Infectious Diseases Flashcards
True or False? No penicillins cover MRSA
True
Which penicillin covers pseudomonas?
Piperacillin/Tazobactam (Zosyn)
Which penicillin covers anaerobes?
Ones with beta lactamase inhibitors:
Pip/tazo
Ampicillin/Sulbactam
Amoxicillin/clavulanic acid
Which penicillins have staph coverage (MSSA)?
Nafcillin
Oxacillin
Dicloxacillin
What is the drug of choice for MSSA?
Nafcillin
Oxacillin
Dicloxacillin
What is the drug of choice for syphilis?
Penicillin
Which penicillins are often used for dental procedures because they cover listeria/mouth anaerobes?
Amoxicillin = Ampicillin > Penicillin
Are anti-staph (MSSA) penicillins renally adjusted?
No. They are not renally eliminated
What is the drug of choice for acinetobacter baumanni?
Ampicillin/sulbactam
What are common adverse effects of amoxicillin and ampicillin?
GI effects and contact dermatitis
What generation of cephalosporins have SOME coverage for gram negative infections containing PEK (proteus, E. coli, K. pneumoniae)
1st generation cephalosporins
What generation of cephalosporins have good coverage for skin/soft tissue infections (staph and strep, not MRSA)
1st generation cephalosporins
List the 1st generation cephalosporins
Cephalexin
Cefazolin
Cefadroxil
List the 2nd generation cephalosporins
2A (aerobic):
Cefaclor
Cefuroxime
2B (belly/anaerobic):
Cefotetan
Cefoxitin
List the 3rd generation cephalosporins
Cefotaxime Ceftriaxone Cefixime Cefpodoxime Ceftazidime
List the 4th generation cephalosporins
Cefepime
List the 5th generation cephalosporins
Ceftaroline
What generation of cephalosporins would be drugs of choice for CAP?
3rd generation cephalosporins (except ceftazidime)
Which 3rd generation cephalosporin covers pseudomonas aeruginosa?
Ceftazidime
Which 3rd generation cephalosporin covers pseudomonas aeruginosa?
Ceftazidime
What are the unique properties of 4th generation cephalosporins?
Broader spectrum than other cephalosporins. It also covers pseudomonas
What are the unique properties of 4th generation cephalosporins?
Broader spectrum than other cephalosporins. It also covers pseudomonas
Which generation of cephalosporins can cause inducible resistance?
3rg generation cephalosporins
Which drug should be given to a patient who has an anaphylactic penicillin allergy and needs gram - coverage
Aztreonam
Which cephalosporin has coverage for MRSA?
Ceftaroline
What cephalosporin covers pseudomonas aeruginosa and also intraabdominal infections and complicated UTIs?
Zerbaxa (ceftolozane/tazobactam)
Which carbapenem does not have pseudomonas coverage?
Ertapenem
What class of antibiotics are the drug of choice for treating extended-spectrum beta lactamases (ESBL)?
Carbapenems
What bugs do carbapenems cover?
Everything (including anaerobes) except MRSA
Ertapenem does not cover pseudomonas
True or False? Aztreonam only has gram positive activity
False. Only gram negative
What do beta lactam antibiotics increase the risk of
Seizures
Which carbapenem has the highest likelihood of increased risk of seizures?
Imipenem
Aminoglycosides can be given with ___ to create synergy (gram positive coverage) and penetrate cells
Beta lactam antibiotics
True or False? Aminoglycosides cover pseudomonas and anaerobes
False. They cover pseudomonas but they do not cover anaerobes
Aminoglycosides are ___-depedent killing
Concentration
Beta lactam antibiotics are ___-depending killing
Time
Aminoglycosides may cause ___toxicity and ___toxicity
Nephro
Oto
List the fluoroquinolones
Moxifloxacin
Ciprofloxacin
Levofloxacin
Delafloxacin
Which fluoroquinolone has the best gram negative coverage but the worst gram positive coverage?
Ciprofloxacin
Rank the fluoroquinolones in terms of the best to worst anaerobic coverage
Moxifloxacin > Levofloxacin > Ciprofloxacin
True or False? Fluoroquinolones cover pseudomonas
True
Fluoroquinolones are ___-dependent killing
Concentration
Rank the fluoroquinolones in terms of best to worst streptococcus pneumoniae coverage
Moxifloxacin = levofloxacin > ciprofloxacin
Which fluoroquinolone has MRSA coverage?
Delafloxacin
What does vancomycin cover?
Gram positive only including MRSA and enterococcus
Vancomycin is given IV unless it is being used to treat ___. In that case, it is given PO
Clostridium difficile
___ is similar to vancomycin in terms of coverage, but it has a long half life and only needs to be given once
Dalbavancin
___ and ___ can be used for vancomycin-resistant enterococcus (VRE)
Daptomycin
Linezolid
___ can cause CPK elevation and rhabdomyolysis
Daptomycin
___ can cause red man syndrome. How is this treated?
Vancomycin
Slow the infusion rate
What are two toxicities that vancomycin can cause?
Nephrotoxicity
Ototoxicity
List the macrolides
Azithromycin
Clarithromycin
Erythromycin
Macrolides cover:
Atypicals (Legionella, mycoplasma pneumoniae, chlamydia)
Streptococcus pneumoniae
H. flu
M. cat
Which macrolide covers H. pylori?
Clarithromycin
True or False? Macrolides can be used for CAP?
True
List the tetracyclines
Tetracycline
Doxycycline
Minocycline
Demeclocycline
True or False? Tetrecyclines do not cover MRSA
False. They do cover MRSA
True or False? Tetracycline is used more than doxycycline
False. Doxycycline is used more because tetracycline has more adverse effects
___ has MRSA, MSSA, and anaerobic coverage and has the highest risk to cause C. diff.
Clindamycin
___ has MRSA coverage, PEK (proteus, e. coli, klebsiella)
Sulfamethoxazole
___ DOC for stenotrophomonas maltophilia/nocardia and PCP pneumonia
Sulfamethoxazole
What skin infections can sulfamethoxazole cause?
Stevens-Johnson syndrome and toxic epidermal necrolysis
Metronidazole can only cover ___ and ___
Anaerobes and c. diff
True or False? Aminoglycosides are the only drugs used to treat severe staphylococcus infections synergistically
False. Rifampin can also be used
___ can treat mycobacterial infections, including tuberculosis
Rifampin
True or False? Rifampin is a strong CYP inhibitor
False. It is a strong inducer and can interact with many HIV meds
___ and ___ are only used to treat UTIs
Nitrofurantoin
Fosfomycin
Nitrofurantoin is contraindicated in patients with CrCl < ___
60mL/min