Infection Disease Antibiotics Flashcards
Coverage of ampicillin and amoxicillin
Same as penicillin (strep Viridans and pyogenes, syphillis, leptospira and oral anaerobes) AND E. coli, Lyme disease , listeria and some gram negative bacilli (hemophilus, proteus, salmonella)
What types/location of infections are ampicillin and amoxicillin used for most commonly?
Otitis media
Dental infection and endocarditis prophylaxis
Early Lyme disease (age
What are the four penicillinase-resistant penicillins?
Oxacillin, cloxacillin, dicloxacillin and nafcillin
What type of infection/location are the penicillinase-resistant penicillins used for?
Skin infections (cellulitis, impetigo, erysipelas) Endocarditis, meningitis or bacteremia due to staph Sensitive osteomyelitis and septic arthritis
Why is methicillin no longer used?
Cause renal failure due to allergic interstitial nephritis
What type of infection/location are penicillinase-resistant penicillins not useful in treating?
MRSA
What are four extended spectrum penicillins?
Pipracillin, ticracillin, azocillin and mezlocillin
What is the coverage for extended spectrum penicillins?
Gram negative bacilli (E.coli and proteus) AND pseudomonas
What types/locations Of infections are extended spectrum penicillins used for?
Cholecystitis and ascending cholangitis Pyelonephritis Bacteremia Hosp-acquired and vent associated pneumonia Neutropenia and fever
What beta lactamase would you pair with: Pipracillin Amoxicillin Ticracillin Ampicillin
Pipracillin/tazobactam
Amoxicillin/clauvalanic acid
Ticracillin/clauvalanic acid
Ampicillin/sulbactam
How does adding a beta lactamase change the efficacy of penicillins?
Added coverage of sensitive staph
They cover anaerobes and are first line for mouth/GI abscess
What bacteria are resistant to all generations of cephalosporins?
MRSA, listeria and enterococcus
If a patient is allergic to penicillin and his reaction is a rash what type of antibiotic do you substitute?
Cephalosporins; only a small chance of cross reaction (3%)
If a patient is allergic to penicillin and his reaction is anaphylaxis what type of antibiotic do you substitute?
Non-beta lactam antibiotic
What organisms do ALL generations of cephalosporins cover?
All cover: group A,B,C strep , Viridans group strep, E.coli, Klebsiella and proteus
What are the first generation cephalosporins ?
Cefazolin, cephalexin, cephradrine and cefadroxyl
What is the coverage of first generation cephalosporins ?
Methicillin-sensitive staph
Strep except enterococcus
Some gram negative bacilli (E.coli)
Osteomyelitis , septic arthritis, endocarditis and cellulitis
What are the second generation cephalosporins ?
Cefotetan, cefoxitin, cefaclor, cefprozil and cefuroximine
What is the coverage for second generation cephalosporins ?
Same as first generation: Methicillin-sensitive staph
Strep except enterococcus
Some gram negative bacilli (E.coli)
Osteomyelitis , septic arthritis, endocarditis and cellulitis
ADD anaerobes and more gram negative bacilli
What types of infections/locations are second generation cephalosporins used to treat?
Cefotetan and cefoxitin: used for PID in combo with doxycycline
Cefuroxime and cefprozil: respiratory infections (bronchitis, otitis media and sinusitis)
What are third generation cephalosporins?
Cefotaxime , ceftriaxone and ceftazidime
What side effect/ adverse reaction is characteristic of cefotetan and cefoxitin?
They have increased risk of bleeding because of depleted prothrombin and can cause a disulfiram-like reaction when mixed with alcohol
What type/location of infections is ceftriaxone used to treat?
First line for pneumococcus Meningitis Community acquired pneumonia (with macrolide) Gonorrhea Lyme disease involving brain or heart
In what pt population is ceftriaxone avoided? And what can be used instead?
In neonates due to decreased biliary metabolism
Cefotaxime is superior in neonates
