Topic 10-Carbapenems. Monobactams. Beta-lactamase inhibitors Flashcards
1st generation carbapenems
ertapenem (no effect against pseudomonas and acinetobacter)
2nd generation carbapenems
imipenem
meropenem
doripenem
Carbapenems spectrum
broad spectrum Gram -/+/aerobes/anaerobes pseduomonas and acinetobacter penicillin resistant pneumococci Enterococcus faecalis, B. fragilis
Carbapenems not effective against
MRSA/E and clostridium difficile, and E. faecium, and intracellular bacteria
Some resistance from klebsiella and acinetobacter
Bacteriocidal or bacteriostatic? Cross reactivity? Administration? Penetration? Elimination?
Bacteriocidal
No cross reactivity with cephalosporin, so if cephalosporin resistance use carbapenems
Adminisration is only parenteral (IV) 3-4 times a day
Penetration is excellent, including CNS (NOT biliary tract)
Eliminated via the kidney
Carbapenems indications
Reserve and broad spectrum
Used in life threatening severe infection (noscomial, acetobacter infection, pneumonia, sepsis)
Carbapenems adverse effects
GI symptoms, pseudomembranous colitis Allergy Seizure (high does of imipenem)
Monobactams drugs
Aztreonam
Aztreonam kinetics
Excretion?
Administration
Kinetics: enter CNS
Good level does in the lungs
Excreted through kidneys
Administered only parenterally (IV, IM), not oral
Aztreonam spectrum
gram negative aerobic bacteria, even aminoglycoside resistant strains of pseudomonas
H. influenzae, pseudomonas, Gram - GI bug
Indications
nosocomial infections gram negative infection in... soft tissues respiratory skin surgery sepsis
side effects of Aztreonam
allergy and GI issues
What are the 3 beta lactamase inhibitors
clavulanic acid
sulbactam
tazobactam
Fixed combinations of beta-lactamase inhibitors
- )amoxicillin-clavulanic acid
- )ampicillin-sulbactam
- )piperacillin-tazobactam
