Renal Infection

Question 0

Trimethoprim-Sulfamethoxazole

AKA Trim-sulfa, TMP/SMX, cotrimoxazole

Answer 0

Renal infx
-a sulfonamide antimicrobial
MOA
-sulfa and trimethoprim - interfere w/ bacterial folic acid metabolism
-bacteria cannot use exogenous folate but must synthesize it from PABA
Synergy
-trimethoprim and sulfa-methoxazole together (cotrimoxazole) show greater inhibition of bacterial growth

Question 1

Sulfonamide Antimicrobials

Answer 1

Renal infx
-“sulfa-“ Inhibition of bac. metabolism (PABA=para-amino-benzoic acid)
MOA
-sulfa and trimethoprim - interfere w/ bacterial folic acid metabolism
-bacteria cannot use exogenous folate but must synthesize it from PABA
Synergy
-trimethoprim and sulfa-methoxazole together (cotrimoxazole) show greater inhibition of bacterial growth
ADE
-crystalluria
-hypersensitivity
-hemolytic anemia
-kernicterus=INC bilirubin

Question 2

Fosfomycin

Answer 2

Renal infx
-single dose tx for UTI caused by E. coli and Enterococcus
MOA
-irreversibly inhibits a cytoplasmic bacterial enzyme preventing the production of N-acetylmuramic acid, an essential element of the peptidoglycan cell wall

Question 3

Nitrofurantoin

Answer 3

Renal infx
MOA
-is activated by flavoproteins (bac. enzymes) that may inactivate or damage ribosomal proteins and other macromolecules including DNA and RNA
ADE
-GI intolerance (common)
-hypersensitivity rx (occasionally)
-pulmonary fibrosis (rare w/ long term use)
-allergic pneumonitis2