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What are 3 high value differentials for a chronic draining tract in a dog's leg (not responsive to antibiotics)?
What drug is a glycopeptide?
What is the MOA of vancomycin?
- binds to D-ala-D-alanine, preventing transglycosylation--> transpeptidases cannot form cross bridges--> autolysins break existing cross bridges--> cell lysis
- [different from beta-lactams b/c binds to a substrate, rather than the PBP enzyme]
What are clinical applications of Vancomycin?
- drug of last resort in human medicine
- only SERIOUS infections with no other therapeutic options (Staph, Enterococcus, C. diff)
What is the spectrum of vancomycin?
How is vancomycin administered?
- IV- diluted in bag of fluids and given over an hour
- PO only for C. diff in humans
What are pharmcodynamic properties of vancomycin?
- time- and concentration- dependent (ie. AUC)
What are adverse reactions to vancomycin? (4)
- [seen in people]
- severe phlebitis
- anaphylaxis/ histamine reaction (red man syndrome)
What are important resistance mechanisms to vancomycin?
- VanA, VanB, VanC- A and B associated with transposons that are inserted by plasmids or chromosomes
- horizontally transmissible among Staph and Enterococci
Describe the use of Linezolid. (4)
- useful for MRSA in humans but there are antimicrobial stewardship issues
- orally administered
- gram neg
- very expensive ($115 per pill)
What is the spectrum of bacitracin?
gram + only
What are pharmodynamic properties of bacitracin?
What are toxicities associated with bacitracin?
How is bacitracin administered?
What is the MOA of bacitracin?
interferes with transport of peptide building blocks of cell wall
What is the spectrum of polymyxin B?
gram neg only
What are pharmacodynamic properties of polymyxin B?
What are toxicities associated with polymyxin B? (2)
Describe clinical used of polymyxin B?
- low-dose systemic use for sepsis
- does not kill bacteria at low doses but binds LPS
Describe the anti-endotoxin effects of polymyxin B.
- decreases fever, plasma TNF, tachycardia, and neutropenia
- don't give with azotemia or dehydration!
What are bacterial differentials for bacteremia in a dog? (4)
- Strep canis (+)
- Staph (+)
- Enterics, esp E. coli (-)
- Enterococcus (+)
What bacteria have reported resistance to Vancomycin?
Staph and Enterococcus