GI Antibiotics - Kinder Flashcards
not treated with antibiotics
EHEC
salmonella
tx shigellosis
antibiotic tx reduces duration by 2.4 days
tx travelers diarrhea
mild to moderate
- loperamide or bismuth
- combine with fluoroquinolone
severe
-cipro, levo, norfloxacin, orfloxacin 3 day course
rifaximin - for noninvasive e coli
azithromycin - quinolone resistant campylobacter
tx c dif infection
metrondiazole - mild to moderate
vancomycin - severe
tx persistent diarrhea
suspect protozoal
giardia - tx metrondiazole
crypto hard to treat - especially in AIDS
colitis due to overgrowth of c dif
clincamycin, ampicillin, cephalosporins, fluoroquinolones, PPIs
metronidazole vs. vanco for c dif tx
metrondiazole - mild to moderate
vancomycin - severe
cipro MOA
inhibit DNA gyrase (topoisomerase II)
inhibit supercoiling gram-negative bacteria
also inhibit topoisomerase IV in gram positive organisms
cipro CI
don’t use in kids - achilles tendon rupture
cipro side effect
nausea, vomiting, GI pain, rashes, fever
cartilage toxicity - achilles tendon rupture children
levo MOA
inhibit DNA gyrase (topoisomerase II)
inhibit supercoiling gram-negative bacteria
also inhibit topoisomerase IV in gram positive organisms
levo CI
dont use in kinds - achilles tendon rupture
levo side effect
nausea, vomiting, GI pain, rashes, fever
cartilage toxicity
trimethoprim sulfamethoxazole MOA
sulfonamide: bacteristatic and competetive inhibitors dihyropteroate synthase (needed for precursot to folic acid)
trimethoprim: inhibits microbial dihydrofolate reductase
trimethoprim sulfamethoxazole side effect
allergic skin rashes, nausea, comtiing, CNS, photosensitivity, renal dysfunction, Stevens-Johnson syndrome
metronidazole MOA
prodrug that requires reductive activation by susceptible organisms
don’t really know
metronidazole clinical use
bacterial vaginosis, amebic liver abscess, Tx anaerobic bacterial infections
part of regimen prophylazis coloretal surgery, C difficile, Crohns
metronidazle side effect
HA, nausea, dry mouth, metallic taste, vomiting, diarrhea, abdominal distress!! esp with alcohol!!!
dizziness, vertigo, encephalopathy
vancomycin MOA
inhibits cell wasll synthesis binding with high affinity to D alanyl D alanine terminal cell wall unites
vancomycin clinical use
orally for C difficle
vancomycin side effect
macular skin rash, chills, fever, red man syndrome from rapid infusion
direct toxicity from vanco on mast cells causing release histamine
ototoxicity, nephrotoxicity
diarrhea length
acute < 14 days
persistant 14-29 days
chronic >30 days
bloody diarrhea
c dif
inflammatory diarrhea
fever, tenesums, dysentery
fecal leukocytes and fecal lactoferrin
