Ear and kidney toxicity
Aminoglycosides bind irreversibly to bacteria 30S and 50S ribosomal subunits to prevent initiation complex formation + protein synthesis BacterioCIDAL
Primarily effective against GRAM NEGATIVES but synergistic with beta-lactams for G+
2 drugs commonly used for anaerobes
Metranidazole or clindamycin
Nucleic acid synthesis inhibitor used for cryptococcus meningitis
Bone marrow toxicity and resistance can develop in days so always use in combination
Antifungal with ability to form pore in cell wall
Inhibition of cytochrome P-450 to block synthesis of ergosterol
Echinocandins do not work on...
Target of echinocandins
Block B-1,3-glucan synthase inhibitors
Good drug for mycoplasma (no cell wall)
Classes of beta-lactams
1. Penicillins 2. Cephalosporins 3. Monobactams 4. Carbapenems
Common concern for treating patients with beta-lactams
Allergies (mild to anaphylaxis)
inhibits cell wall synthesis by binding to and preventing PBP function of cross-linking NAM and NAG BacterioCIDAL
Ceftriaxone is what generation cephalosporin?
Cefezolin is what generation cephalosporin?
1st often used as surgical prophylaxis
Subclasses of cephalosporins
1. Classified from 1st to 5th generation 1st narrow spectrum (G+) 5th broad spectrum and better with G-
Poor penetration into CSF --> don't use for meningitis
Bind 50S ribosomal subunit, prevents elongation of peptide chains—suppresses protein synthesis (same spot as macrolides) Can be bacteriostatic or bacteriocidal
Fluoroquinalone spectrum with increasing generation
Early better for G- Later better for G+
First gen fluoroquinalone
Third gen fluoroquinalone
Second gen fluoroquinalones
Ciprofloxacin and levofloxacin
Fourth gen fluoroquinalones
Moxifloxacin and Gemifloxacin
Inhibit DNA gyrase +/- topoisomerase IV to inhibit chromosomal replication BacterioCIDAL
Leuconostoc has intrinsic resistance to what antibiotic
Klebsiella isolate resistant to aztreonam and ceftriaxone has what resistance mechanism?
K-1 beta lactamase
Macrolide side effects
Broad-spectrum: Gram positives, some Gram-negative, anaerobes, atypical mycobacteria, and “atypical” respiratory pathogens (mycoplasma, chlamydiae, Legionella) that are less susceptible to β-lactams
Bind reversibly to 23S of rRNA of the 50S ribosomal subunit, block translocation of tRNA from acceptor to donor side on ribosome BacterioSTATIC
A predefined stable antibiotic gradient is present on a thin carrier strip.