Anti-infective III

Question 1

T or F. Clindamycin, vancomycin and the macrolides are all in the same drug class.

Answer 1

F. They are 3 separate drug classes.

Question 2

What does Clindamycin cover?

Answer 2

Gram +, anaerobes.

NO GRAM -.

Question 3

Indications for Clindamycin? What other Abx is also used for this and is actually preferred?

Answer 3

Acne (topical application)

Tetracycline - Minocycline (acne + inflammation)

Question 4

Clindamycin is/is not typically used for enterococcus infections.
Is it cheap or expensive?

Answer 4

is not used for enterococcus

Expensive

Question 5

Why might dentists use clindamycin?

Answer 5

abscesses - it is pH stable and can penetrate acidic abscesses

Question 6

What is the #1 drug that may cause C.diff?

Answer 6

Clindamycin (10% of all C. Diff infections)

Question 7

What is Mupirocin active against?

Answer 7

Gram + causing skin infections (SA)- folliculitis, impetigo, and nasal staph.

Question 8

Mupirocin is only available ____.

Answer 8

topically

Question 9

What is the DOC for nasal staph? impetigo?

Answer 9

Mupirocin (Bactroban)

Question 10

Linezolid is used for treatment of what type of infections?

Answer 10

Serious infections caused by MRSA or VRE

Question 11

What is the advantage of using Linezolid over IV vancomycin?

Answer 11

Linezolid has excellent bioavailability and absorbed orally…so it can be given PO. Patients then do not have to have a home health nurse.

Question 12

Name 2 AEs of Linezolid.

Answer 12

1. Thrombocytopenia

2. Reversible weak MAO-I…do not combine with SSRI for fear of 5-HT syndrome

Question 13

Name an OTC weak MAO-I.

Answer 13

St. John’s Wart - SSRI

Question 14

What is another option other than IV vancomycin for MRSA infection?

Answer 14

Linezolid (Zyvox)

Question 15

Importance of Daptomycin?

Answer 15

BACK UP COVERAGE for gram +, including PCN-resistant SA or MRSA, enterococci

Question 16

Importance of Quinupristin-Dalfopristin?

Answer 16

BACK UP COVERAGE for VRE.

Question 17

What do aminoglycosides cover? What purpose does it usually have?

Answer 17

Gram - (PA), and enterococci (+)

Add to other Abx for synergy.

Question 18

Name 5 aminoglycosides. Are they absorbed orally?

Answer 18

Gentamicin, Amikacin, Neomycin, Tobramycin, Streptomycin (GANTS)
Not absorbed orally

Question 19

What is the brand name for Neomycin? Why might you use PO neomycin?

Answer 19

Neosporin.

to lesson severity of hepatic encephalopathy

Question 20

Why would you use Neomycin for hepatic encephalopathy? What is the only possible AE?

Answer 20

It kills bacteria that chew up the food in your GI tract, thus decreasing the ammonia that gets into the blood stream. Ammonia acts as GABA in the brain.
AE - diarrhea

Question 21

What are 2 AEs of the aminoglycosides?

Answer 21

Nephrotoxicity

Ototoxicity

Question 22

What 3 drugs may cause ototoxicity - tinnitus?

Answer 22

ASA OD
Loop Diuretics - Lasix, Furosemide (pushing it too fast)
Aminoglycosides

Question 23

What does QIDP stand for? Why would you use these drugs?

Answer 23

Qualified Infectious Disease Products
Tx of acute bacterial skin, skin structure infections (ABSSSI) …caused by Gram +, including SA, MSSA, MRSA, strep pyogenes
FAST TRACK simple MRSA Tx

Question 24

Nitrazoxanide is anti-______ and used for the treatment of __________. What bugs does it cover?

Answer 24

anti-protozoa
Diarrhea
Cryptosporidium or Giardia

Question 25

Rifaximin is used to treat _______________ caused by non-invasive strains of ________. It also has potential efficacy against 3 other bugs...what are they?

Answer 25

``` Travelor's Diarrhea E. Coli 1. C. jejuni 2. Shigella 3. Salmonella - chicken, eggs ```

Question 26

Would you want Rifaximin to have high or low PO absorption?

Answer 26

low - treat GI tract infections

Question 27

What two Abx are considered helpful in treating hepatic encephalopathy?

Answer 27

PO neomycin | PO Rifaximin

Question 28

Nitrofurantoin (Macrobid) is used to safely treat ________ in what 2 patient populations?

Answer 28

uncomplicated UTIs | pregnant women and nursing home people

Question 29

What 3 drugs are used for uncomplicated UTIs?

Answer 29

Norfloxacin Bactrim Nitrofurantoin (Macrobid)