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MBChB > Microbiology 1 > Flashcards

Microbiology 1 Flashcards

1
Q

What infections are associated with broad antibiotic spectrum use?

A

Candida

C.diff

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2
Q

What antibiotic has activity against gram positive and gram negative bacteria?

A

Meropenem

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3
Q

What does Benzyl-penicillin have activity against?

A

Streptococci

Neisseria

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4
Q

What are the three different types of antibiotic therapy?

A

Guided therapy
Empirical therapy
Prophylactic therapy

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5
Q

Beta-lactam antibiotics can be separated into four groups. What are they?

A
  1. Penicillin
  2. Cephalosporins
  3. Carbapenems
  4. Monobactams
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6
Q

Give three examples of penicillins

A
  1. Benzylpenicillin
  2. Flucloxacillin
  3. Amoxicillin
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7
Q

Give an example of a cephalosporin antibiotic

A

Ceftriaxone

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8
Q

Give an example of a cabapenem antibiotic

A

Meropenem

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9
Q

Give an example of a monobactem antibiotic

A

Aztreonam

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10
Q

What makes up Augmentin?

A

Amoxicillin + clavulanic acid

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11
Q

What makes up Tazocin?

A

Piperacillin + tazobactam

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12
Q

What is the MoA of beta-lactam antibiotics?

A

inhibit cross-linking of the cell wall peptidoglycan
Causes lysis of the bacteria
Bactericidal

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13
Q

Describe beta-lactamases

A

Enzymes that lyse and inactivate the beta-lactam drugs by lysis of the beta-lactam ring

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14
Q

What bacteria commonly secrete beta-lactamases?

A

Gram negatives

S.aureus

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15
Q

How are beta-lactam antibiotics excreted?

A

Unchanged in urine and bile

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16
Q

Why do beta-lactam antibiotics often need to be given IV?

A

Poorly absorbed via GI tract

Can cause vomiting which limits dose

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17
Q

What GI toxicity is associated with beta-lactam antibiotics?

A

Nausea and vomiting
Diarrhoea
Cholestasis - abnormal LFTs

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18
Q

What hypersensitivity reactions can occur following beta-lactam antibiotic use?

A

Stage 1 - urticaria, anaphylaxis

Stage 4 - Stephen-Johnson syndrome and toxic epidermal necrolysis

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19
Q

What infections are associated with beta-lactam antibiotic use?

A

Candidiasis - oral, vulvovaginal

C.diff

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20
Q

What are rare reactions associated with beta-lactam antibiotics?

A

Seizures
Haemolysis
Leukopenia

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21
Q

What is the first choice Abx for a serious streptococci infection such as erysipelas?

A

Benzylpenicillin

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22
Q

How should Benzylpenicillin be administered?

A

IV

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23
Q

What does amoxicillin have activity against?

A

Gram negative bacteria (streptococcus, enterococcus, Neisseria, haemophilus, clostidium)

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24
Q

What does flucloxacillin have activity against?

A 
Staphylococcus aureus (not MRSA)
Streptococci
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25
Q

Beta-lactamase inhibitors greatly broaden the activity of penicillins against which bacteria?

A

Gram negative

S.aureus

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26
Q

What bacteria do Cephalosporins have good activity against?

A

Gram positive

Gram negative

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27
Q

When is Ceftriaxone prescribed?

A

Bacterial meningitis

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28
Q

What type of beta-lactam antibiotics can be given to patients with a penicillin allergy?

A

Monobactems

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29
Q

How should monobactem antibiotics be administered?

A

IV - no oral absorption

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30
Q

What is the MoA of Vancomycin?

A

Inhibits cell wall formation in gram positive bacteria

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31
Q

For what type of infection is Vancomycin first line, and why?

A

MRSA

Not dependent upon penicillin binding proteins (PBP)

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32
Q

When should Vancomycin be given orally?

A

For treatment of C.diff

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33
Q

What toxicity is associated with Vancomycin?

A

Nephrotoxicity
Red Man Syndrome (give over 2-3 hours)
Ototoxicity

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34
Q

What 3 classes of antibiotics target the 50S subunit of bacterial ribosomes?

A
  1. Macrolides
  2. Clindamycin
  3. Chloramphenicol
35
Q

What are three examples of macrolide antibiotics?

A
  1. Erythromycin
  2. Chlarithromycin
  3. Azithromycin
36
Q

What 2 classes of antibiotics target the 30S subunit of bacterial ribosomes?

A
  1. Aminoglycosides

2. Tetracycline

37
Q

Give an example of an aminioglycoside

A

Gentamicin

38
Q

Give an example of a tetracylcine

A

Doxycycline

39
Q

What activity do macrolides have?

A

Gram positive
Respiratory gram negatives
Atypicals (chlamdyia, legionella, mycoplasma)

40
Q

How should macrolides be administered?

A

Orally (unless patient is severely unwell - vomiting or poorly perfused GIT)

41
Q

What can clarithromycin be used against?

A 
Streptococcus
Staphylococcus
Neisseria
Haemophilus
Enterococcus
Atypicals
42
Q

For what specific type of infection is clarithromycin useful for?

A

Respiratory tract infections

43
Q

What are the adverse effects of macrolides?

A

D&V

QT prolongation

44
Q

What drug interactions are associated with macrolides?

A

Simvastatin
Atorvastatin
Warfarin

45
Q

What is the principle action of clindamycin?

A

Gram positives

46
Q

What is clindamycin particularly good at doing?

A

Stopping exotoxin production

47
Q

In what infections should clindamycin be given?

A

Toxic Shock Syndrome

Necrotizing fasciitis

48
Q

Why should clindamycin not be given to patients who are more vulnerable at developing C.diff infections?

A

Very broad anaerobe activity
Disrupt gut flora
Increase risk of C.diff

49
Q

How long can it take for the gut flora to recover its diversity following antibiotic use?

A

6-9 months

50
Q

What are the 4 c.differgic antibiotics?

A
  1. Clindamycin
  2. Co-amoxiclav
  3. Cephalosporins
  4. Ciprofloxacin
51
Q

What is the MoA of chloramphenicol?

A

Inhibits 50S ribosomal subunit

52
Q

What are the toxic effects of chloramphenicol?

A

Bone marrow suppression
Aplastic anaemia
Optic neuritis

53
Q

What are the uses of chloramphenicol?

A

Topic therapy to eyes

Bacterial meningitis with beta-lactam allergy

54
Q

Aminoglycosides have activity against what type of bacteria?

A

Gram negative

55
Q

What are the bacteriostatic and bactericidal effects of aminoglycosides?

A

Bacteriostatic - reversibly binds to 30S subunit

Bactericidal - affects cell membrane at high concentrations

56
Q

What toxicity is associated with aminoglycosides?

A

Nephrotoxicity
Ototoxicity
Neuromuscular blockade - myasthenia gravis

57
Q

Describe the dosing that should be used for aminoglycosides?

A

High initial dose - rapid killing

Long dosing interval (24-48h) - minimise toxicity

Measure trough level

3 days only

58
Q

Tetracyclines have activity against what type of bacteria?

A 
Streptococcus
Staphylococcus
Neisseria
Haemophilus
Enterococcus
59
Q

Who should not be given tetracyclines and why?

A

Pregnant women
Children

Bone abnormalities
Tooth discolouration

60
Q

What are the types of antibiotics which target DNA repair and replication?

A

Quinolones

Rifampicin

61
Q

Give two examples of quinolones

A

Ciprofloxacin

Levofloxacin

62
Q

Which quinolone has stronger activity against gram negative bacteria?

A

Ciprofloxacin

63
Q

Which quinolone has stronger activity against gram positive bacteria?

A

Levofloxacin

64
Q

For what type of infections is ciprofloxacin commonly used for?

A

UTI

Abdominal infection

65
Q

What type of infection is levofloxacin commonly used for?

A

Respiratory tract infections

66
Q

What toxicity is associated with quinolones?

A

GI toxicity
QT prolongation
Tendonitis

67
Q

What is rifampicin particulary useful against?

A

Biofilms

68
Q

What are the interactions associated with rifampicin?

A

Potent CYP450 inducer
Most drugs that undergo hepatic metabolism
OCP is ineffective

69
Q

What is the mechanism of action of trimethoprim?

A

Inhibits folate synthesis

70
Q

When should trimethoprim be used?

A

Uncomplicated UTI

71
Q

What toxicity is associated with trimethoprim?

A

Elevation of serum creatinine (action on PCT)
Elevation of serum K (potassium sparing diuretic)
Rash and GI disturbances - uncommon

72
Q

What toxicity is associated with co-trimoxazole?

A

Bone marrow suppression

Steven Johnson syndrome

73
Q

What antibiotic causes an unpleasant reaction with alcohol?

A

Metrondiazole

74
Q

What is the mechanism of action of metrondiazole?

A

Enters the bacteria by passive diffusion

Produces free radicals

75
Q

What is metrondiazole effective against?

A

Anaerobic bacteria

76
Q

What is associated with long term use of metrondiazole?

A

Peripheral neuropathy

77
Q

In 80% of young women with cystitis, what is the causative bacteria?

A

E.coli

78
Q

What is the first line antibiotic for uncomplicated UTI?

A

Trimethoprim

79
Q

Apart from trimethoprim, what other antibiotic is useful for UTI infections?

A

Nitrofuratoin

80
Q

When should nitrofuratoin be avoided?

A

In renal failure

81
Q

What antibiotic should be used in complicated UTI (fever, flank pain but no sepsis)?

A

Ciprofloxacin (oral)

82
Q

What antibiotic should be used in UTI with sepsis?

A

Gentamicin (lots of activity against E.coli but requires monitoring) IV

83
Q

What antibiotics are not safe for use during pregnancy?

A
  1. Tetracyclines - bone/tooth abnormalities
  2. Trimethoprim - neural tube defect (1st trimester)
  3. Nitrofurantoin - haemolytic anaemia (3rd trimester)
  4. Aminoglycosides - ototoxicity (2/3rd trimester)
  5. Quinolones - bone/joint abnormalities

MBChB (14 decks)

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