February 11, 2016 - Bugs and Drugs

Question 1

HACEK Organisms

Answer 1

A group of organisms that can cause acute endocarditis. They are usually found in the upper airway and the mouth.

Haemophilus sp.

Aggregatibacter sp.

Cardiobacterium hominis

Eikenella corrodens

Kingella kingae

Question 2

Pathogens of Cellulitis

Answer 2

Staphylococcus aureas (MSSA / MRSA)

Group A Streptococcus sp.

Vibro sp. (if water)

Question 3

Pathogens of Community Acquired Pneumonia

Answer 3

Streptococcus pneumoniae

Haemophilus influenzae

Klebsiella sp.

Moraxella sp.

Question 4

Mechanisms of Antibacterials

Answer 4

Inhibits cell wall

Inhibits protein synthesis

Disrupts DNA & NA synthesis

Disrupts cell membrane

Question 5

Beta-Lactams

Answer 5

Inhibit cell wall synthesis.

Include penicillins.

Question 6

Beta Lactamase Inhibitors

Answer 6

Combined with beta lactams to increase coverage against bacteria that have evolved beta lactamases.

Examples are amoxicillin-clavulanic acid, ampicillin-sulbactam, and pipercillin-tazobactam.

Question 7

What Doesn’t Pip-Tazo Cover?

Answer 7

Atypicals that don’t have cell walls (Mycoplasma, Chlamydia, Legionella)

MRSA

Enterococcus faecium

Penicillin resistant S. pneumoniae

Question 8

Cephalosporins

Answer 8

A class of beta-lactam antibiotics.

Come in different generations. Generally, first generation is more limited to good gram + coverage with minimal gram -, while later generations have much more broad coverage.

Cephalosporins do not cover enterococcus, MRSA, and atypical pneumonia pathogens.

Question 9

Carbapenems

Answer 9

Broad spectrum beta-lactam class antibiotics.

Good coverage for gram negatives (including Pseudomonas), gram positives, and anaerobes.

Question 10

Vancomycin

Answer 10

Bactericidal glycopeptide.

Covers man resistant gram positive organisms including MRSA, coagulase negative Staph, Enterococcus, and C. difficile.

Question 11

Macrolide Triangle

Answer 11

Erythromycin

Azithromycin

Clarithromycin

Question 12

Lincosamides - Clindamycin

Answer 12

Lincosamide class inhibits 50S ribosome.

Good for covering MRSA, dental infections, and has good oral bioavailability.

The bad is that it is the major culprit to C. difficile infections.

Question 13

Tetracyclines

Answer 13

Protein synthesis inhibitor.

The good is it can be used to treat many respiratory infections, GU infections, and other misc. infections. It has good tissue and intracellular penetration.

The bad is it is teratogenic, depoits in bones and teeth, and causes photosensitivity.

Question 14

Fluoroquinolines

Answer 14

Inhibit DNA synthesis.

Include ciprofloxacin, levofloxicin, and moxifloxicin.

Bacteriocidal, excellent oral bioavailability, good penetration.

The bad is prolonged QT intervals, achilles tendon ruptures, and a risk of C. dif.