Other CWI Flashcards
Vancomycin
MOA: Bind to d-ala-d-ala and inhibit elongation and transpeptidation
- bactericidal
Spectrum
- Useful in Gram positive
- –»_space; penicillin and methicillin resistant staph
- –» pseudomembranous colitits (c.difficile)
- –» DOC for MRSA
- Useful in pts with penicillin allergy
- combined with animoglycosides for s. fecalis and MRSA (inc. risk of nephro and ototoxicity)
- Not useful for CNS infections- does not penetrate the CNS
- Gram negative are NOT sensitive
PK:
- IV
- orally for tx of pseumonebraneous colitis
- intrathecally for meningitis
- excreted in kidney unchanged
SE:
- ototoxicity and nephrotoxicity
- redman syndrome- due the histamine release
- hypersensitivity reactions (anaphlysis)
Telavancin
MOA: binds to D-ala-D-ala terminus and inhibits elongation and also inc. the cell - permeability
- administered once daily
Spectrum
- gram positive
- – MRSA
Used to tx
- complicated skin and skin structure infections
- last line agent in tx of nosocomial infections caused by staph. aureus
CI
- pregnancy
- renal insufficiency
Fosfomycin
MOA: inhibits the cell wall synthesis at one of the first steps in the synthesis of peptidoglycan
Use: uncomplicated UTI infections in women
Spectrum
- Active against gram positive and gram negative bacteria
PK
- given orally
- excreted by the kidney
Bacitracin
MOA: interferes with final dephosphorylate step in the phospholipid carrier cycle: inhibts mucopeptide transfer to the growing cell wall
Uses:
- Topically to prevent superficial skin and eye infections following minor injuries (used in combination with polymycin and neomycin)
- Can be used parenteral but major nephrotoxicity risk
Spectrum:
- Gram positive bacteria
Cycloserine
MOA: competes with D-ala enzymes (L-racemase, and D-alanine synthetase) and therefore inhibtis the incorporation of D-ala into the cell wall
Neurotoxic
Daptomycin
MOA: Lipopeptide antibiotics that binds to bacterial membranes and causes depolarization of membrane potential
- inhibits protein, DNA, RNA synthesis and causes cell death
- do not penetrate the membrane
- Bactericidal
Spectrum
- Gram positive
PK:
- IV admin
- excreted in the kidney
- long half life
