Antibiotics

Question 1

antibiotics that are effective against Pseudomonas aeruginosa

Answer 1

عشان متنساش
فاكر بتدي ايه في eprical antibiotics في high risk؟
فاكر بتوع monotherapy ؟
*Pipracillin +tazobactam
*cefepime
*Imipnem +cilastatin
*Imipnem
+
زود اللي باقي من carbabnem اللي هو Aztronem
+
Aminoglycoside اللي كنت بتزوده في dual therapy
+
Ceftazidime
+
+Fluroquinolones
ما عاد moxi

Question 2

antibiotics that have anaerobic coverage.

Answer 2

قول نفس حروف Atypical bacteria
Culm
C..clinda,carpapenem
Unasyn,augmentin
moxiflox,metronidazole

ومتنساش
Pipracillin tazobactam

Question 3

MRSA antibiotics…

Answer 3

(3Mycin) + CBD
Vancomycin
Daptomycine
Clindamycin
+
Ceftaroline الخامس
+
Doxycycline
+
Bacteim

Question 4

Organisms not covered by Cephalosporins (1st - 4th Generation)

Answer 4

التحشيشة Male
MRSA
Atypical including (Mycoplasma - Chlamydia)
Listeria
Enterococci

Question 5

HACEK

Answer 5

Definition
A group of Gram-negative bacteria with unusual cause of infective endocarditis, previously they were called “culture-negative” endocarditis because they were not isolated.

Question 6

HACEK

Answer 6

Members
1-Haemophilus
2-Aggregatibacter (Actinobacillus actinomycetemcomitans)
3-Cardiobacterium hominis
4-Eikenella corrodens ايكنيلا
5-Kingella kingae كنجلا

Question 7

HACEK

Answer 7

Pathogenesis
*HACEK group are a part of the normal flora of the mouth and upper respiratory tract. The disease occurs due to colonization of the bacteria in oropharynx or upper respiratory space due to trauma or local infection.

Question 8

HACEK

Answer 8

Diagnosis
1-History:
Patient has previous valvular defect
-IV drug abuser
* Hx of dental, urologic or other procedure.
2-Fever is common but may be absent in elderly or immunocompromised.
3-Heart murmur but may be absent in Rt sided endocarditis.
4-Trans-esophageal echo to assess vegetations.
5-Blood Cultures:
Blood culture negative organisms but if organisms are exposed to CO₂ or enriched blood culture medium, it may be identified.
So, it’s better to do the culture on:
* Sheep blood
* Chocolate agar
at 37°C under 5-10% CO₂
Good prognosis & good response

Question 9

HACEK

Answer 9

Treatment
1-The standard Rx is Ceftriaxone 2gm IV / day (therapy is for 4 weeks but if there is prosthetic valve → 6weeks)
*Alternatives → if Beta-lactam allergy → Moxi- Cipro- levo
2-Surgical Intervention when??)
* Heart failure
* Persistence of infection in spite of proper Rx
* Prevention of embolization
→ After surgery → if culture is -ve → Continue duration started with the 4-6 week culture after diagnosis. If culture +ve → Full course according to Abx in culture.
3-Prophylactic antibiotics)
Amoxicillin 2 gm orally @ 1V
Ampicillin 2 gm

Question 10

Atypical pneumonia

Answer 10

1-Mycoplasma pneumoniae
2-Chlamydia pneumoniae:
3-Legionella pneumophila:
4-Coxiella burnetii
5-Viruses: influenza virus, respiratory syncytial virus (RSV), and coronaviruses

Question 12

Atypical bacteria

Answer 12

Definition
bacteria not coloured by gram stain because of
absence of the cell wall.

Question 13

Atypical bacteria

Answer 13

Members…

Culm
-Mycoplasma, ureaplasma
- Chlamydia
- Legionella

Question 14

Atypical bacteria

Answer 14

Clinical affection
1- Mycoplasma: Atypical pneumonia
2- Ureaplasma: Urogenital infection
3- Chlamydia
Cl. Trachomatous: Conjunctivitis, non-gonococcal urethritis, PID in women.
-C.pneumoniae: Pneumonia
*C.psittacci: Psittacosis
4- Legionella: Severe form of pneumonia (Legionnaire disease)

Question 15

Atypical bacteria

Answer 15

Antimicrobial therapy (MDF)
- Macrolides
- Doxycycline
- Fluoroquinolones