Antibiotics

Question 1

Majority of pharyngitis cases are ___ and treated with ____

Answer 1

viral

nothing

Question 2

If pharyngitis is caused by bacteria (only 10-15%) it is treated with ___?

Answer 2

GABHS - penicillin

alternative: azithromycin or cephalosporin

Question 3

bacterial etiologies for Otitis Media?

Answer 3

Strep Pneumo - 35%
H Flu - 25%
Moraxella catarrhalis - 15%

Question 4

what is treatment protocol for otitis media

Answer 4

observation method
if child doesn’t improve in 48-72 hours begin ab therapy
*always treat children with severe symptoms and children <6 months and children > 2 who have AOM with otorrhea

Question 5

First line ab for AOM

Answer 5

amoxicillin

alternative: cephalosporins (ceftriaxone), macrolides (asithromycin)

Question 6

when do you initiate tx for sinusitis?

Answer 6

after 10 days of sx which indicates bacterial infection

Question 7

first line tx for sinusitis?

Answer 7

amoxicillin, doxycline

second line: cephalosporins, azithromycin

Question 8

most common etiology of CAP

Answer 8

strep pneumo
h flu
mycoplasma pneumonia
etc

Question 9

tx for CAP

Answer 9

macrolide

Question 10

tx for uncomplicated cystitis

Answer 10

nitrofurantoin (macrobid)
cipro is second line
*avoid fluoroquinolones

Question 11

uncomplicated cystitis

Answer 11

infection of bladder in a host without structural abnormalitis, neurological urinary abnormalitis, or signs of systemic infection (fever)

Question 12

common etiology for uncomplicated cystitis

Answer 12

e coli - 75-95%
klebsiella
staph saprophyticus - common in post-coital

Question 13

tx for gonorrhea

Answer 13

ceftriaxone plus azithromycin

* no fluoroquinolones due to resistance

Question 14

tx for chlamydia

Answer 14

doxycycline

azithromycin

Question 15

cellulitis tx for uncomolicated and non MRSA

Answer 15

amoxil-vlavulanate
dicloxacillin
cephalaxin

Question 16

tx for suspicion of MRSA cellulitis

Answer 16

TMP sulfa
clindamycin
doxycyclin

Question 17

example of narrow spectrum ab

Answer 17

penicillin

Question 18

broad spectrum ab

Answer 18

piperacillin

Question 19

bacteriostatic ab

Answer 19

tetracycline

Question 20

time dependent antibiotics: maximize effect by total time in body

Answer 20

penicillins
cephalosporins
macrolides
clindamycin

Question 21

concentration dependent antibiotics: most effective by reaching concentration above dependent activity

Answer 21

quinolones
aminoglycosides
azithromycin
ketolides

Question 22

which antibiotics have b lactam structure

Answer 22

penicillins

Question 23

drug of choice for n meningitidis and syphilis

Answer 23

penicillin

Question 24

indications for aminopenicillins (ampicillin, amoxicillin)

Answer 24

sinusitis, otitis, lower resp tract infections, endocarditis

Question 25

extended spectrum penicillins (piperacillin0

Answer 25

IV ONLY for severe infections - broad spectrum

Question 26

what is used for anaerobes

Answer 26

penicillin/b-lactamase inhibitors - amoxicilin, augmentin

Question 27

adverse reactions to penicillin

Answer 27

``` allergic rxn (anaphylaxis, rash, fever, urticaria) diarrhea ```

Question 28

Type 1 IgE reaction to penicilin

Answer 28

within 1 hour | urticaria, flushing, angioedema of face, anaphylaxis

Question 29

most severe cause of antibiotic induced diarrhea

Answer 29

pseudomembranous colitis (c difficile colitis) from amoxicillin and clavulanate

Question 30

how are penicillins cleared?

Answer 30

renal

Question 31

1st generation cephalosporins

Answer 31

cefazolin, cephalexin used for UTIs, skin, reps alternative to penicillins

Question 32

cefriaxone

Answer 32

3rd generation cephalosporin broad spectrum used in resp infections (CAP)

Question 33

what is used to treat seroius hospital infections

Answer 33

cefepime (4th generation cephalosporin)

Question 34

adverse reactions to cephalosporins

Answer 34

allergic reaction | diarrhea

Question 35

macrolides MOA

Answer 35

inhibit bacterial protein biosynthesis by binding 50s subunit - bacterostatic

Question 36

macrolides

Answer 36

erythromycin azithromycin good coverage of resp infections and atypical resp pathogens

Question 37

adverse reactions of macrolides

Answer 37

GI - nausea, vomitting, diarrhea | interact with CYP

Question 38

Tetracycline MOA

Answer 38

inhibits protein synthesis by binding to 30s ribosomal subunit - bacteriostatic

Question 39

which antibiotic classes are bacteriostatic?

Answer 39

macrolides, tetracycline, sulfonamides

Question 40

adverse reactions of tetracycline

Answer 40

photosensitivity nausea and diarrhea tooth discoloration

Question 41

sulfonamides (sulfa drugs) MOA

Answer 41

inhibits folic acid synthesis via enzyme inhibition

Question 42

what is used to treat community acquired MRSA

Answer 42

sulfamethoxazole with trimethoprim

Question 43

bactrim (sulfonamide) adverse reactions

Answer 43

allergic rash fever, photosensitivity | steven johnsons syndrome

Question 44

Fluoroquinolones MOA

Answer 44

inhibit DNA gyrase which inhibits DNA replication and transcriptpin - bactericidal

Question 45

Fluoroquinolones

Answer 45

levofloxacin ciproflaxacin potent broad spectrum

Question 46

anti-anaerobes

Answer 46

metronidazole | clindamycin

Question 47

anti-anaerobe MOA

Answer 47

inhibit nucleic acid synthesis

Question 48

tx for MRSA

Answer 48

IV vancomycin

Question 49

do you use penicillin to treat staph infection?

Answer 49

No, staph inactivates penicillin with penicilinase

Question 50

What bacteria is penicillin good for

Answer 50

gram positive streptococci, n meningitidis | not staph

Question 51

what is cephriaxone good at killing?

Answer 51

gram positive strep and MSSA gram negative - very good anaerobes - oral only

Question 52

what are 4th generation cephalosporins used for?

Answer 52

Cefepime IV serious hospital infections gram neg - excellent for P. Aeruginosa

Question 53

what should be avoided with tetracycline

Answer 53

ca or dairy products | the sun

Question 54

what can cause steven johnsons syndrome?

Answer 54

bactrim/sulfamethoxazole with trimethoprim (bactrim)