Exam II Flashcards
(79 cards)
1
Q
MSSA MOR
A
NSBL
2
Q
MRSA MOR
A
NSBL
Modified PBPs
3
Q
MSSE MOR
A
90% NSBL
4
Q
MRSE MOR
A
NSBL
Modified PBPs
5
Q
PSSP MOR
A
No beta lactamase
most susceptible
6
Q
PRSP MOR
A
Modified PBPs
7
Q
Streptococci (non- S. pneumoniae) MOR
A
Strep viridans more susceptible than others
8
Q
Enterococcus faecalis/ faecium MOR
A
Modified PBPs
VRE has modified PTG
9
Q
Listeria monocytogenes MOR
A
Modified PBPs
Ribosome is similar to traditional gram (+)
10
Q
Corynebacterium MOR
A
Modified PBPs similar to enterococcals
11
Q
Bacillus MOR
A
No beta lactamase
12
Q
Acinetobacter MOR
A
Modified PBPs
Modified pores in OM
70-90% BSBL
Some carbapenemase
13
Q
Moraxella catarrhalis MOR
A
20-50%, but up to 75% BSBL
14
Q
Neisseria gonorrhea MOR
A
20-50% BSBL
Some have modified PBPs
15
Q
Neisseria meningitides MOR
A
PRNM has modified PBPs
16
Q
Haemophilus influenza MOR
A
20-50% BSBL
17
Q
Pasteurella/Eikenella MOR
A
No beta lactamases
18
Q
E. coli MOR
A
20-50% BSBL
Can make IRSBL (effective against all pens)
20% ESBL (nosocomial)
19
Q
Salmonella MOR
A
20% BSBL
20
Q
Shigella MOR
A
20% BSBL
21
Q
Proteus mirabilis MOR
A
BSBL
Least likely to make beta lactamase
22
Q
Proteus vulgaris MOR
A
BSBL
Modified PBPs
23
Q
Klebsiella MOR
A
70-90% BSBL
20% ESBL
Some make carbapenemase
24
Q
Citrobacter, morganella, and providencia MOR
A
70-90% BSBL
20% AmpC
25
Enterobacter MOR
70-90% BSBL
20% AmpC
Some make carbapenemase
26
Serratia MOR
70-90% BSBL
20% AmpC
Some make carbapenemase
27
Pseudomonas aeruginosa MOR
```
Restrictive outer membrane
Unique PBPs
70-90% BSBL
20% AmpC
Some make carbapenemase
```
28
Stenotrophomonas maltophilia MOR
Carbapenemase
29
Burkholderia cepacia MOR
Multiple MOR
30
Legionella pneumophilia MOR
Low affinity PBPs
31
Bacteroides fragilis MOR
70-90% BSBL
32
Clostridium MOR
No beta lactamase
33
Clostridium difficile MOR
Beta lactamase
| Spore former
34
Peptostreptococcus and Propionibacterum MOR
No beta lactamases
35
MSSA Drugs
```
ASP (resists NSBLs and BSBLs)
Pen+BLI
1st>2nd>3rd/4th>5th generation cephs
Cephamycin not great for staph
No aztreonam
All carbapenems (Dori most effective)
Vancomycin only use if patient has beta lactam allergy
Dapto and tela
2.5, 3, or 4 generation FQs may work, but other drugs are better and resistance develops quickly during therapy (MOR on plasmid that bug carries causing end treatment resistance)
```
36
MRSA Drugs
```
No penicillin (absolute resistance)
Ceftaroline (5th generation)
No aztreonam
No carbapenem
Vancomycin, dapt, and tele
No FQs
```
37
MSSE Drugs
```
ASP
Pen+BLI
1st>2nd>3rd-5th generation cephs
No aztreonam
All carbapenems
Vanco if beta lactam allergy
Dapto and televancin but don’t use
2.5, 3, and 4th generation FQs work but do not use them
```
38
MRSE Drugs
```
No penicillin (absolute resistance)
Ceftaroline (5th generation)
No aztreonam
No carbapenem
Vancomycin, dapto, and televancin
No FQ
```
39
PSSP Drugs
Any penicillin (Pen G would be most appropriate)
1st>2nd>3rd/4th>5th generation cephs (must have a non-acid AKI group)
No aztreonam
No carbapenems
Vancomycin if beta lactam allergy
Dapto and televancin work but don’t use
2.5 and up FQs work, (resistant to early gen FQs because they don’t bind PAR)
40
PRSP Drugs
```
Pens ineffective at normal dose
Cephs need to have non-acid AKI group
2nd generation: cefpodoxime and cefuroxime
3rd-5th gens: ceftriaxone, cefepime, and ceftaroline
No aztreonam
All carbapenems (Dori> Imi> the rest)
Vanco, dapto, and televancin
2.5 and up FQs (respiratory FQs)
```
41
Other Streptococci Drugs
All pens effective (Pen G most appropriate)
1st>2nd>3rd-5th generation cephs as long as non-acidic AKI group
No aztreonam
All carbapenems
Vanco (especially for viridans)
Dapto and televancin
2.5 and up FQs (except cipro)
42
Enterococcus faecalis Drugs
Amino penicillins work the best> Pen G+ AG
ASP will not work (PB doesn’t bind)
Piperacillin works but is not great (PIP>TICAR, ticar not effective)
No cephs are effective because they do not bind the PBPs
No aztreonam
All carbapenems except ertapenem
Vanco is AOC in serious infections
Dapto?
Telavancin
No FQs (but more susceptible than faecium)
43
Enterococcus faecium Drugs
```
Less susceptible than faecalis
AP> Pen G+ AG
ASPs won’t work
Piperacillin works but not great (AP only drug that is really effective)
No cephs because they do not bind the PBPs
No aztreonam
No carbapenems
All glycopeptides
No FQs
```
44
Listeria monocytogenes Drugs
```
AP> Pen G+ AG
Pen V does not work
ASPs do not work
ESPs work slightly
No cephs work because they do not bind the PBPs
No aztreonam
No carbapenems
Vanco IV for gram + meningitis
Dapto and televancin
```
45
Corynebacterium Drugs
Not susceptible to many beta lactams (can maybe use Pen G+ AG)
No aztreonam
Maybe carbapenems?
All glycopeptides
46
Bacillus Drugs
Vancomycin is used for B. cereus
| All other bacilli are susceptible to pens/ beta lactams
47
Acinetobacter Drugs
AP/ESP+BLI may be effective, but you would never use it alone
3rd and 4th generation cephs may be effective, but are not reliable
Do not use Ceftaroline!!!
No aztreonam
All carbapenems can kill 75% of these except ertapenem
Susceptible to FQs (always want to recommend multiple drugs for this bug such as carbapenem+ FQ)
48
Moraxella catarrhalis Drugs
Do not use NP or ASP
AP+BLI or ESP+BLI
2nd-5th generation cephs. When possible use a 2nd generation with an AKI group
Cefamycins will work, but you want to save them for more complicated infections
Aztreonam works
All carbapenems
All FQs
49
Neisseria gonorrhea Drugs
ASPs will not work
NP+BLI may work, but probably has a really high MIC90, so therefore is not used
AP+BLI or ESP+BLI will work
2nd-5th generation cephs will all work.
Ceftriaxone (3rd) is the antibiotic of choice because it has a long half life
3rd>2nd in general, but can use either
Others listed: cefuroxime, cefpodoxime, cefixime
Aztreonam works
All carbapenems
FQ resistance, so do not use
50
Neisseria meningitides Drugs
NP or AP are pretty effective
All penicillins work, but Pen G is drug of choice
Caution with high Pen G doses and seizures
3rd>2nd gen
Cefuroxime is the drug of choice
Aztreonam works
All carbapenems (do not use imipenem because it can cause seizures)
Gram Negative Bacilli
No FQs because they can cause seizures
51
Haemophilus influenza drugs
```
NP and ASP don’t work
AP+BLI or ESP+BLI
2nd-5th gen cephs work, but use 2nd gen when possible but do not use 2nd gen in meningitis
Aztreonam
All carbapenems
All FQs
```
52
Pasteurella/Eikenella drugs
```
All penicillins except ASPs
Pasteurella= NP
Eikenella= AP
Prefer to use amox/clav to cover staph as well
Penicillins work better than cephalosporins, but all cephs are active (5th>2nd>rest)
Aztreonam
All carbapenems
All FQs
```
53
E. coli drugs
AP+BLI or ESP+BLI
Clavulanate is the only BLI that inhibits ESBLs
NP and ASPs will not work
2nd-5th gen cephs can work, but 3rd-5th are best (2nd are not likely to be effective)
Aztreonam
All carbapenems (mero and dori are the best)
All FQ's, although seeing more resistance
54
Salmonella drugs
```
AP alone likely effective (ampicillin alone is the antibiotic of choice)
AP+BLI or ESP+BLI
NP and ASP will not work
2nd through 5th work but 3rd>2nd
All FQs
```
55
Shigella drugs
```
AP alone likely effective
AP+BLI or ESP+BLI
NP and ASP will not work
2nd through 5th work but 3rd>2nd
Aztreonam
All carbopenems
All FQs
```
56
Proteus mirabilis drugs
```
AP or ESP (possibly use BLI, but probably unnecessary)
3rd-5th generation>2nd generation cephs
Aztreonam
All carbapenems
All FQs
```
57
Proteus vulgaris drugs
```
No penicillin is reliable
No ceph is reliable
Aztreonam
All carbapenems
All FQs
```
58
Klebsiella drugs
ESP+BLI if not ESBL
AP+BLI if not BSBL possibly
3rd-5th generation ceph if not ESBL
Aztreonam if not ESBL, AmpC or carbapenemase producing
All carbapenems unless producing carbapenemase
All FQs
59
Citobacter, morganella, and providencia drugs
```
ESP+BLI if it’s not Amp C
3rd-5th generation ceph if not ESBL
Aztreonam if not aove BSBL
All carbapenems
All FQs aren’t great for providencia retigeri, although they all work well against providencia stuartii
FQs work nest for citrobacter
Cipro best for Morganella
```
60
Enterobacter drugs
```
ESP+BLI if it is not Amp C
3rd-5th generation ceph if not ESBL: cefepime, ceftazadine
Aztreonam if not above BSBL
All carbapenems
All FQs
```
61
Serratia drugs
```
ESP+BLI if not Amp C
3rd-5th generation ceph if not ESBL
Aztreonam if not above BSBL
All carbapenems
Cipro>Levo>Gati/moxi
```
62
Pseudomonas aeruginosa drugs
Only use ESP+BLI
Only tazo covers Amp C
Cefoperazone, ceftazadin, cefepime, ceftaroline (add tazobactam for AmpC)
Aztreonam- inhalation product for CF patients
All carbapenems except ertapenem (mero has highest PBO affinity)
Cipro is FQ with the best activity for this bug however all FQs could work but have more resistance
63
Stenotrophomonas drugs
No beta lactam works
| Functionally resistant to FQs
64
Burkholderia drugs
```
No penicillin works
No ceph works
No aztreonam
Meropenem works
Functionally resistant to FQs
```
65
Legionella drugs
```
Penicillins are not reliable
No cephs work due to modified PBPs
No aztreonam
No carbapenems
Moxi/Gati>Levo>Cipro (use later gen FQs for respiratory infections)
```
66
Brucella drugs
No beta lactam works
67
Francisella drugs
No beta lactam works
68
Yersinia pestis
No beta lactam works
69
Helicobacter pylori drugs
Patient will be on a 3-4 drug antibiotic regimen, which will be amoxicillin, clarithromycin, and lansoprazole
70
B. fragilis drugs
```
AP+BLI or ESP+BLI
2nd gen cephamycins only (-OCH3 group)
All carbapenems
No aztreonam
No FQs, if forced use moxi (but don’t trust FQ alone)
```
71
Fuso/prevotella drugs
Any penicillin will work except for the anti-staph.
Any ceph will work although 1st gen is least likely
All carbapenems
No aztreonam
No FQs, if forced use moxi (but don’t trust FQ alone)
72
Clostridium drugs
Any penicillin (ASPs least effective to not effective at all)
Any ceph will work although 1st gen and cefamycins are the best
All carbapenems
No aztreonam
No FQs, if forced use moxi (but don’t trust FQ alone)
73
Clostridium defficile drugs
No penicillin works
Ampicillin is known to cause this infection
No cephs work (3rd gen can cause CDAD)
No carbapenems
No aztreonam
Oral vanco
No dapto and tela because can’t be given orally
74
Peptostrep and propionibacterium drugs
Any penicillin works
All carbapenems
No aztreonam
No FQs, if forced use moxi (but don’t trust FQ alone)
75
Treponema and Borrelia (spirochetes) drugs
Any penicillin works, but use Pen G, because it is the most appropriate
Can give IM dose of benzanthine salt (slow absorption, very susceptible)
No aztreonam
76
Chlamydia/Rickettsia drugs
No beta lactam works
| Moxi/Gati>levo>cipro
77
Mycoplasma drugs
No beta lactam works
78
Mycobacteria drugs
No beta lactam works
| Moxi/gati>levo>cipro (gati has lower MIC, cipro MIC slightly greater than cut off point so don’t pick
79
Fungi/parasites drugs
No beta lactam works
