New Antibiotics Flashcards
Linezolid
How does it work?
When to use?
Side effects?
Inhibits protein synthesis - 50S inhibitor
Gram positive cover + mycobacteria + Nocardia
Same as vanc
Side effects:
- GIT upset
- Cytopenias
- Neuropathy
- MAO-inhibition - aviod SSRIs, Tramadol, pethidine
Daptomycin
How does it work?
When to use?
Cyclic lipopeptide –> binds to cell membrane –> inhibits synthesis of DNA, RNA and protein –> bactericidal
Gram positives and VRE
Not VISA or VRSA
Not for pnuemonia
Tigecycline
How does it work?
When to use?
Protein synthesis inhibitor - bacteriostatic
MRSA, MSSA, VISA, VRE and many gram negative except pseudomonas
Many induce gram negative resistance
Ceftroline
How does it work?
When to use?
Cephlosporin - bacteriocidal
MRSA and VISA
Not VRE or ESBL
Mostly pneumonia and skin infections
Colistin
How does it work?
When to use?
Side effects?
Binds lipopolysaccharides and phospholipids in outer cell membrane –> disruption of cell membrane –> leakage and cell death
Most gram negatives
Side effects:
- Sulphur allergy
- Neurotoxicity
- Renal toxicity
Fosfomycin
How does it work?
When to use?
Inihibits MurA enzyme –> inhibits bacterial cell wall biogenesis - bactericidal
Resistant UTIs - not pseudomonas
Ceftazidime + avibactam
Ceftolozane + tazobactam
When to use?
MDR gram negative including pseudomonas
CIAIs and complicated UTIs
Not anaerobes
Moxifloxacin
When to use?
Side effects?
Very broad spectrum
Not pseudomonas
Requires 2 step resistance
Side effects:
- C. difficle
- Increased QT interval
Inhibitors of cell wall synthesis?
Penicillins Cephalosporins Vancomycin Monobactams Carbopenems
Inhibitors of DNA gynase by binding to topoisomerase IV?
Quinolones - ciprofloxicin
Inhibitors of folate metabolism?
Trimethoprim
Sulfonamides
Disruptors of cytoplasmic membrane structure?
Daptomycin
Inhibitors of RNA elongation?
Actinomycin
DNA directed RNA polymerase inhibitors?
Rifampin
30S ribosomal inhibitors?
–> inaccurate RNA translation
Aminoglycosides - gentamycin etc
Tetracyclines - doxycycline etc
Amikacin
Nitrofuratoin