Intro to Antibiotics

Question 1

1st line Tx for endocarditis, Strep. pyogenes, oral anaeobres, syphilis, and Leptospira?

Answer 1

penicillins

Question 2

What does amoxicillin and ampicillin cover that penicillin does not?

Answer 2

HELPS

H. influenzae, E. coli, Listeria, Proteus, and Salmonella

Question 3

True or False: Penicillin- resistant penicillins are active against MRSA and enterococcus?

Answer 3

False

Question 4

The 1st line therapy for cholecystitis, ascending cholangitis, pyelonephritis, and bacteremia with Gram negative is what class?

Answer 4

Piperacillin, ticarcillin, azlocillin, and mezlocillin

Question 5

True or false: If you have an allergy to PCN, you should not use a cephalosporin?

Answer 5

False (unless it’s anaphylaxis)

Question 6

What organisms are resistant to all forms of cephalosporins?

Answer 6

Listeria
MRSA (except Ceftaroline)
Enterococcus

Question 7

Of the cephalosporins, which drugs cover anaerobes?

Answer 7

cefotetan and cefoxitin

Question 8

Avoid using ceftriaxone in which patient populations?

Answer 8

Neonates (don’t have developed biliary metabolism)

Cirrhotic pts (same as neonate reasoning)

Question 9

Which 3rd gen. cephalosporin has pseudomonal coverage?

Answer 9

ceftazidime

Question 10

What are the side effects of cephalosporins?

Answer 10

cefoxitin and cefotetan - deplete PT –> increase bleeding risk

ceftriaxone –> can accumulate if don’t have good liver metabolism

Question 11

Which carbapenem does not have pseudomonal coverage?

Answer 11

ertapenem

Question 12

Aztreonam has good coverage for which organisms?

Answer 12

gram negative bacilli and pseudomonas (ONLY)

Question 13

What is a pro for using aztreonam?

Answer 13

NO cross-reaction with PCN

Question 14

Which drug can be used as a single agent for diverticulosis?

Answer 14

Moxifloxacin

Question 15

What are known side effects of fluoroquinolones?

Answer 15

Bone growth abnormalities in children and prego

Tendonitis and Achilles tendon rupture

Question 16

Which group of drugs are aminoglycosides synergistic with?

Answer 16

beta-lactam antibiotics

Question 17

What are known side effects of aminoglycosides?

Answer 17

ototoxic and nephrotoxic

Question 18

What are known side effects of doxycycline?

Answer 18

tooth discoloration (children), Fanconi syndrome (Type II RTA proximal), photosensitivity, and esophagitis/ulcer

Question 19

What are known side effects of TMP/SMX?

Answer 19

rash
hemolysis in G6PD deficiency
bone marrow suppression

Question 20

Why does TMP/SMX cause bone marrow suppression?

Answer 20

it is a folate antagonist

Question 21

Beta-lactam/Beta-lactamase combos are first line treatment for what type of infection?

Answer 21

mouth and GI abscesses

Question 22

What are antibiotics to treat major MRSA infections?

Answer 22

vancomycin
linezolid
daptomycin
tigecycline
caftaroline
telavancin

Question 23

What are antibiotics to treat minor MRSA infections?

Answer 23

TMP/SMX
Doxycycline
Clindamycin
Linezolid

Question 24

What is a known side effect of linezolid?

Answer 24

Reversible bone marrow toxicity (decreased PLTS)

Question 25

What is a known side effect of daptomycin?

Answer 25

Elevated CPK

Question 26

What are best choice drugs for abdominal/GI infections?

Answer 26

Metronidazole

Beta-lactam/lactamase combinations

Question 27

What drugs cover gram negative bacilli?

Answer 27

Quinolones
Aminoglycosides
Carbapenems
Piperacillin, Ticarcillin
Aztreonam
Cephalosporins