EXAM #4: ANTIBIOTICS IV Flashcards
For a skin infection, what are good first choice drugs?
1st generation cephalosporin
- Treats gram positive organisms that commonly cause infection
What are good alternatives for uncomplicated skin infections with hypersensitivty?
Vancomycin or Clindamycin
What is a good first choice drug for a complicated skin infection?
Ticarcillin and a lactamase inhibitor i.e. clavulanate
*Note that Ticarcillin has anti-pseudomonal activity
What three drugs are good options for MRSA skin infection?
1) Vancomycin
2) Linezolid
3) Daptomycin
What causes uncomplicated skin infection?
S. aureus
S. pyogenes
What causes complicated skin infections?
- E. coli
- Pseudomonas aeruginosa
In bone and joint infections, what are good first line emperic agents?
Vanocmycin and 3rd/4th generation cephalosporins
What is being targeted by Vancomycin and 3rd/4th generation cephalosporins?
Cell wall inhibitors
What is a good abx option for bone and joint infection post-op?
Ticracillin + Clavulanate
What is a good abx for septic arthritis?
Cetftriaxone
What is a good first choice abx for acute sinusitis and chronic bronchitis?
Augmentin i.e. amoxicillin and clavulanate
What abx can be used to treat pharyngitis? Why?
PCN–pharyngitis is more often caused by gram positive bacteria that are covered by PCN
What are the three main organisms that cause URIs?
S. pneumoniae
H. influenza
Moraxella catarrhalis
What bacterium causes pharyngitis?
S. pneumoniae (gram +) covered by PCN
From a microbioloical perspective, what is unique about the bacteria that cause pneumonia?
Mycoplasma pneumonia does NOT have a peptidoglycan cell wall; thus, Beta-Lactams won’t work
What is the drug of choice to treat ambulatory pneumonia?
Macrolides i.e. erythromycin, azithromycin, and clarithromycin
How does the treatment change for a patient with pneumonia that has to be hospitalized?
Macrolide + Beta-Lactam
What is the treatment of choice for nosocomial pneumonia?
Ceftriaxone
What is the treatment of choice for uncomplicated UTI?
TMP-SMX
What is the most common cause of uncomplicated UTI?
E. coli
How is uncomplicated pyelonephritis treated?
TMP-SMX
Fluoroquinolones
How does the treatment of complicated UTIs differ from uncomplicated?
It doesn’t i.e.
- TMP-SMX
- Fluoroquinolone
What is the treatment of choice for intra-abdominal infections?
Ticracillin and clavulanate
What type of bacteria typically cause intra-abdominal infections?
Gram negative
How is C. diff treated?
1) Metronidazole (moderate)
- C. diff is anaerobic
- Metronidazole releases ROS
- Induces DNA damage
2) Vancomycin (severe)
What antibiotic is highly implicated in the pathogenesis of C. diff?
Clindamycin
What are the drug choices for community acquired bacterial meningitis for patients older than 2 y/o?
1) 3rd and 4th generation Cephalosporins
- Ceftriaxone
- Cefotaxime
2) Vancomycin
What drugs as used to treat neonatal meningitis?
1) Ampicillin
2) Cephalosporin
3) +/- Gentamicin
What is the rationale for using Gentamicin in neonatal meningitis?
L. monocytogenes (under cooked meat/ lunch meat consumed by the Mom) is a cause–best covered by Gentamicin
What is the initial treatment approach to treating Sepsis?
1) 3rd/4th generation cephalosporin i.e. Cefepime
2) Vancomycin
What is the best approach to treated Endocarditis?
1) Ceftriaxone
2) Vancomycin
What are the best empiric antibiotics used to treat neutropenic fever?
Ciprofloxacin + Amoxacillin/Clavulanate (Augmentin)
What drugs are used to treat enterococci infections?
1st- note that enterococci infections are notirous for resistance; thus,
- Daptomycin
- Tigacycline
How are gram-negative antibiotic resistant organisms treated?
1) Carbapenam
- Imipenem
- Meropenem
2) Carbapenemases
- Polymyxin B
- Tigecycline
