Antibiotics

Question 1

Penicillin mechanism of action

Answer 1

Penicillins contain a Beta-lactam ring, which binds to transpeptidase (PBP) and prevents cell wall synthesis.

Question 2

What are penicillins used to treat?

Answer 2

Most strep (not strep pneumo)
Neisseria meningitidis
Treponema palladium

Question 3

What are penicillins inactive against?

Answer 3

Strep pneumo
MRSA
MRSE
Gram negative rods

Question 4

Methicillin resistance is due to ______.

Answer 4

Altered PBP

Question 5

What are the clinical uses of anti-Staph penicillins?

Answer 5

MSSA

MSSE

Question 6

What are the anti-Staph penicillins?

Answer 6

Nafcillin

Dicloxacillin

Question 7

What are the clinical uses of aminopenicillins?

Answer 7

E. coli
Shigella
Salmonella enterica
Borrelia burgdorferi
Plus same activity as natural penicillins

Question 8

What are the aminopenicillins?

Answer 8

Ampicillin

Amoxicillin

Question 9

What are the ESPs?

Answer 9

Piperacillin
Ticarcillin
Carbenicillin

Question 10

How do you treat Pseudomonas?

Answer 10

Usually with a 2 drug regimen.

1. Beta-lactam (Penicillin or Cephalosporin) + aminoglycoside (Gentamicin)
2. Beta-lactam + Beta-lactamase inhibitor (Ticarcillin/Clavulanate)
3. Carbapenems
4. Ceftazidime
5. Cipro / Levofloxacin
6. Cefepime
7. Aztreonam

Question 11

Clinical uses of Vancomycin

Answer 11

1. MRSA
2. Penicillin-resistant Strep pneumo
3. Serious C. diff infections

Question 12

What drug is used for TB, plague, tularemia, brucellosis, Mycobacterium avium complex?

Answer 12

Streptomycin

Question 13

How would you treat E. coli, Klebsiella, and Proteus?

Answer 13

Ampicillin
Cefazolin
TMP/SMX
Fluoroquinolones

Question 14

Most Neisseria meningitidis strains are susceptible to _____. If resistant, use ______.

Answer 14

Penicillin

Ceftriaxone or Cefotaxime (3rd generation Cephalosporins)

Question 15

What is the treatment for Neisseria gonorrhoeae?

Answer 15

Ceftriaxone + azithromycin/doxycycline (for likely concurrent chlamydia infection)

Question 16

Which antibiotics are usually effective against anaerobes?

Answer 16

Clindamycin

Metronidazole

Question 17

Which antibiotics may result in C. diff infections?

Answer 17

Clindamycin
2nd/3rd generation Cephalosporins
Aminopenicillins

Question 18

What drug is used as prophylaxis for Neisseria-related meningitis?

Answer 18

Rifampin

Question 19

Klebsiella treatment

Answer 19

3rd generation Cephalosporin

Question 20

E. coli treatment

Answer 20

TMP-SMX
Penicillin (UTI)
3rd generation Cephalosporin (meningitis, sepsis)

Question 21

How do you treat Salmonella typhi?

Answer 21

Ceftriaxone

Cipro, Ampicillin for carriers

Question 22

Shigella treatment

Answer 22

Oral rehydration for moderate cases

Fluoroquinolones for severe cases

Question 23

Proteus mirabilis treatment

Answer 23

TMP-SMX

Ampicillin

Question 24

Vibrio cholerae treatment

Answer 24

Oral/IV rehydration

Tetracycline

Question 25

Yersinia pestis treatment

Answer 25

Streptomycin | Tetracycline

Question 26

Helicobacter pylori treatment

Answer 26

Triple: PPI + Amoxicillin + Clarithromycin

Question 27

Campylobacter jejuni treatment

Answer 27

Erythromycin | Ciprofloxacin

Question 28

H. influenzae treatment

Answer 28

3rd generation Cephalosporin

Question 29

Legionella treatment

Answer 29

Erythromycin

Question 30

Bordetella treatment

Answer 30

Erythromycin

Question 31

Brucella treatment

Answer 31

Doxycycline + Gentamicin

Question 32

Mycoplasma treatment

Answer 32

Erythromycin | Tetracycline

Question 33

Chlamydia trachomatis treatment

Answer 33

Azithromycin | Tetracycline ( + ceftriaxone)

Question 34

Rickettsia rickettssi treatment

Answer 34

Doxycycline | Chloramphenicol

Question 35

Rickettssia prowazekii treatment

Answer 35

Tetracycline | Chloramphenicol

Question 36

Coxiella burnetii treatment

Answer 36

Tetracycline

Question 37

What drug is commonly used for CA-MRSA?

Answer 37

TMP-SMX

Question 38

What drugs are contraindicated in pregnant women?

Answer 38

TMP-SMX Metronidazole Ciprofloxacin Doxycycline

Question 39

What is used for CA-pneumonia?

Answer 39

Macrolides: Erythromycin, Clarithromycin, Azithromycin

Question 40

What is the drug of choice for Legionella, Mycoplasma, Chlamydia?

Answer 40

Macrolides and Ketolides

Question 41

What drug is used especially for atypical bacteria?

Answer 41

Tetracycline

Question 42

Aminoglycoside toxicities

Answer 42

Nephrotoxicity

Question 43

Tetracycline toxicities

Answer 43

Liver and kidney toxicity | Photosensitization

Question 44

Clindamycin is used for _____ gram negatives.

Answer 44

Anaerobic