Antibiotics

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Author:
jdwein39
ID:
310734
Filename:
Antibiotics
Updated:
2015-11-01 15:12:40
Tags:
antibiotics cfm
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  1. Treatment for strep pyogenes
    Penicillin
  2. Natural Penicillins
    • Narrow spectrum
    • Group A and B streptococci; s. penumoniae
  3. Aminopenicillins
    • Ampicillin, Amoxicillin
    • Adverse Reaction: EBV (mono)
  4. Penicillinase-Resistant Penicillins
    • Oxacillin, Nafcillin
    • Indicated for MSSA as well as susceptible streptococcal infections
  5. Piperacillin
    • Best gram negative coverage
    • Used for hospital acquired pneumonia
  6. Beta lactamase inhibitor combinations
    • Bind irreversibly to many plasmid and some chromosomal beta lactamases
    • Restores activity of antibiotic to some organisms such as MSSA and H. influenza
    • Indicated for URIs and LRIs including pneumonia
  7. Cephalosporins
    • First generation: best gram + and weakest gram -; used for surgical prophylaxis
    • Second generation: better gram - coverage
    • Third generation: best gram - except pseudomonas; used for community acquired pneumonia
    • Fourth generation: more resistant to beta lactamases; broad activity including Pseudomas; used for hospital acquired gram - infections
  8. Carbapenems
    • Broadest spectrum antibiotic
    • Used for serious HA-infections when resistant pathogens are suspected
    • One of them has CNS toxicity
  9. Monobactam
    • Aztreonam
    • No anaphylaxis in penicillin allergic patients
    • Treatment of gram - infections in penicillin allergic patients
  10. Beta Lactams Pharmacology
    Time-dependent killing
  11. Vancomycin
    • Red-person syndrome (non-immune release of histamine; treat with antihistamine)
    • Indicated for MRSA and coagulase - staph/enterococci, gram + infections in PCN-allergic patients
  12. Aminoglycosides
    • Post antibiotic effect and concentration dependent killing - enables once daily dosing with lower toxicity
    • Major toxicity is nephrotoxicity
    • Indicated for serious gram-negative infections including Pseudomonas and other resistant strains
  13. Macrolides
    • Clarithromycin and azithromycin
    • Toxicity includes QT prolongation
    • Indicated for community-acquired pneumonia and non-gonococcal urethritis
  14. Clindamycin
    • Adverse reaction of diarrhea
    • Indicated for anaerobic infections
    • Antitoxin effect
  15. Tetracyclines
    • Resistance via efflux pump
    • Avoid taking with dairy products or antacids
    • Indicated for spirochetes (Lyme, syphilis)
  16. Tigecycline
    • Unique tetracycline with less resistance by efflux ad ribosomal mutations
    • Active against multiply-drug resistant gram negative bacilli
  17. Daptomycin
    • Myopathy (muscle pain)
    • Indicated for serious S. aureus infections
    • Do not use for pneumonia; inactivated by surfactant (which is located in the lungs, so daptomycin does not work in the lungs)
  18. Oxazolidinones
    • Linezolid
    • Bacteriostatic
    • Decrease in platelet counts; serotonin syndrome (beware if patient on SSRIs)
    • Used for infections due to resistant gram +'s (MRSA, VRE)
  19. Fluoroquinolones
    • May delay dx of TB if used for > 10 days
    • Don't use in children or during pregnancy
    • Used for complicated UTIs and prostatitis
  20. Adverse events with quinolones
    • Prolonged QT interval
    • Arthritis/tendonitis
    • ***C diff
  21. Metronidazole
    • Disulfiram effect (hypersensitivity to alcohol)
    • Indicated for anaerobic infections and C. diff (as well as trichomoniasis and amebiasis)
  22. Bactrim
    • Trimethoprim-Sulfamethoxazole
    • Toxicity - skin rash
    • Indicated for UTIs and prostatitis, pneumocystis jiroveci pneumonia and prophylaxis, CA-MRSA
  23. Polymyxin
    • Detergent
    • Adverse effect on kidneys
    • Last resort for multiply-drug resistant gram - infections, especially pseudomonas
    • Not well tolerated

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