Exam 2 study guide Flashcards
(49 cards)
What is the DOC for ESBL-producing gram-negative rod bacteria?
Carbapenems
What gene is associated with EBSL producers?
CTX-M beta-lactamases
Which microorganisms are considered at moderate to high risk for clinically significant AmpC production?
Eneterobacter cloacae
Citrobacter freundii
Klebsillea aerogenes
What are risk factors for developing Pseudomonas aeruginosa?
Mechanical ventilation
resent antibiotic use
prolonged hospitalization
Cystic fibrosis
Why do we sometimes use two empiric antibiotic therapy when Pseudomonas aeruginosa is suspected?
when patients are critically ill and/or who have a history or strong suspicion of multidrug-resistant organisms
What are risk factors for developing C. difficile infections?
Broad-spectrum antibiotic use
Immunosuppression
longer hospital stays
What is the chemical mechanism for the gyrase and topoisomerase enzymes bacterial use?
They use an active site _____ residue which attacks the ____ di_____ bond in the DNA to catalyze the formation of ______ _______ breaks.
tyrosine
phosphodiester
double strand
Drugs like ciprofloxacin bind to both ______ and _____ to stabilize the double-strand breaks created by the gyrase and topo-IV.
DNA and protein
What chemical features in the FQ are important for the drug to bind to the DNA-enzyme complex?
amino group with Asp binding and carboxylic acid with Ser and Glu binding
What are the 3 or 4 interesting FQs that were mentioned in class?
Levofloxacin (Levaquin)
Ciprofloxacin (Cipro)
Moxifloxacin (Avelox)
Delafloxacin (Baxdela)
Which are respiratory FQ?
Levofloxacin and Moxifloxacin
Which FQ has activity against anaerobic organisms?
Gatifloxacin
Which FQ have activity against Pseudomonas?
Cipro, Levaquin and Delafloxacin
what are the severe side effects of FQs?
tendon rupture, aneurysm dissection, hypoglycemia, Qt prolongation
I had a patient taking Fioricet 2 tabs q8h (like around the clock routinely). She always had a
history of agitation and a history of IBS/IBD for which she was prescribed Cipro 500mg po bid x
10day. On day two she called and said she was feeling especially anxious and it worsened over
the next day. What is going on here with this patient?
Increased fioricet concentrations.
What is the primary treatment for Escherichia coli?
Nitrofurantoin (only for cystitis)
1st through 3rd gen cephs
cipro or levaquin
Bactrim
Cefepime, or zosyn
ESB:E-producing strains: Carbapenems
What is the primary treatment for Klebsiella sp.?
Nitrofurantoin (only for cystitis)
1st through 3rd gen cephs
cipro or levaquin
Bactrim
Cefepime, or zosyn
ESB:E-producing strains: Carbapenems
What is the primary treatment for Enterobactoer sp.?
2nd or 3rd gen cephs
cipro or Levaquin
Cefepime or carbapenems for AmpC producing strains
What is the primary treatment for Pseudomonas aeruginosa?
Zosyn
Cefepime
Aztreonam
Carbapenems (not ertapenem)
Cipro and Levaquin
Aminoglycosides
Ceftolozane/tazobactam
What is the primary treatment for Axinetobacter baumannii?
Carbapenems (not ertapenem)
Unasyn
What is the primary treatment for C. difficile?
Vancomycin PO
Fidaxomicin PO
What is the primary treatment for Bacteroides fragilis?
Metronidazole (DOC)
Unasyn, Augmentin
Zosyn
Carbapenems
Cefoxitin
What is the primary treatment for atypicals?
Azithromycin
Doxycycline
Levofloxacin
What are the atypical bacteria?
Legionella spp., Mycoplasma Pneumoniae and Chlamydia Pneumoniae
