Question 3

Oxazolidinone

Answer 3

Linezolid:
Mechanism of action:
protein synthesis inhibitor on ribosomal 5OS subunit
prevents bacterial reproduction

Application:
Gram +
MRSA, VRE, PCN resistance, s pneumoniae
pneumonia
skin and soft tissue infections
use only for serious infections with resistance

Avoid use:
gram -

Side effects :
Superinfection, C diff, pancytopenia, and SIADH