Clinical Use of antimicrobial Agents Flashcards
Principles in antimicrobial Chemoprophylaxis
- Prophylaxis should always be directed toward a specififc apthogen
- No resistance should develop during the period of drug use
- Prophylactic drug use should be of limited duration
- Conventional therapeutic doses should be used
- Prophylaxis should be used only in situations of documented drug efficacy
Empiric antimicrobial therapy
begun before a specific pathogen has been identified and is based on the presumption of an infection that requires immediate drug treatment
Amikacin is used to treat sepsis on an AIDS patient. Monitoring of serum drug level may be advised because this drug
Has narrow therapeutic window
Combiantion drug for Cryptococcal meningitis
Amphoteric B + Flucytosine
Combination drugs for coliform infections
Sulfamethoxazole and trimethoprim
Combiantion therapy for enterococcal infections
Rifampin + vancomycin
Combination therapy for pseudomonal infections
Carbenicllin and gentamicin
Drugs that may not require dosage modification in renal problems
- cefoperazone
- erythromycin
- clindamycin
- doxycyline
- INH
- ketoconazole
- nafcillin
Patient will be undergoing ELECTIVE colonic surgery. what prophylactic antibiotics is ideal
Oral erythromycin and neomycin
Drugs not removed by dialysis
- Amphotericin B
- cefonicid
- ceforperazone
- ceftriaxone
- erythromycin
- nafcillin
- tetracycline
- vancomycin
Concentration dependent antibiotics
Aminoglycosides and fluoroquinolones
Time dependent Antibiotics
Beta lactams, vancomycin
If ampicillin and piperacillin are used in combiantion in the treatment of psedomonas aeruginosa, anatagonism may occur because_________
Ampicillin induces beta lactamase production
Erythromycin inhibits heaptic metabolism of ___________
- cloazapine
- lidocaine
- loratidine
- phenytoin
- quinidine
- sildenafil
- theophylline
- warfarin
Ketoconazole inhibits the metabolism of
- Caffeine
- carbamazepine
- cyclosporine
- statins
- methadone
- oral contraceptives
- phenytoin sildenafil
- verapamil
- zidovudine
Rifampin, an inducer of hepatic-drug metabolizing enzymes, decreases the effects of
- Digoxin
- ketoconazole
- oral contraceptives
- propanolol
- quinidine
- several antiretroviral drugs
- warfarin
DOC of Enterococcus
Ampicillin +/- gentamicin
DOC of S. aureus or epidemidis
Methicillin-susceptible = Nafcillin
Methicillin-resitant = vancomycin +/- gentamicin +/- rifampin
DOC of strep pneumoniae
Penicillin-susceptible = Pen G, amoxicillin
Penicillin - resitant = Vancomycin + ceftriaxone or cefotaxime +/- rifampin
DOC of N. gonorrhea
Ceftriaxone, cefixime
DOC of N. meningitidis
Pen G
DOC of M. catarrhalis
Cefuroxime, TMP-SMZ
DOC of C. difficile
Metronidazole
DOC of C, trachomatis
Azihromycin or tetracycline
DOC of C. pneumoniae
Erythromycin or tetracycline
DOC of C. pneumoniae
Eythromycin or tetracycline
DOC of T. pallidum
Pen. G
DOC of bacteroides
Metronidazole
DOC of C. jejuni
Macrolide
DOC of enterobacter spp
Carbapenem, TMP-SMZ
DOC of E.coli
Cephalosporin (forst and 2nd generation), TMP-SMZ
DOC of K. pneumoniae
Cephalosporin (1st or 2nd Generation), TMP-SMZ
DOC of P. mirabilis
Ampicillin
DOC of Proteus-indole posite
Cephalosporin (1st pr 2nd generation, TMP-SMZ
DOC of S. typhi
Ceftriaxone or fluoroquinolone
DOC of serratia
Carbapenem
DOC of shigella
Fluoroquinolone
