Osteomyelitis (staph A)

Question 1

Medications for OM Staph A

Answer 1

Ceftriaxone and Vancomycin

Question 2

Mechanism of action of Ceftriaxone

Answer 2

Bacterial cell wall synthesis inhibitor: inhibit transpeptidase

Question 3

Mechanism of action of Vancomycin

Answer 3

Bacterial cell wall synthesis inhibitor: inhibit transglycosylation

Question 4

Class of Ceftriaxone

Answer 4

Beta lactam, 3rd gen cephalosporin

Question 5

Class of vancomycin

Answer 5

Non beta lactam, Glycopeptide

Question 6

Adverse effect of Ceftriaxone

Answer 6

Rash, diarrhoea, thrombophlebitis

Question 7

Adverse effect of Vancomycin

Answer 7

Nausea, vomiting, anaphylaxis, superinfection, nephrotoxicity, ototoxicity, red man syndrome

Question 8

What to monitor for vancomycin when taken with aminoglycoside

Answer 8

Nephrotoxicity (by monitoring renal panel)
Ototoxicity (by vestibular function & hearing acuity)

Question 9

Why do red man syndrome occur

Answer 9

Rash above nipple line due to fast infusion, causing histamine to be released

Question 10

How do red man syndrome be solved

Answer 10

Antihistamine/slow infusion

Question 11

Signs of allergic reaction to abx

Answer 11

Aft 1hr of consumption = anaphylaxis / rash, swelling of face, difficulty breathing / Steven Johnson syndrome (flu to painful rash that spread & blisters)

Question 12

Indication of vancomycin

Answer 12

Reserved for serious infection like MRSA / used as last resort in case of bacterial resistance to Ceftriaxone