Intro to Antibiotics II Flashcards
carbapenems
same MOA as PCNs
resistant to hydrolysis until emergence of KPC carbepenemase
carbapenem coverage
aerobic and anaerobic, gram positive, excellent against enterobacter, pseudomonas, acinetobacter
stenotrophomonas maltophilia
resistant to carbapenams
carbapenems
ertapenem
imipenem
meropenem
ertapenem
lower resp tract infection tx
carbapenems
monobactam mechanism
same as PCNs
monobactam spectrum
gram negative
NO activity against gram positive cocci or anaerobes
glycopeptide mechanism
inhibit cell wall synthesis
-binds high afinity D-ala-Dala terminal of cell wall precursor units
-unable to penetrate outer membrane of gram negatives
glycopeptide coverage
gram positive
-staph aureus (MRSA), staph epidermidis (MRSE), streptococci, bacillus, corynbacterium, actinomyces, clostridium
all gram negative and mycobacterium
resistant to glycopeotides
vancomycin
glycopeptide
give IV**
MRSA tx
vancomycin
clostridium dificile tx
vancomycin (orally)
important for vancomycin
monitor serum drug concentrations
red-man syndrome
side effect of rapid vancomycin infusion
-flushing, tachycardia, hypotension
mast cells - histamine release
fluoroquinolones mechanism
concentration dependent killing
target bacterial DNA gyrase and topoisomerase
DNA gyrase - introduces negative supercoils
fluoroquinolone spectrum
E. coli, salmonella, shigella, enterobacter, campylobacter, neisseria, pseudomonas, s. aureus
respiratory fluoroquniolones
levofloxacin
gatifloxacin
moxifloxacin
cover streptococcus species
ciprofloxacin
fluoroquinolone
-covers pseudomonas
adverse with FQs
GI sx, CNS, rash, photosensitive, achilles rupture
aminoglycoside mechanism
concentration dependent killing
bind 30S ribosome - interfere with protein synthesis
alters permeability
diffusion through outer pore proteins in gram negatives
aminoglycoside spectrum
aerobic gram negatives, limited gram positive
synergistic bactericidal activity against gram positive
aminoglycoside PLUS
beta-lactam or vancomycin
gentamicin
aminoglycoside
active against serratia
hospital acquired pneumonia tx
gentamicin
tetracycline and glycylcyclines mechanism
bacteriostatic
-inhibits protein synthesis by binding 30S ribosome
prevents receptor of aminoacyl tRNA acceptor site
spectrum for tetracyclines and glycylcyclines
aerobic and anaerobic gram positive and gram negative
also - rickettsia, coxiella burnetii, mycoplasma pneumonia, chlamydia species, legionella, burrelia burdorferi, treponema pallidum
all strains of pseudomonas
resistant to tetracyclines and glycylcyclines
community acquire pneumonia
doxycycline
rock mountain spotted fever tx
rickettsial infection
tetracyclines and glycylcyclines
anthrax tx
tetracyclines and glycylcyclines
Q fever tx
tetracyclines and glycylcyclines
macrolides mechanism
bacteriostatic
-reversibly binds 50S subunit
macrolides
clarithromycin
azithromycin
macrolide spectrum
aerobic gram positive cocci and bacilli
inactive against most gram negatives
azithromycin tx
respiratory tract infetion
-coverage of strep pneumonia, h. influenza and atypicals - mycoplasma, chlamydophilia, legionella
macrolide drug interaction
CYP3A4 inhibition
lincosamide mechanism
bind to 50S suppress protein synthesis
spectrum of lincosamides
pneumococci, s. pyogenes, viridans streptococci, MSSA, b. fragilis
lung abscess tx
clindamycin
lincosamide
clindamycin
lincosamide
anaerobic lung and pleural space infetcion
clindamycin
oxazolidinones mechanism
inhibit protein synthesis binding 50S subunit
prevent larger fmet-tRNA complex formation
oxazolidinones specdtrum
gram positive staph (MSSA, MRSA, VRSA), streptococcus, enterococci, gram positive anaerobic cocci, gram positive rods
linezolid
oxazolidinone
absorbed well orally
reserve for multi-drug resistant organisms**
hospital acquired pneumonia by MSSA and MRSA
linezolid
adverse of oxazolidones
myelosuppression
-anemia, leukopenia, thrombocytopeina
GI sx, HA, rash