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1

Antibiotics eliminated by non renal functions (D-CRIMES)

Doxycycline
Clindamycin
Rifampin- inducer of P450 hepatotoxicity
isoniazid- genetic polymorphism hepatotoxicity
Metronidazole- drug to drug interaction with alcohol due to inhibition of aldehyde metabolism
Erythromycin- inhibition of P450
Sulfonamides- risk of renal crystalluria

2

Mechanisms of antibacterial drugs

1. Cell wall synthesis
2. DNA
3. DNA gyrase
4. Folic acid metabolism
5. Protein synthesis inhibitors 50s and 30s
6. Protein synthesis
7. Cell membrane
8. DNA-directed RNA polymerase

3

Cell membrane attacking antibacterial drugs

Polymyxins
Daptomycin

4

Folic acid metabolism mechanism drugs

Trimethoprim
sulfonamides

5

cell wall synthesis mechanism drugs

vanco
penicillins V and G, amoxicillin, ampicillin, pipercillin tazo
cephalosporins (cephalexin, cefazolin 1st gen), Cefuroxime 2nd gen, ceftriaxone 3rd)

6

DNA mechanism drugs

metronidazole
nitrofurantoin
Fluoroquinolones (cipro, levo, moxiflo)

7

DNA gyrase mechanism

quinolones

8

DNA-directed RNA polymerase mechanism drugs

rifampin

9

protein synthesis 50s inhibitors

Macrolides (eryhtromycin), azithromycin
clindamycin

10

protein synthesis 30s inhibitors

tetracycline (doxy and tetracycline)
streptomycin
tobramycin (aminoglycosides)
amikacin

11

Mechanisms of resistance

1. decreased entry
2. efflux pump
3. bypass pathway
4. enzymatic degradation
5. altered target site

12

MRSA, S. pneumoniae and enterococci use Antibiotic target site alteration resistance mechanisms to which antibiotics?

B-lactam antibiotics (penicillins, cephalosporins, carbapenems)

13

S. aureus, Pseudomonas species use Antibiotic target site alteration resistance mechanisms to which antibiotics?

Fluoroquinolones

14

Enterococci, staphylococci use Antibiotic target site alteration resistance mechanisms to which antibiotics?

Vancomycin

15

Streptococci, staphylococci and enterococci use Antibiotic target site alteration resistance mechanisms to which antibiotics?

erythromycin, clindamycin

16

S. aureus, P aeruginosa, bacteroides and enterococci use antibiotic modification or inactivation resistant mechanisms against which antibiotics?

B-lactams ( penicillins and cephalosporins)

17

Enterococci alone uses acetyl-phospho-adenylyl transferases modification or inactivation against which antibiotic?

aminoglycosides

18

Pseudomonas aeruginosa uses decreased entry (natural resistance to which antibiotic?

B-lactam antibiotics

19

Pseudomonas species in general use decreased entry (natural resistance to which antibiotic?

Fluoroquinolones

20

E.coli, pseudomonas decreased entry (natural resistance to which antibiotic?

Aminoglycosides

21

Streptococci, staphylococci and enterococci use increased efflux resistance to which antibiotics?

Tetracyclines, Macrolides (was a question on his powerpoint)

22

Pseudomonas species use use increased efflux resistance to which antibiotics?

Fluoroquinolones

23

Mechanisms of bactericidal drugs

1. inhibition of cell wall synthesis
2. Disruption of cell membrane function
3. interference with DNA function or synthesis

24

mechanisms of bacteriostatic drugs

1. inhibition of protein synthesis
2. Inhibition of intermediary metabolic pathways

25

What are the gram positive cocci

Streptococci (pneumonia, pyogenes)
Staphylococci (aureus: MSSA-MRSA)
Enterococci

26

What are the gram negative cocci

Neisseria (meningitidis, gonorrhoeae), M. Catarrhalis

27

Rods: gram (-) and (+)

Gram (-): E. coli, pseudomonas aeruginosa, H. Influ)
Gram (+): Listeria

28

Anaerobes gram (-) and (+)

Gram (+): Clostridium difficile, H. Pylori
Gram (-): Bacteroides fragilis

29

Atypical organisms?

Chlamydia
Mycoplasma
Rickettsia

30

describe narrow spectrum I.E what are they effective against

either gram negative or gram positive