Endocarditis

Question 0

Enterococcus

Endocarditis

Answer 0

Primary for native valve
-penicillin G + gentamicin (4-6 weeks)
-ampicillin + gentamicin (4-6 weeks)
Primary for prosthetic valve
-vancomycin + gentamicin + rifampin

Question 1

S. Aureus, Strept

Endocarditis

Answer 1

Primary
-vancomycin + ceftriaxone or
-vancomycin + gentamicin
Alternate
-substitute daptomycin for vancomycin

Question 2

Aminoglycoside

gentamicin, tobramycin, amikacin

Answer 2

-antibiotic
-used for mycobacterial infections, and aerobic Gr- bacteria
MOA
-irreversible inhibitors of protein synthesis (bind to specific 30S-subunit ribosomal proteins)
ADE
-Nephrotoxicity
-ototoxicity (cochlear, vestibular)
-neuromuscular blockage
Pharmacodynamics
-conc-dependent killing
-post-antibiotic effect (PAE)
-synergism w/ other drugs
Pharmacokinetics
-poor lipid solubility
-“dosing weight”

Question 3

Monobactam

aztreonam

Answer 3

-beta lactam antibiotic
-narrow spectrum activity
-Gr- aerobes (holes: Gr+ & aerobes)
MOA
-bind to transpeptidase enzyme (aka PBP=penicillin binding protein) inibiting cross-linking of the peptidoglycan in cell wall
-used when pt has allergy to other beta-lactam
Cross rx
-ceftazidime

Question 4

Carbapenem

imipenem/cilastatin, doripenem, meropenem

Answer 4

-“-penem”
-beta lactam antibiotic
-broad spectrum activity
-Gr+, Gr-, inc. ESBL+, anaerobic B. frag.
-holes: MRSA, organisms w/ carbapenemases
MOA
-bind to transpeptidase enzyme (aka PBP=penicillin binding protein) inibiting cross-linking of the peptidoglycan in cell wall
ADE
-seizures (imipenem), allergic rx (w/ cross-sensitivity w/ penicillin and cephalosporins), C. diff colitis