Cell Wall Inhibitors

Question 1

Monobactams

Answer 1

Interacts with G- to form filamentous structure

Question 2

AZTREONAM

Answer 2

Binds with PBP3
Coli, Klebsiella, Proteus, Serratia, Citrobacter and Pseudomonas

Treats: UTI, LRTI, Intra-abdominal infection, Gynecological infection, Septicemia

Question 3

TIGEMONAM

Answer 3

PO
Resistant to beta lactamases
Used to treat systemic infections
Basic compounds with good solubility

Question 4

CARBAPENEMS

Answer 4

Has broadest antimicrobial spectrum of any antibiotic
Analogues of penicillins or clavams , the sulfur or oxygen being replaced with carbon
Has beta-lactamase resistance

Question 5

OLIVANIC ACIDS

Answer 5

Potent inhibitors of beta-lactamases
Naturally – occuring from Streptomyces olivaceus

Question 6

THIENAMYCINS

Answer 6

Chemically unstable

Question 7

IMIPENEM

Answer 7

N – formimidoyl derivative of thienamycin
From Streptomyces cattleya
Readily hydrolysed by renal dehydropeptidase
Imipenem + Cilastatin (Primaxin ®)

Question 8

MEROPENEM

Answer 8

Dimethylcarbamoyl pyrolidinyl derivative of thienamycin
More stable against dehydropeptidase enzyme Meropenem (Merrem IV®)

Question 9

ERTAPENEM

Answer 9

Once daily
Effective against Gram-positive bacteria and Enteribacteriaceae
Ertapenem (Invanz®)

Question 10

Vancomycin

Answer 10

Streptomyces orientalis (Amycolopsis orientalis)
Bactericidal to gram +
Slow IV injection or infusion
ADRs: Red Man or Red Neck Syndrome, Decreased auditory acuity, Renal Damage, Phlebitis and rashes
Vancocin® DOC for MRSA

Question 11

Bacitracin

Answer 11

Bacillus subtilis
From debrided wound of 7-year old Margaret Tracy
Very active against G(+) bacteria
Orally, topically and parenterally= NEPHROTOXIC
MOA: Interfere with lipid component (BACTOPRENOL) that carry peptidoglycan