Exam 2 - Cephalosporin & Carbapenem Spectrum of Activity/Clinical Uses Flashcards

(34 cards)

1
Q

Spectrum of 1st gen cephalosporins

A

Excellent GP coverage
(MSSA and PSSP)
Limited GN (PEK)

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2
Q

spectrum of 2nd gen cephalosporins

A

Same GP as 1st gen (MSSA and PSSP)
Some GN (HENPEK)
Some anaerobes

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3
Q

what 2nd gen cephalosporins cover below the diaphragm anaerobes (BDA)

A

cefoxitin, cefotetan, cefmetazole
includes Bacteroides fragilis coverage

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4
Q

spectrum of 3rd gen cephalosporins

A

GP aerobes (PRSP + PSSP + MSSA only ceftriaxone and cefotaxime)
GN aerobes (HENPECKSSS and Pseudomonas aeruginosa)
Limited anaerobes

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5
Q

what third gen cephalosporins cover pseudomonas aeruginosa?

A

ONLY ceftazidime and cefoperazone

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6
Q

what 3rd gen cephalosporins are strong inducers of BLases (Class C or AmpC)

A

ceftazidime

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7
Q

spectrum of 4th gen cephalosporins

A

GP (PSSP, PRSP, MSSA)
GN (Pseudomonas aeruginosa, BLase producing Enterobacter and E. Coli)

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8
Q

do 4th gen cephalosporins induce BLases?

A

Poor inducers of type1/AmpC

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9
Q

Spectrum of Ceftaroline

A

GP (PSSP, PRSP and MSSA, MRSA)
GN (HENPECKSSS and no pseudomonas)

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10
Q

spectrum of cefiderocal

A

GP: none
GN: enterobacterales, P. aeruginosa, ESBLs, AmpCs, and carbapenamases (KPCs)

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11
Q

spectrum of ceftolozane-tazobactam (Zerbaxa)

A

GP: very little
GN: Pseudomonas Aeruginosa, ESBLs, HENPECKSSS

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12
Q

spectrum of ceftazidime-avibactam

A

GP: little to none
GP: ESBLs, AmpC enterbacterales, Pseudomonas aeruginosa

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13
Q

what is the “weakness” of cephalosporins when it comes to coverage?

A

no enterococcus coverage

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14
Q

clinical uses of 1st gen cephalosporins

A

skin and soft tissue infections of MSSA and streptococci

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15
Q

what is the drug of choice for surgical prophylaxis against surgical site infections

A

Cefazolin

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16
Q

should 1st cephalosporins be used for meningitis?

A

NO, cant access CNS

17
Q

clinical uses of 2nd gen cephalosporins

A

pharyngitis, tonsillitis, sinusitis, otitis media, bronchitis, community acquired pneumonia

18
Q

can you use cefuroxime for meningitis?

19
Q

what 2nd gens are good for bacteroides fragilis, surgery prophylaxis in abdomin/pelvic, and polymicrobial infections?

A

cephamycins, cefoxitin, cefotetan, cefmetazole

20
Q

clinical uses of 3rd gen cephalosporins

A

infections caused by GN bacteria (including nosocomial) and pseudomonas aeruginosa

21
Q

if pseudomonas aeruginosa is suspected what 3rd gens should be used?

A

ceftazidime or cefoperazone

22
Q

what 3rd gen is used for uncomplicated gonorrhea

A

single IM of ceftriaxone

23
Q

what 3rd gens should be used for PRSP

A

cefotaxime and ceftriaxone

24
Q

what is cefepime used for

A

antipseudomonal activity

25
what can ceftaroline treat
skin and soft tissue infections (including thos caused by MRSA and CABP
26
why is cefiderocol not used more
very expensive and IV only
27
what is the GP coverage of carbapanems
PSSP and MSSA *imipenem and doripenem the best*
28
what is the gram negative coverage for carbapenems
DRUG OF CHOICE for ESBL and AmpC producing bacteria (dori and mero the best) pseudomonas aeruginosa
29
what carbapenem does NOT cover pseudomonas aeruginosa
ertapenem
30
do carbapenems cover c. diff
NO
31
what GN anaerobes do carbapenems cover
bacteroides spp.
32
when are carbapenems typically used
polymicrobial infections, empiric for nosocomial infections, and infections due to GN resistant bacteria especially ESBLs or AmpCs
33
what is the spectrum coverage for monobactams
GN aerobes (pseudomonas aeruginosa)
34
when is monbactams (aztreonam) particularly useful?
treating GN infections in patients w/ a histroy of severe penicillin or B-lactam allergy