Aminoglycosides Doxycycline TMP-SMX B-lac/B-lactamase Combos

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Author:
dakine619
ID:
280248
Filename:
Aminoglycosides Doxycycline TMP-SMX B-lac/B-lactamase Combos
Updated:
2014-08-06 18:39:05
Tags:
ABx
Folders:
Infectious Dz
Description:
Step 2
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  1. Aminoglycosides
    • Gentamicin
    • Tobramycin
    • Amikacin
  2. Coverage
    GNB (bowel, urine, bacteremia)
  3. Synergistic with beta-lactam ABx for coverage of:
    • enterococci
    • staphylococci
  4. No effect against anaerobes bc
    they need O2 to work
  5. Aminoglycoside RF
    • Nephrotoxic: inhibits protein synth at renal tubules; Acute Tubular Necrosis l/t Renal Failure
    • - prevent with combo of loop diuretic (N-acetylcysteine)
    • Ototoxic - esp Gentamycin!
  6. DOXYCYCLINE
    - Tx?
    - Prophylaxis?
    - Adverse effects?
    • Tx:
    • Anthrax!
    • Chlamydia
    • Lyme Dz (lim to rash, jnt, CN7 palsy)
    • Rickettsia
    • MRSA of skin/soft tissue (cellulitis)
    • 1' and 2' Syphilis for those allx to PCN
    • Borrelia, Ehrlichia, and Mycoplasma
    • Prophylaxis:
    • Malaria
    • Adverse: tooth discolor (kids), Fanconi synd (Type II RTA proximal), Photosens, esophagitis/ulcer
  7. Trimethoprim/Sulfamethoxazole
    Tx of:
    Adverse:
    • Tx of: cystitis
    • pneumocystis pneum Tx & Prophylaxis (@ CD4 < 200)
    • MRSA of skin/soft tissue (cellulitis)
    • Risk/Adverse: Rash; Hemolysis w G6PD def; Bone Marrow Suppression (bc its a folate antagonist)
  8. Beta-lactam/Beta-lactamase Combos
    • :) adds coverage for sensitive staph
    • while also cover anaerobes
    • 1st choice for: Mouth and GI Abscess
  9. Beta-lactam/Beta-lactamase Combos
    • Amoxicillin / Clavulanate = Augmentin (1st Line Tx of Cat bites - Pastuerella)
    • Ticarcillin / clavulanate = Timentin
    • Ampicillin / sulbactam = Unasyn
    • Piperacillin / tazobactam = Zosyn

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