C/17. Glycopeptides. Fusidans. Lipopeptides. Bacitracin. Mupirocin. Pharmacotherapy Of Skin And Soft Tissue Infections.

Question 1

Drugs need to know in this topic

Answer 1

Vancomycin
Teicoplanin
Oritavancin

Daptomycin

Bacitracin

Fusidic acid
Mupirocin

Question 2

Glycopeptide antibiotics

MOA

Answer 2

Binding at the D-ala-D-ala terinal of the nascent peptidoglycans pentapeptide side chains
->inhibits the transglycoslyation reactions invloved in elongation of peptidoglycan chains
Bactericidal

Question 3

Vancomycin, Teicoplanin

Answer 3

Glycopeptide antibiotics

Narrow spectrum
Gram-positive
Infection caused by MRSA and PRSP
Clostridium difficile

Parenteral
Renal elimination

Chills, fever
Injection site phlebitis
Ototoxicity
Nephrotoxicity

Question 4

Oritavancin

Answer 4

Glycopeptide antibiotic

Narrow spectrum
Gram positive
Tx severe skin infections

Parenteral
GI symptoms
Elevated liver enzymes
Elevated CK

Question 5

Daptomycin

Answer 5

Lipopeptide antibiotics
Disrupt ionic gradients and membrane depolarization
Bactericidal effect

Narrow spectrum
Gram positive

Parenteral administration
Renal elimination

Pulmonary surfactant antagonizes daptomycin
So cant use for pneumonia tx

Myopathy
Pneumonitis

Question 6

Bacitracin

Answer 6

Polypeptide antibiotic
Inhibition of peptidoglycan precursor translocation across the bacterial membrane
Bacteriostatic or bactericidal effect depending on the concentration of the drug

Gram-positive

Parenteral

Nephrotoxicity
Hypersensitivity

Question 7

Fusidic acid

Answer 7

Miscellaneous antibiotics
Inhibits elongation factor G
Bacteriostatic effect

Gram-positice
Aerobes and anaerobes
Topical for skin infections
Systemic for MRSA infection

Topical/parenteral

Hepatotoxicity(with systemic use)

Question 8

Mupirocin

Answer 8

Miscellaneous antibiotics
Inhibitis bacterial protein synthesis by selectively binding to isoleucyl-tRNA synthetase

Active against gram-positive cocci
Tx of impetigo caused by staphylococci, B-hemolytic streptococci, S.pyogenes
Intranasal ointment for eliminating nasal carriage of S. Aureus

Topical

Local itching and burning
Rash, erythema, contact dermatitis

Question 9

Pharmacotherapy of skin and soft tissue infections. Skin and soft tissue infections

Answer 9

Cellulitis, impetigo
Topical: fusidic acid, mupirocin, colistin
Staph, strep: nafcillin IV, Oxacillin IV
MRSA: Vancomycin IV

Necrotizing fasciitis (Group A strep): Clindamycin IV and Penicillin G IV

Gas gangrene (C. Perfringens): Clindamycin IV and penicillin G IV