PHARM- Antimicrobials Flashcards
Which penicillins are narrow spectrum?
No staphylococcal activity:
- Penicillin G
- Benzylpenicillin
- Penicillin V
Staphylococcal activity:
- Flucloxacillin
- Dicloxacillin
What are the main organisms that narrow spectrum penicillins are active against?
- G+ cocci: strep, entero ± staph
- G+ rods: Listeria
- Some G- cocci: Neisseria meningitidis
- Syphilis
What are the moderate spectrum penicillins? What are they active against?
- Amoxycillin and ampicillin
- More effective at G- organisms (choice for enterococcus)
What are the beta-lactamase inhibitors?
- Clavulanate
- Tazobactam
What are the broad spectrum penicillins?
- Piperacillin
- Ticarcillin
What are the first generation cephalosporins and what do they cover?
- Cephalexin, cefazolin, cefalothin
- Gram positive: strep and staph
What are the second generation cephalosporins and what do they cover?
- Cefaclor, cefuroxime
- Reasonable G+ cover and some G- cover (Hib)
What are the third generation cephalosporins and what do they cover?
- Ceftriaxone, cefotaxime
- Some G+ cover (good strep), G- cover and good CNS penetration, extended 3rd gen anti-pseudomonal
What are the fourth generation cephalosporins and what do they cover?
- Cefepime
- Covers pseudomonas
What are the fifth generation cephalosporins and what do they cover?
- Ceftraroline
- Covers MRSA
What are the carbapenems and what do they cover?
- Imipenem, meropenem, ertapenem
- Broad spectrum: most G+ (not MRSA) and G-
- Usually for severe nosocomial infections
What type of Abx is vancomycin? What does it cover?
- Glycopeptide
- Staph, strep, enterococci
- Main use = MRSA, C. difficile
- Penicillin resistant bugs or if allergy
What type of Abx is gentamicin? What does it cover?
- Aminoglycoside
- Gram negatives including Pseudomonas
What are the main A/E associated with gentamicin?
Ototoxicity and nephrotoxicity
What type of Abx is doxycycline? What does it cover?
- Tetracycline
- IC pathogens: Chlamydia, Mycoplasma, Legionella
What are the quinolones? What do they cover?
- Ciprofloxacin: broad spectrum G-, some G+
- Norfloxacin: GIT/GUT infection
- Moxifloxacin: add strep cover
What are the macrolides? What do they cover?
- Azithromycin, clarithromycin, erythromycin
- Gram positives (increasing resistance), atypical pathogens and pertussis
What pathogens does metronidazole cover?
- C perfringens
- C difficile
- Protozoa: Trichomonas, Giardia
What classes of Abx can be used against Pseudomonas infections?
- Broad spectrum penicillins + BLI
- Extended 3rd gen and 4th gen cephalosporings
- Carbapenems
- Gentamycin
What Abx are used in mild CAP?
Amoxycillin/doxycycline
What Abx are used in moderate CAP?
Benzylpenicilin + doxycycline
What Abx are used in severe CAP?
3rd gen cephalosporin + macrolide ± vancomycin
What Abx are used in mild NAP?
Co-amoxyclav
What Abx are used in moderate NAP?
3rd generation cephalosporin
What Abx are used in severe NAP?
Piperacillin + tazobactam + vancomycin
What Abx can be used first line in a UTI?
- Trimethoprim
- 3rd generation cephalosporins
- Co-amoxyclav
What Abx are first line in meningitis (adults and children >2mo)?
3rd generation cephalosporin ± benzylpenicillin (Listeria), ± vancomycin
Give with dexamethasone
