Cell wall inhibitors- Penicillins Flashcards
Benzyl penicillin Forms
- penicillin G IV/IM
- penicillin V PO
Benzyl penicillin Coverage
GP except Staphylococcus Enterococcus N. meningitidis Oral anaerobes Syphilis
Benzyl penicillin MOA
Bactericidal: β-lactam inhibits cell wall synthesis by binding penicillin binding protein (PBP) preventing cross-linking of peptidoglycan
Benzyl penicillin Adverse Effects
Immediate allergy (IgE): anaphylaxis, urticaria
Late-onset allergy (IgG): urticaria, rash, serum sickness Interstitial nephritis
Dose related toxicity: seizures
Diarrhea
Benzyl penicillin Indications
Mild to moderately severe infections caused by susceptible organisms including:
actinomycosis
streptococcal pharyngitis
streptococcal skin and soft tissue infections
pneumococcal pneumonia
syphilis
Benzyl penicillin Contraindicaions
Hypersensitivity to penicillin cov?
Aminopenicillin Forms
- ampicillin IV
- amoxicillin PO (Amoxil®)
NOTE: Same adverse effects and MOA as benzyl penicillin
Aminopenicillin Coverage
Same as penicillin AND Enterococcus Listeria Some strains of: H. influenzae E. coli K. pneumoniae
Aminopenicillin Indications
Bacterial meningitis and endocarditis (IV ampicillin)
acute otitis media (AOM)
streptococcal pharyngitis
sinusitis
acute exacerbations of COPD
part of multidrug therapy for H. pylori treatment
Lyme disease
pneumococcal pneumonia
UTI (amoxicillin and ampicillin)
for most enterococci and susceptible Gram negative pathogens
Aminopenicillin Contraindicatons
Hypersensitivity to penicillin or β-lactam antibiotics
Isoxazyolyl penicillin Forms
- cloxacillin
- methicillin
- nafcillin
- oxacillin
NOTE: Same adverse effects and MOA
Isoxazyolyl penicillin Coverage
Methicillin-sensitive Staphylococcus aureus;
streptococci
Isoxazyolyl penicillin Indications
Bacterial infections caused by staphylococci and streptococci including skin and soft-tissue infections
Isoxazyolyl penicillin Contraindications
Hypersensitivity to cloxacillin or any penicillin
β-lactam/β-lactamase inhibitor combinations
- amoxicillin-clavulanate (Clavulin®, Augmentin®)
- piperacillin/tazobactam (Tazocin®)
NOTE: Same adverse effects
β-lactam/β-lactamase inhibitor combinations Coverage
Same as penicillin AND Staphylococcus H. influenzae Enterococcus Anaerobes (oral and gut)
β-lactam/β-lactamase inhibitor combinations MOA
β-lactamase produced by certain bacteria inactivate β-lactams. Lactamase inhibitors prevent this process, preserving antibacterial effect of β-lactams
β-lactam/β-lactamase inhibitor combinations Indications
Various β-lactamase producing bacteria Clavulin® sensitive bacteria including RTI sinusitis AOM skin and soft tissue infections UTI severe intra- abdominal and pelvic infections
β-lactam/β-lactamase inhibitor combinations Contraindications
Hypersensitivity
to penicillin or cephalosporin History of Clavulin®- associated jaundice or hepatic dysfunction
