EXAM #4: ANTIBIOTICS IV

Question 1

For a skin infection, what are good first choice drugs?

Answer 1

1st generation cephalosporin

- Treats gram positive organisms that commonly cause infection

Question 2

What are good alternatives for uncomplicated skin infections with hypersensitivty?

Answer 2

Vancomycin or Clindamycin

Question 3

What is a good first choice drug for a complicated skin infection?

Answer 3

Ticarcillin and a lactamase inhibitor i.e. clavulanate

*Note that Ticarcillin has anti-pseudomonal activity

Question 4

What three drugs are good options for MRSA skin infection?

Answer 4

1) Vancomycin
2) Linezolid
3) Daptomycin

Question 5

What causes uncomplicated skin infection?

Answer 5

S. aureus

S. pyogenes

Question 6

What causes complicated skin infections?

Answer 6

• E. coli

- Pseudomonas aeruginosa

Question 7

In bone and joint infections, what are good first line emperic agents?

Answer 7

Vanocmycin and 3rd/4th generation cephalosporins

Question 8

What is being targeted by Vancomycin and 3rd/4th generation cephalosporins?

Answer 8

Cell wall inhibitors

Question 9

What is a good abx option for bone and joint infection post-op?

Answer 9

Ticracillin + Clavulanate

Question 10

What is a good abx for septic arthritis?

Answer 10

Cetftriaxone

Question 11

What is a good first choice abx for acute sinusitis and chronic bronchitis?

Answer 11

Augmentin i.e. amoxicillin and clavulanate

Question 12

What abx can be used to treat pharyngitis? Why?

Answer 12

PCN–pharyngitis is more often caused by gram positive bacteria that are covered by PCN

Question 13

What are the three main organisms that cause URIs?

Answer 13

S. pneumoniae
H. influenza
Moraxella catarrhalis

Question 14

What bacterium causes pharyngitis?

Answer 14

S. pneumoniae (gram +) covered by PCN

Question 15

From a microbioloical perspective, what is unique about the bacteria that cause pneumonia?

Answer 15

Mycoplasma pneumonia does NOT have a peptidoglycan cell wall; thus, Beta-Lactams won’t work

Question 16

What is the drug of choice to treat ambulatory pneumonia?

Answer 16

Macrolides i.e. erythromycin, azithromycin, and clarithromycin

Question 17

How does the treatment change for a patient with pneumonia that has to be hospitalized?

Answer 17

Macrolide + Beta-Lactam

Question 18

What is the treatment of choice for nosocomial pneumonia?

Answer 18

Ceftriaxone

Question 19

What is the treatment of choice for uncomplicated UTI?

Answer 19

TMP-SMX

Question 20

What is the most common cause of uncomplicated UTI?

Answer 20

E. coli

Question 21

How is uncomplicated pyelonephritis treated?

Answer 21

TMP-SMX

Fluoroquinolones

Question 22

How does the treatment of complicated UTIs differ from uncomplicated?

Answer 22

It doesn’t i.e.

• TMP-SMX
• Fluoroquinolone

Question 23

What is the treatment of choice for intra-abdominal infections?

Answer 23

Ticracillin and clavulanate

Question 24

What type of bacteria typically cause intra-abdominal infections?

Answer 24

Gram negative

Question 25

How is C. diff treated?

Answer 25

1) Metronidazole (moderate) - C. diff is anaerobic - Metronidazole releases ROS - Induces DNA damage 2) Vancomycin (severe)

Question 26

What antibiotic is highly implicated in the pathogenesis of C. diff?

Answer 26

Clindamycin

Question 27

What are the drug choices for community acquired bacterial meningitis for patients older than 2 y/o?

Answer 27

1) 3rd and 4th generation Cephalosporins - Ceftriaxone - Cefotaxime 2) Vancomycin

Question 28

What drugs as used to treat neonatal meningitis?

Answer 28

1) Ampicillin 2) Cephalosporin 3) +/- Gentamicin

Question 29

What is the rationale for using Gentamicin in neonatal meningitis?

Answer 29

L. monocytogenes (under cooked meat/ lunch meat consumed by the Mom) is a cause--best covered by Gentamicin

Question 30

What is the initial treatment approach to treating Sepsis?

Answer 30

1) 3rd/4th generation cephalosporin i.e. Cefepime | 2) Vancomycin

Question 31

What is the best approach to treated Endocarditis?

Answer 31

1) Ceftriaxone | 2) Vancomycin

Question 32

What are the best empiric antibiotics used to treat neutropenic fever?

Answer 32

Ciprofloxacin + Amoxacillin/Clavulanate (Augmentin)

Question 33

What drugs are used to treat enterococci infections?

Answer 33

1st- note that enterococci infections are notirous for resistance; thus, - Daptomycin - Tigacycline

Question 34

How are gram-negative antibiotic resistant organisms treated?

Answer 34

1) Carbapenam - Imipenem - Meropenem 2) Carbapenemases - Polymyxin B - Tigecycline