antibacterial agents - ID

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antibacterial agents - ID
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2014-06-03 15:58:41
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  1. gentamicin
    • -
    • MOA: ribosomes/CD/PAE
    • Aminoglycoside- Negative (pseudo), synergy (Positive cocci)
    • Dose: 1-3 mg/kg/dose, ext 4-7 mg/kg (concentration dep + PAE)
    • IV/IM
    • BBW: neurotoxicity, nephrotoxicity, fetal harm
    • SE: nephrotoxicity, ototoxicity
    • Dose IBW unless obese (ADJ BW)
  2. tobramycin
    • -
    • MOA: ribosomes/CD/PAE
    • Aminoglycoside- Negative (pseudo)
    • Dose: 1-3 mg/kg/dose, ext 4-7 mg/kg (concentration dep + PAE)
    • IV/IM
    • BBW: neurotoxicity, nephrotoxicity, fetal harm
    • SE: nephrotoxicity, ototoxicity
    • Dose IBW unless obese (ADJ BW)
  3. amikacin
    • -
    • MOA: ribosomes/CD/PAE
    • Aminoglycoside- Negative (pseudo)
    • Dose: 5-7 mg/kd/dose, ext 15-20 mg/kg (concentration dep + PAE)
    • IV/IM
    • BBW: neurotoxicity, nephrotoxicity, fetal harm
    • SE: nephrotoxicity, ototoxicity
    • Dose IBW unless obese (ADJ BW)
  4. amoxicillin
    • Amoxil, Moxatag
    • MOA: cell wall/PBP/TD/cidal
    • Beta-lactams/Aminopenicillins- Positive, Negative
    • PO
    • DOC: acute otitis media, H. pylori, pregnancy, prophy for endocarditis
  5. amoxicillin + clavulanate
    • Augmentin
    • MOA: cell wall/PBP/TD/cidal
    • Beta-lactams/Aminopenicillins- Positive, Negative
    • PO
  6. ampicillin
    • -
    • MOA: cell wall/PBP/TD/cidal
    • Beta-lactams/Aminopenicillins- Positive, Negative
    • PO/IV
  7. ampicillin + sulbactam
    • Unasyn
    • MOA: cell wall/PBP/TD/cidal
    • Beta-lactams/Aminopenicillins- Positive, Negative
    • IV (NS only)
  8. penicillin
    • Pen VK
    • MOA: cell wall/PBP/TD/cidal
    • Beta-lactams/Natural penicillins- Positive, Negative
    • PO
  9. penicillin G benzathine
    • Bicillin L-A
    • MOA: cell wall/PBP/TD/cidal
    • Beta-lactams/Natural penicillins- Positive, Negative
    • IM
  10. piperacillin
    • -
    • MOA: cell wall/PBP/TD/cidal
    • Beta-lactams/Ureidopenicillins- Positive, Negative
    • IV
  11. piperacillin + tazobactam
    • Zosyn
    • MOA: cell wall/PBP/TD/cidal
    • Beta-lactams/Ureidopenicillins- Positive, Negative (pseudo)
    • IV
  12. nafcillin
    • -
    • MOA: cell wall/PBP/TD/cidal
    • Beta-lactams/Antistaphylococcal penicillins- Positive, Negative
    • IV
  13. ceFAZolin
    • Kefzol
    • MOA: cell wall/PBP/TD/cidal
    • Beta-lactams/1st generation cephalosporin- staph, low strep and low Negative (PEK)
    • IV/IM
  14. cephalexin
    • Keflex
    • MOA: cell wall/PBP/TD/cidal
    • Beta-lactams/1st generation cephalosporin- staph, low strep and low Negative (PEK)
    • PO
  15. cefoTEtan
    • -
    • MOA: cell wall/PBP/TD/cidal
    • Beta-lactams/2nd generation cephalosporin- better Negative (HNPEK), similar Positive, anaerobic (Bacteriodes fragilis)
    • IV/IM
    • NMTT side chain = disulfiram and bleeding
  16. cefOXitin
    • -
    • MOA: cell wall/PBP/TD/cidal
    • Beta-lactams/2nd generation cephalosporin- better Negative (HNPEK), similar Positive, anaerobic (Bacteriodes fragilis)
    • IV/IM
  17. cefuroxime
    • Ceftin, Zinacef
    • MOA: cell wall/PBP/TD/cidal
    • Beta/lactams/2nd generation cephalosporin- better Negative (HNPEK), similar Positive
    • PO/IV/IM
  18. cefdinir
    • Omnicef
    • MOA: cell wall/PBP/TD/cidal
    • Beta-lactams/3rd generation cephalosporin- better Negative (HNPEKS), less staph, enhanced strep
    • PO
  19. cefTAZidime
    • Fortaz, Tazifcef
    • MOA: cell wall/PBP/TD/cidal
    • Beta-lactams/3rd generation cephalosporin- better Negative (HNPEKS), less staph, enhanced strep, less Positive, enhanced Negative with Pseudo
    • IV/IM
  20. cefTRIAXone
    • Rocephin
    • MOA: cell wall/PBP/TD/cidal
    • Beta-lactams/3rd generation cephalosporin- better Negative (HNPEKS), less staph, enhanced strep
    • IV/IM
    • biliary sludging with calcium or in neonates
  21. cefepime
    • Maxipime
    • MOA: cell wall/PBP/TD/cidal
    • Beta-lactams/4th generation cephalosporin- best Negative: (HNPEKS), Citrobacter, Acinetobacter, Pseudo, Enterobacter (CAPE), similar Positive
    • IV/IM
  22. ceftaroline fosamil
    • Teflaro
    • MOA: cell wall/PBP/TD/cidal
    • Beta-lactams/5th generation cephalosporin- best positive: MRSA, some Negative
    • IV
  23. imipenem/cilastatin
    • Primaxin
    • MOA: cell wall/PBP/TD/cidal
    • Beta-lactam/Carbapenems- most Positive, Negative (Pseudo), anaerobic (NO: atypical, MRSA, VRE, C. diff, Stenotrophomonas)
    • IV
    • SE: seizures
  24. meropenem
    • Merrem
    • MOA: cell wall/PBP/TD/cidal
    • Beta-lactam/Carbapenems- most Positive, Negative (Pseudo), anaerobic (NO: atypical, MRSA, VRE, C. diff, Stenotrophomonas)
    • IV
    • SE: seizures
  25. ertapenem
    • Invanz
    • MOA: cell wall/PBP/TD/cidal
    • Beta-lactam/Carbapenems- most Positive, Negative, anaerobic (NO: atypical, MRSA, VRE, C. diff, Stenotrophomonas, Pseudo, Acinetobacter)
    • IV
    • SE: seizures
  26. doripenem
    • Doribax
    • MOA: cell wall/PBP/TD/cidal
    • Beta-lactam/Carbapenems- most Positive, Negative (Pseudo), anaerobic (NO: atypical, MRSA, VRE, C. diff, Stenotrophomonas)
    • IV
    • SE: seizures
  27. ofloxacin
    • Floxin - otic
    • MOA: topo IV/II-gyrase/CD/cidal
    • FQs- extensive Negative, Positive, average to excellent atypical
    • PO
    • BBW: tendon rupture (esp corticosteroid), organ transplant, >60 yo
    • Warnings: QT prolongation, peripheral neuropathy, seizures, hypoglycemia, hepatotoxicity, avoid in children
  28. ciprofloxacin
    • Cipro
    • MOA: topo IV/II-gyrase/CD/cidal
    • FQs- extensive Negative (enhanced - Pseudo), Positive, average to excellent atypical
    • PO/IV
    • BBW: tendon rupture (esp corticosteroid), organ transplant, >60 yo
    • Warnings: QT prolongation, peripheral neuropathy, seizures, hypoglycemia, hepatotoxicity, avoid in children
    • CI: tizanidine
    • Notes: do not refrigerate, no NG or feeding tube (oil based suspension), hold tube feedings 1 hour before and 2 hours after
  29. levofloxacin
    • Levaquin
    • MOA: topo IV/II-gyrase/CD/cidal
    • FQs- extensive Negative (enhanced - Pseudo), Positive, average to excellent atypical (enhanced), Strep Pneumo (respiratory FQ)
    • PO/IV
    • BBW: tendon rupture (esp corticosteroid), organ transplant, >60 yo
    • Warnings: QT prolongation, peripheral neuropathy, seizures, hypoglycemia, hepatotoxicity, avoid in children
    • Notes: empty stomach, at room temp
  30. moxifloxacin
    • Avelox, Vigamox (opthal)
    • MOA: topo IV/II-gyrase/CD/cidal
    • FQs- extensive Negative, Positive (enhanced), average to excellent atypical (enhanced), enhanced anaerobic (mixed infections - intra-abdominal)
    • Strep Pneumo (respiratory FQ)
    • PO/IV
    • BBW: tendon rupture (esp corticosteroid), organ transplant, >60 yo
    • Warnings: QT prolongation, peripheral neuropathy, seizures, hypoglycemia, hepatotoxicity, avoid in children
  31. azithromycin
    • Zithromax, Z-Pak
    • MOA: ribosomes/(AUC/MIC)/static
    • Macrolides- Positive (Strep), some Negative (better than Erythromycin) - (Haem, Neis, Morax), atypical (Chlam, Mycop, Mycobact, Legion), Upper and lower respiratory and sexually transmitted infxn
    • PO/IV
    • Warnings: QT prolongation, hepatotoxicity, GI
    • Notes: room temp (suspension)
  32. clarithromycin
    • Biaxin
    • MOA: ribosomes/(AUC/MIC)/static
    • Macrolides- Better Positive (Strep), some Negative - (Haem, Neis, Morax), atypical (Chlam, Mycop, Mycobact, Legion), Upper and lower respiratory and sexually transmitted infxn
    • PO
    • Warnings: QT prolongation, hepatotoxicity, GI
    • Notes: with food, room temp
  33. erythromycin
    • E.E.S, Ery-Tab, EryPed, Erythrocin
    • MOA: ribosomes/(AUC/MIC)/static
    • Macrolides- Positive (Strep), some Negative - (Haem, Neis, Morax), atypical (Chlam, Mycop, Mycobact, Legion), Upper and lower respiratory and sexually transmitted infxn
    • PO/IV
    • Warnings: QT prolongation, hepatotoxicity, GI
    • Notes: refrigerate E.E.S. use w/i 10 days, erythromycin powder suspension stable room temp x 35 days
  34. doxycycline
    • Oracea, Doryx, Vibramycin
    • MOA: ribosomes/(AUC/MIC)/static
    • Tetracycline- Positive (Staph, Strep, Entero, Nocar, Bacillus, Propio), Negative (respi tract - Haem, Morax, atypicals), unique (spiroch, ricketts, anthrax, syphil, acne, Chlam, malaria, etc), MRSA (mild), VRE (urinary tract)
    • PO/IV
    • Warnings: ≤8 yo, preggo, breastfeed (discolors teeth, suppress bone growth)
    • Notes: most used - tolerability and broader coverage, ratio 1:1, room temp (suspension), protect from light
  35. minocycline
    • Minocin, Solodyn, Dynacin
    • MOA: ribosomes/(AUC/MIC)/static
    • Tetracycline- enhanced Positive (Staph, Strep, Entero, Nocar, Bacillus, Priop), Negative (respi tract - Haem, Morax, atypicals), unique (spiroch, ricketts, anthrax, syphil, acne (preferred), Chlam, malaria, etc)
    • PO/IV
    • Warnings: ≤8 yo, preggo, breastfeed (discolors teeth, suppress bone growth)
  36. sulfamethoxazole and trimethoprim
    • Bactrim, Septra, Sulfatrim
    • MOA: inhibit folic acid/collectively cidal
    • Sulfonamides- Positive (Staph-MRSA), Negative (HPEK, Entero, Acineto, Shigella, Salmon, Steno), Opportunistic (Nocar, Pneumocystis, Toxop), NO- pseudo, Enterococci, atypical, anaerobic
    • PO (uncom UTI 1 DS BIDx3D), (PCP prophy- 1 DS, or SS daily)
    • CI: sulfa allergy
    • SE: GI, skin, crystalluria, hyper kalemia, hypo glycemia, QT
    • Notes: 5:1 ratio (400 SMX/80 TMP), room temp, 2C9 (FAB4)
  37. vancomycin
    • Vancocin
    • MOA: cell wall/D-Ala-D-Ala/TD/cidal
    • -Positive (staph- MRSA, strep, entero - not VRE, c.diff)
    • PO (C.diff 125-500 mg QID x10-14d)/IV (DOC MRSA - 15-20 mg/kg Q8-12H)
    • SE: red man syndrome (30 min infusion), nephrotoxicity, thrombocytopenia
    • Monitor: troughs 15-20 mcg/mL - BHOME, 10-15 all else
    • Notes: NTE 5 mg/mL peripheral IV, consider alternative agent when MIC ≥2 mcg/mL
  38. linezolid
    • Zyvox
    • MOA: ribosomes/static
    • Oxazolidinone- Positive (MRSA, VRE faecium&faecalis), Pneumo, ST&T (un/c) - diabetic foot, staph aureus, strep, VRE
    • PO/IV
    • CI: MAOi 2 weeks
    • Warnings: myelosuppression (CBC), peripheral and optic neuropathy >28 days, hypoglycemia
    • Notes: room temp, avoid tyramine
  39. quniupristin/daltopristin
    • Synercid
    • MOA: ribosomes/cidal
    • Streptogramin- Positive (MRSA, VRE faecium only), S&ST (c) - Staph aureus and Strep pyogenes
    • IV
    • SE: athralgias/myalgias, infusion reaction, edema and pain at infusion site, phlebitis, hyperbilirubinemia
    • Notes: no renal, D5W (peripherally), IV refrigerated after reconstitution
  40. daptomycin
    • Cubicin
    • MOA: cell membrane/CD/cidal
    • Cyclic lipopeptide- Positive (MRSA, VRE faecium&faecalis), S&ST (c), Staph aureus bloodstream, right-sided endocarditis
    • IV
    • Warnings: eosinophilic pneumonia (2-4 weeks after), myopathy (muscle tox- CPK weekly)
    • Notes: not for pneumonia - surfactant inactivation, NS, false elevations PT/INR
  41. telavancin
    • Vibativ
    • MOA: cell wall/D-Ala-D-Ala/lipophilic moiety/CD/cidal
    • Lipoglycopeptide (derived from vancomycin)- Positive (MRSA, NO VRE), S&ST (c), HAP
    • IV
    • BBW: fetal risk, nephrotoxicity, increased mortality with HABP/VABP
    • Warnings: QT, red man (60 mins)
    • SE: metallic taste, NV
    • Note: alternative use
  42. aztreonam
    • Azactam, Cayston (inhaled)
    • MOA: cell wall/PBP/cidal
    • Monobactam- Negative (Pseudo)
    • IV
    • Note: can use with PCN-allergy
  43. colistimethate sodium
    • Colistin, Coly-Mycin M
    • MOA: inactive prodrug/cationic detergent/CD/cidal
    • Polymyxin- Negative (Entero, e. coli, Kleb, Pneumo, Pseudo aeru) - for multidrug resistant Negative
    • IV
    • Warning: nephrotoxicity (dose dependent)
    • SE: nephro, neurologic disturbances
  44. chloramphenicol
    • -
    • MOA: reversible ribosomal/cidal
    • -Positive, Negative, anaerobes, atypicals
    • BBW: blood dyscrasias (aplastic anemia, thrombocytopenia) - monitor CBC
    • Warning: Gray syndrome
    • Notes: rarely used, no renal
  45. telithromycin
    • Ketek
    • MOA: ribosomes/CD/cidal
    • Ketolide- Positive (Strep, macrolide resistant), Negative, some anaerobes, Mycobacteria atypicals, FDA- CAP only
    • PO
    • BBW: not used in myasthenia gravis due to respiratory failure
    • CI: allergy to macrolides
    • Warnings: QT prolongation, acute hepatic failure
    • Monitoring: LFTs
    • Note: 3A4
  46. tigecycline
    • Tygacil
    • MOA: ribosomes/static
    • Glycylcyclines (derived from minocycline related to tetracyclines)- Positive (MRSA, VRE faecium&faecalis), Negative (NO 3Ps- pseudo, proteus, providencia), anaerobes, atypicals, S&ST (c)- intra-abdominal, CAP, FDA- alternative when necessary
    • IV
    • BBW: increased risk of death
    • Warnings: hepatotoxicity, pancreatitis, photosen, ≤8 yo (suppresses growth, discolor teeth perm)
    • Note: avoid bloodstream infections - lipophillic
  47. clindamycin
    • Cleocin
    • MOA: ribosomes/static
    • -aerobic Positive (NO enterococcus), anaerobic Negative and Positive
    • PO/IV
    • BBW: fatal colitis (c.diff)
    • SE: GI
    • Note: no renal
  48. metronidazole
    • Flagyl
    • MOA: DNA breakage/cidal
    • -anaerobes, protozoal, DOC bacterial vaginosis, trichomoniasis, giardiasis, amebiasis, pseudomembranous colitis (c.diff)
    • PO/IV (500 mg TID x10-14d - mild-mod c.diff)
    • BBW: carcinogenic animal data
    • CI: preggo (1st)- disulfiram w/i 2 weeks, ETOH within 3 days of d/c
    • Warnings: CNS effects
    • SE: GI, metallic, peripheral neuropathy
    • Note: room temp IV, warfarin (FAB4)
  49. rifaximin
    • Xifaxan
    • MOA: bind to RNA polymerase/cidal
    • -related to rifampin, traveler's diarrhea by noninvasive E. coli, prevention of hepatic encephalopathy
    • PO
    • Note: no renal, not effective for systemic infection (absorption minimal)
  50. fosfomycin
    • Monurol
    • MOA: cell wall/cidal
    • -single dose for uncom UTI (cystitis only) e.coli and E. faecalis (VRE)
    • PO
    • Note: mix with cold water
  51. nitrofurantoin
    • Macrodantin, Macrobid, Furadantin
    • MOA: cell wall/cidal
    • -uncom UTI (cystitis only) e.coli, Enterococcus, Kleb, Enterobacter
    • PO
    • CI: renal <60 (inadequate urinary concentrations, risk for neurotoxins), preggo (term)
    • Notes: food enhance absorption, dark urine (harmless), avoid magnesium trisilicate-containing antacids, probenacid
  52. fidaxomycin
    • Dificid
    • MOA: RNA polymerase/cidal
    • -c.diff associated diarrhea (select cases - costly)
    • PO 
    • Notes: not effective for systemic infections

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