NewABXSH1

Question 1

New ABX

Answer 1

Omadacycline ( nuzyra ) : a tetracycline derivative : binds to 30s ribosomal subunit

Lefamulin ( xenlenta ) : a systemic pleuromutilin : inhibits protein synthesis by binding to 50s ribosomal subunit

Question 2

Omadacycline

Answer 2

Nuzyra IV and oral ( empty stomach )

MOA: 30s subunit

Indications: CAP( strep / MSSA / H. influ, / klebsiella,/ Leigionella ,/ mycoplasma / &
/ Skin and skin structure infections ( MRSA , STREP, E. Faecalis, Klebsiella ) BUT NO ANAEROBES

DDI : anticoagulants adjustment

SE: GI, HA, insomnia, photosensitivity

Precautions: no kids < 8y/o / no pregnancy

Question 3

Lefamulin

Answer 3

Xenleta IV and oral ( empty stomach )
L in Lefamulin for LIVER

MOA: binds 50s
Similar to Linezolid, erythromycin, clindamycin , tedizolid

Indications: CAP : strep , staphylococcus , h influ, legionella, mycoplasma

SE: liver ( hepatic enzyme elevation ), hypokalemia

Precautions: QT prolongation , PREGnancy category X, goes through liver so lots of DDI it’s a cyp3a4 substrate

Question 4

Tefenoquine

Answer 4

Arakoda

Like mefloquine ( recall #1 side effect was CNS effect ) , you avoid tefenoquine in patients with psychosis
Big difference in dosing it’s 3 days before travel ; once weekly while traveling and once e7 days after the last dose

Avoid in pregnancy