chloramphenicol, daptomycin, fidaxomicin Flashcards
a parent of a young boy, 1 years old comes in to express their concerns. The doctor has prescribed her son some abx ointment for an eye infection but she has done some googling and is not sure if it is safe to use for his age due to concerns about boron exposure.
What do you say?
chloramphenicol - can be used in children under 2 safely as advised by a prescriber
benefits of chloramphenicol ED containing borax or boric acid outweighs potential risk and the exposure is very low
chloramphenicol interacts with this diabetes medicine.
hint hypo
SUs - chloramphenicol predicted to INCREASE exposure to SUs. monitor BG
why should chloramphenicol be reserved for treatment of life threatening infections only
Associated with serious haematological side-effects when given systemically
use of chloramphenicol in pregnancy
IV or oral: avoid, grey baby syndrome if used in 3rd trimester
eye: avoid unless essential, no info on topical use
use of chloramphenicol in BF
avoid
may cause bone marrow toxicity in infant
conc in milk usually insufficiency to cause grey syndrome
true or false - avoid chloramphenicol in BF because it can cause grey baby syndrome
false
may cause bone-marrow toxicity in infant; concentration in milk usually insufficient to cause ‘grey syndrome’.
MOA chloramphenicol
to inhibit protein synthesis in microbes by binding to the 50S subunit of the 70S ribosome
choramphenicol - bactericidal or bacteriostatic
primarily bacteriostatic but can be bactericidal in high concentrations against some bacteria
what is daptomycin and what is it similar to
Daptomycin is a lipopeptide antibacterial with a spectrum of activity similar to vancomycin but its efficacy against enterococci has not been established
the serious interactions with daptomycin are to do with rhabdomyolosis. name some.
statins, fibrates, ciclosporin
these are predicted to increase risk of rhabdomyolosis when given with daptomycin. monitor
what to do if unexplained muscle pain, tenderness, weakness, or cramps develop during treatment with daptomycin
measure creatine kinase every 2 days; discontinue if unexplained muscular symptoms and creatine elevated markedly.
monitoring for daptomycin
plasma creatine phosphokinase (CPK) before treatment and then at least weekly during treatment
more freq in pt at higher risk of developing myopathy including RI, other drugs associated with it, or if CPK >5x ULN before treatment
also renal function regularly during concomitant administration of potentially nephrotoxic drugs.
what is fidaxomicin
macrocyclic antibacterial that is poorly absorbed from the gastro-intestinal tract, and, therefore, it should not be used to treat systemic infections.
should fidaxomicin be used to treat systemic infections
no bc poorly absorbed from the gastro-intestinal tract
oral 2nd line for CDI, or oral 1st line for infection within 12 weeks of symptom resolution (relapse)
fidaxomicin
