Antibiotics Flashcards
(22 cards)
Treatment for H. pylori
Triple Therapy
-Amoxicillin (or Metronidazole if PCN allergy)
-Clarithromycin
-PPI
Failure of Triple = Quadruple
-Bismuth/ pepto
-Tetracycline
-PPI
-Metronidazole
Treatment for Spontaneous Bacterial Peritonitis (SBT)
Bugs + Drugs
-Bugs = Enteric gram neg rods, strep pneumoniae
-Drugs = 3rd Gen Cephalosporin
Ceftriaxone, Cefotaxime
Treatment of Pyogenic Liver Infection/ Abscess
Bugs + Drugs (empiric)
-Typically polymicrobial, b/c coming from gut
-Empiric antibiotics until culture results available and x6 weeks
-Ideally initiated after drainage, unless patient is unstable
-Options: GNR + Anaerobes
-3rd G cephalosporin (ceftriaxone) + Metronidazole
-Piperacillin-tazobactam
-Ampicillin + Gentamicin + Metronidazole
-Fluoroquinolone (cipro) + Metronidazole
-Carbapenem (drug-resistant infections)
Treatment for Klebsiella Liver Abscess (Solitary Abscess)
-Drain abscess
-3rd Gen Cephalosporin x4-6 weeks
-Ceftriaxone, Cefotaxime
-4th Gen Cefepime
What are the 4 options in the Beta-lactams category?
Mechanism of action?
-Penicillin
-Cephalosporin
-Monobactam
-Carbapenems
-Cell wall synthesis inhibitors = inhibit cell wall polymer cross-linking
-inhibition of transpeptidases & inhibiting the action of penicillin binding proteins
Treatment for C. diff colitis
-Oral fidaxomicin or vancomycin
-Add IV metronidazole for fulminant disease
-Severe, fecal transplant
Vancomycin
-MOA
-SEs
-MOA = inhibition of cell wall synthesis in gram + bacteria by binding D-alanine-D-alanine of the peptidoglycan layer
inhibiting wall elongation & cross-linking
-SEs = Infusion reaction, a non-allergic rxn when drug is too rapidly infused = direct activation of mast cells & release of histamine
“red man” syndrome = flushing & itching
Can stop vanco & give diphenhydramine, restart slower
-Bugs = S. aureus (infective endo)
-Bacterial pneumonia following viral pneumonia = likely S. aureus and treated like MRSA until known otherwise
Treatment for Rocky Mountain Spotted Fever?
-Bug = Rickettsia rickettsii
-Doxycycline
-MOA = Inhibits protein synthesis by binding to the bacterial 30S ribosomal subunit
Fluoroquinolones
-MOA?
-MOA = prevents DNA gyrase & topoisomerase from unwinding bacterial double-stranded circular DNA
-Use = Typhoid fever (salmonella typhi; step-wise fever, salmon colored rose spots on trunk, intestinal bleeding/perforation)
Trimethoprim-sulfamethoxazole (TMP-SMX)
-MOA?
-MOA = inhibits bacterial replication by blocking 2 steps in bacterial folate metabolism
-SMX competes with para-aminobenzoic acid in the synthesis of dihydrofolic acid
-TMP inhibits dihydrofolate reductase
Treatment for syphilis
Penicillin
Treatment for lymphogranuloma venereum (chlamydia trachomatis)?
Doxycycline
Macrolides
-Example
-MOA
-Fidaxomicin (C. diff)
-MOA = Inhibits RNA polymerase sigma subunit (inhibiting transcription) = bactericidal
Treatment for Listeria m or Listeriosis
-Gram + rod
-Ampicillin
Treatment for hospital-acquired pneumonia or pneumonia due to pseudomonas?
-piperacillin/tazobactam
-Aztreonam
-Cefepime
-Meropenem
-May also want to add Vancomycin for S. aureus also
-If pt has to go to ICU = addition of Ciprofloxacin
Pneumonia due to anaerobic infection
-amoxicillin/clavulanate (covering anaerobes, Strep, & gram negatives)
Treatment for in-patient usual pneumonia
-β-lactam + macrolide
-ceftriaxone & azithromycin
Treatment for community acquired pneumonia or out-patient (consolidation present but not sick enough for admission)
-Macrolide alone
-Azithromycin
-Other options = Amoxicillin, Doxycycline
Treatment for male gonococcal urethritis alone?
Ceftriaxone
Treatment for male gonococcal urethritis + chlamydia?
Ceftriaxone + Doxycycline
Treatment for male chlamydia/ mycoplasma?
Azithromycin
Treatment for male Trichomonas?
Metronidazole
