Principles of Infectious Disease and Antimicrobial Therapy + Summary Flashcards
Pathogenicity
ability to cause disease in host organism
Virulence
extent or degree of pathogenicity
gram positive stains _____
purple - peptidoglycan cell wall
gram negative stains ________
pink - no cell wall
what are the 4 groups of gram + bacteria
staphylococci
streptococci
enterococci
listeria monocytogenes
what are the 3 groups of gram negative bacteria
enterobacteriales (gut bacteria)
respiratory tract gram negatives (H. influenzae, M. catarrhalis, N meningitidis)
lactose nonfermenting gram negatives (pseudomonas aeruginosa, stenotrophomonas maltophilia)
what are the 3 types of resp tract gram negatives
H. influenzae, M. catarrhalis, N meningitidis)
what are the 3 atypicals
legionella spp
mycoplasma spp
chlamydia/ chlamydophila spp
what are the 3 oral anaerobes
peptostreptococci, fusobacterium, prevbotella
what are the 2 gut anaerobes
bacteroides spp
closteridiodes spp
what are some common bugs for CAP
s pneumoniae
respiratory viruses
m pneumoniae
c pneumoniae
h influenzae
what are some common bugs for AOM
s pneumoniae
h influenzae
m catarrhalis
what are some common bugs for UTI
E. coli
Proteus spp
S. saprophyticus
what are some common bugs for furuncles/ carbuncles
S. aureus (MSSA, MRSA)
what are some common bugs for cellulitis
streptococcal spp
which antibiotics are DNA synthesis inhibitors
fluoroquinolones
nitroimidazoles (ex- metronidazole)wh
which antibiotics are protein synthesis inhibitors
macrolides
aminoglycosides
lincosamides
tetracyclines
oxazolidinones
(MALTO)
which antibiotics are cell wall inhibitors
penicillins
cephalosporins
carbapenems
glycopeptides (ex- vancomycin)
beta lactam beta lacatamase inhibitors
lipopeptides (daptomycin)
phosphonics (fosfomycin)
which abx are folate synthesis inhibitors
TMP-SMX
which abx are bactericidal
beta lactams
vancomycin
daptomycin
fluoroquinolones
metronidazole
which abx are bacteristatic
tetracyclines
macrolides
clindamycin
linezolid
(too many close lines)
which abx are high risk for ADRs
chloramphenicol
aminoglycosidesw
which abx are mod risk for ADRs
macrolides
fluoroquinolones
what is the spectrum of activity for PIP-TAZ
gram + and gram -
some oral anaerobes and some gut anaerobes
which abx exhibit time dependent killing
beta lactams
macrlides
vancomycin
which abx exhibit conc dep killing
quinolones
aminogycosides
which class of abx exhibits a post antibiotic effect (continued suppression fo normal growth with abx levels below MIC)
aminoglycosides
what is conc dependent killing
bacterial killing determined by peak drug levels or AUC/MIC ratio
AMG are ____ killing
concentration
for gram + synergy dosing, AMG should be dosed every _____________
8-24 hrs depending on pathogen/ renal fxn
AMG are commonly known for _____ against gram ___ organisms
PAE
gram negative
once daily dosing of AMG should be avoided in
pregnant pts, severe renal impairment, cirrhosis, burns
what are the advantages and disadvantages of once daily dosing of AMG
pros; no need for peak levels, less risk of nephrotoxicity, similar efficacy for most infxns
cons: may be associated with higher risk for ototoxicity compared to multiple daily dosing if used long term
vancomycin is ____ and ____ dependent killing
time and concentration dependent
which abx should be avoided in pregnancy
SMX/TMP
Fluoroquinolones
Macrolides
Metronidazole
AMG
Tetracyclines
Nitrofurantoin
Safe Fetus MMeans Avoid These Now
what is a type 1 hypersensitivity
immediate hypersensitivity, IgE mediated
sx start within 1hr of ingestion of initial dose
anaphylaxis
what is a type 2 rxn
cytotoxic (IgG/IgM) mediated rxn
sx: thrombocytopenia, interstitial nephritis, hemolytic anemia
what is a type 3 rxn
immune complex formation (complement)
serum sickness syndrome
what is a type 4 rxn
cell mediated hypersensitivity (T cell)
contact dermatitis, maculopapular eruptions, SJS
sx start after days of tx
what are the beta lactam beta lactamase inhibitor combinations
pip tazo
amoxi/clav
what are the 1st gen cephalosporins
cefazolin, cephalexin
what are the 2nd gen cephalosporins
cefuroxime, cefoxitin, cefprozil, cefaclor
what are the 3rd gen cephalosporins
ceftriaxone, cefixime, cefotaxime, ceftaxidime
what is the 4th gen cephalosporin
cefepime
what are the carbapenems
ertapenem, imipenem, meropenem, doripenem
how should cloxacillin be administered
IV preferred
PO = poorly absorbed, must take on empty stomach 1hr before or 2hrs after meals
what is the drug of choice for staphylococcus (not MRSA)
cloxacillin
Pip-Tazo is bacteri____
cidal
what are the SPACE organisms
Serratia, pseudomonas, acinetobacter, citrobacter, enterobacter
what are the SPICE organisms
Serratia, providencia spp, indole positive proteus spp, citrobacter, enterobacter
what do 1st gen cephalosporins cover
G+ cocci, MSSA, streptococci
S. epidermidis
oral anaerobes
what do 2nd gen cephalosporins cover
cefuroxime/ cefaclor: H influenzae (including b-lactam producing), M. catarrhalis, oral anaerobes, streptococci
cefoxitin: covers PEcK + gut anaerobes (B fragilis)
cefaclor, cefuroxime: URTIs
cefoxitin: uncomplicated intraabdominal infxns, PID, surgical procedures, infxn due to G- _ anaerobes
what do 3rd gen cephalosporins cover
more gram - coverage
more H influenza and M catarrhalis
which class of cephaalosporins have better CNS penetration
3rd
what does cefepime cover
mixed infections (+/- , pseudomonas)
difficult to tx organisms like SPICE/SPACE
