Week 3 Acute Care Antibiotics Flashcards by Sara Smoller

Name 2 multidrug-resistant G+ organisms?

Staphylococcus aureus

Enterococcus faecium

How well did you know this?

Not at all

Perfectly

Name 3 multidrug-resistant G- organisms?

Acinetobacter baumannii

Pseudomonas aeruginosa

ESBL enterobacteriacea

How well did you know this?

Not at all

Perfectly

Penicillins Examples

Eg: Penicillin G (IV or IM), Penicillin V (oral), Amoxicillin, Ampicillin

How well did you know this?

Not at all

Perfectly

MOA of Penicillins

Disrupt bacterial cell wall

How well did you know this?

Not at all

Perfectly

Spectrum of PCNs

G+ (Streptococcus, Actinomyces)

G- (Neisseria meningitidis)

No activity against MRSA

How well did you know this?

Not at all

Perfectly

Indications for PCNs

Group A strep (Strep pyogenes)

PNA

Meningitis

Strep endocarditis

Neuro syphilis

Genital clostridial infxns

Lyme disease

Cystitis

How well did you know this?

Not at all

Perfectly

PCN Adverse effects

Anaphylaxis (IgE mediated)

Morbilliform rash

Diarrhea

How well did you know this?

Not at all

Perfectly

Antistaphylococcal PCNs

Amoxicillin-Clavulanate

Ampicillin-sulbactam

Pipercillin-Tazobactam

How well did you know this?

Not at all

Perfectly

First Gen Cephalosporins

Eg: Cefazolin

Spectrum: G+ (including Staph), some G-

Uses: SSTI, bacterial PNA, UTIs

How well did you know this?

Not at all

Perfectly

Second Gen Cephalosporins

Eg: Cefoxitin, Cefotetan

Not used much

Good for anaerobic coverage

How well did you know this?

Not at all

Perfectly

Third Gen Cephalosporins

Eg: Ceftriaxone, Ceftazidime

Spectrum

G+ (Staph, Strep), G-

Ceftazidime covers Pseudomonas also

How well did you know this?

Not at all

Perfectly

MOA of Cephalosporins

Disrupt bacterial cell wall

How well did you know this?

Not at all

Perfectly

Uses of third-gen cephalosporins

SSTI

Bacterial PNA

UTI

Bacterial meningitis

How well did you know this?

Not at all

Perfectly

Fourth Gen Cephalosporins

Eg: Cefepime

Spectrum: G+, G- including Pseudomonas

Uses: Pseudomans infxns (PNA, skin infections, sepsis)

How well did you know this?

Not at all

Perfectly

Fifth Gen Cephalosporins

Eg: Ceftaroline

Spectrum: G+ , G- rods, and MRSA

Uses: CAP, SSTIs (esp. those by MRSA)

How well did you know this?

Not at all

Perfectly

Carbapenems

Eg: Imipenem, Merropenem, ertapenem, doripenem

Spectrum

G+, Aerobic G- rods, Anaerobes, Not MRSA

Uses

HAI (VAP, UTI), Mixed Infxns

Side effects

Diarrhea, rash, seizures

How well did you know this?

Not at all

Perfectly

Monobactam

Eg: Aztreonam

Spectrum

Aerobic G- rods, including Pseudomonas

Uses

Pseudomonal Infxns (VAP, UTIs, Intra-abd)

Side effects

Diarrhea, rash, anaphylaxis

How well did you know this?

Not at all

Perfectly

Fluoroquinolones

Eg: Ciprofloxacin, Levofloxacin, Moxifloxacin, Gemifloxacin

Spectrum

G+ cocci, G- rods

Uses

UTIs, chronic prostatitis, Atypical PNA

How well did you know this?

Not at all

Perfectly

MOA of Fluoroquinolones

Inhibit synthesis and replication of DNA in bacterial cells

How well did you know this?

Not at all

Perfectly

MOA of Aminoglycosides

Inhibit synthesis and replication of DNA in bacterial cells

How well did you know this?

Not at all

Perfectly

Aminoglycosides

E.g-Gentamicin, Tobramycin, Amikacin

Spectrum

Aerobic G- rods

Uses

Multidrug-resistant infections, VAP, Endocarditis, Zoonotic infections

Side Effects
Nephrotoxicity, Ototoxicity, issues with neuromuscular blockade

Glycopeptides

*Eg**: Vancomycin and Lipoglycopeptides (Oritavancin, Dalbavancin)
*Spectrum**

G+ organisms (Strep, Enterococcus, MRSA, MRSE, Clostridium)

Uses

SSTI, prosthetic device infections, Cdiff Colitis

Side Effects
Red man syndrome, fever, reversible nephrotoxicity, immune thrombocytopenia

MOA of Glycopeptides

Prevents assembly of bacterial cell wall

Macrolides

Eg: Erythromycin, Clarithromycin, and azalides (Azithromycin)
Mechanism

Interfere with protein synthesis
Spectrum

G+, G- (not Pseudomonas), Mycobacterium, Rickettsiae, Treponema, Mycoplasma, Chlamydia

Uses of a macrolide

upper and lower respiratory tract infxns Chlamydial STIs non-tuberculous mycobacterial infxns H.pylori infxns

Adverse effects of Macrolides

Prolonged QT interval Transient and reversible tinnitus Worsens symptoms of Myasthenia gravis

Lincosamides

Eg: Clindamycin **Spectrum** Aerobic G+ (Staph, CA-MRSA), Anaerobes, Protozoa

MOA of Lincosamides

Interfere with protein synthesis

Side effects of Lincosamides

Cdiff Colitis, Diarrhea, liver enzymes (reversible)

Oxazolidinones

Eg: Linezolid, Tedizolid **Uses** Infxns due to G+ MRSA and VRE, SSTI, CAP, HAP

MOA of Oxazolidinones

Ribosomal protein inhibitors

Side effects of Oxazolidinones

Bone marrow suppression peripheral neuropathy optic neuropathy lactic acidosis

Lipopeptides

Eg-Daptomycin **Mechanism** Accumulates in the cell membrane of G+ organisms **Spectrum** Multi-drug resistant G+ organisms

Uses and side effects of Lipopeptides

**Uses** Staph bacteremia, R. side endocarditis, complicated SSTIs **Side Effects** Skeletal muscle toxicity, immune thrombocytopenia

Polypeptides

Eg-Colistin **Mechanism** Disrupts outer membrane of G- organisms **Spectrum** Multi-drug resistant G- rods (Pseudomonas, Klebsiella, Acinetobacter, E.coli)

Uses and side effects of Polypeptides

**Uses** Last resort for MDR G- rods in critically ill **Side Effects** Nephrotoxicity, reversible neurotoxicity

Nitroimidazoles

**Eg**: Metronidazole, Tinidazole **Spectrum** Most anaerobes

MOA of Nitroimidazoles

Disrupts electron transport system of anaerobic bacteria

Uses and side effects of Nitroimidazoles

**Uses** Intra-abdominal infxns, Cdiff colitis, anaerobic protozoal infxns (eg: Trichomonas vaginalis) **Side Effects** seizures, peripheral neuropathy

Rifamycins

* *Eg**-Rifampin, rifabutin, rifaximin * *Spectrum** Aerobic and anaerobic G+ cocci and rods

MOA of Rifamycins

Block the interaction of DNA with RNA polymerase

Uses of Rifamycins

TB (rifampin) prosthetic valve endocarditis traveler’s diarrhea (rifaximin) hepatic encephalopathy (rifaximin)

Side effects of Rifamycins

Discoloration of body fluids hepatotoxicity drug-drug interactions

Tetracyclines

**Eg**-Doxycycline, Tigecycline **Spectrum** Intracellular bacteria, Rickettsia, Mycoplasma, Chlamydia, Acenitobacter baumannii (G-)

Uses of Tetracyclines

Rocky Mountain spotted fever complicated SSTIs complicated intraabdominal infxns VAP (A. baumanii)

Side effects of Tetracyclines

Permanent tooth discoloration photosensitivity hepatoxicity

Sulfonamides

Eg-Trimethoprim-sulfamethoxazole **Spectrum** G+, G-, Mycobacterium, fungi, parasites (eg: Toxoplasma gondii)

MOA of Sulfonamides

Interfere with folic acid synthesis

Uses of Sulfonamides

CA-MRSA, UTI, cerebral toxoplasmosis

Side effects of Sulfonamides

Drug-drug interactions hyperkalemia hemolytic anemia SJS