ID I: Bugs and Drugs

Question 1

Gram positive cocci in clusters

Answer 1

MRSA, MSSA

Question 2

Gram positive cocci in pairs and chains

Answer 2

Strep pneumo
Strep spp.
Enterococcus (VRE)

Question 3

Gram positive rods

Answer 3

Listeria
Corynebacterium

Question 4

Gram positive anaerobes

Answer 4

Peptostreptococcus
Propionibacterium acnes
C. diff
Clostridium

Question 5

Gram negative cocci

Answer 5

Neisseria

Question 6

Gram negative rods that colonize the gut

Answer 6

Proteus
E. coli
Klebsiella
Serratia
Enterobacter cloacae
Citrobacter

Question 7

Gram negative rods that DON’T colonize the gut

Answer 7

Pseudomonas
H. influenzae
Providencia

Question 8

Gram negative coccibacilli

Answer 8

Acinetobacter
Bordetella
Moraxella

Question 9

Gram negative anaerobes

Answer 9

B. fragilis
Prevotella

Question 10

ABX that are folic acid synthesis inhibitors

Answer 10

Sulfonamides
TMP
Dapsone

Question 11

ABX that are cell wall inhibitors

Answer 11

Beta-lactams
Monobactams
Vanco
Dalbavancin
Telavancin
Oritavancin

Question 12

ABX that are protein synthesis inhibitors

Answer 12

AGs
Macrolides
TTCs
Clindamycin
Linezolid, tedizolid
Quinupristin/dalfopristin

Question 13

ABX that are cell membrane inhibitors

Answer 13

Polymixins
Dapto
Telavancin
Oritavancin

Question 14

ABX that are DNA/RNA inhibitors

Answer 14

Quinolones
Metronidazole
Tinidazole
Rifampin

Question 15

Hydrophilic ABX

Answer 15

Beta-lactams
AGs
Vanco
Dapto
Polymixins

Question 16

Lipophilic ABX

Answer 16

TTCs
Linezolid
Quinolones
Macrolides
Rifampin

Hint: these don’t require renal dose adjustment!

Question 17

ABX that exhibit concentration-dependent killing (Cmax:MIC)

Answer 17

AGs
Quinolones
Dapto

Question 18

ABX that exhibit exposure-dependent killing (AUC:MIC)

Answer 18

Vanco
Macrolides
TTCs
Polymixins

Question 19

ABX that exhibit time-dependent killing (time>MIC)

Answer 19

Beta-lactams

Question 20

ABX commonly used for MSSA

Answer 20

dicloxacillin, nafcillin, oxacillin
cefazolin, cephalexin, other 1st and 2nd generation cephalosporins
amox/clav, amp/sulbactam

Question 21

ABX commonly used for MRSA

Answer 21

vanco
linezolid
dapto (just not in PNA)
ceftaroline
SMX/TMP (MRSA SSTIs)
doxycycline, minocycline (MRSA SSTIs)
clindamycin (MRSA SSTIs)

Question 22

ABX commonly used for VRE

Answer 22

Penicillin G
ampicillin
linezolid
dapto
nitrofurantoin, fosfomycin, doxycycline- cystitis only

Question 23

ABX commonly used for atypicals

Answer 23

azithromycin, clarithromycin
doxycycline, minocycline
quinolones

Question 24

ABX commonly used for HNPEK organisms

Answer 24

beta-lactam/beta-lactamase inhibitors
cephalosporins (except 1st generation)
carbapenems
AGs
quinolones
SMX/TMP

Question 25

ABX commonly used for Pseudomonas

Answer 25

pip/tazo cefepime ceftazadime ceftazadime/avibactam ceftolozine/tazobactam carbapenems (but NOT ertapenem) cipro, levo aztreonam tobramycin colistimethate, polymixin B

Question 26

ABX commonly used for CAPES organisms

Answer 26

pip/tazo cefepime carbapenems AGs colistimethate, polymixin B ## Footnote C (cefepime, carbapenems, colistimethate) A (AGs) P (pip/tazo, polymixin B)

Question 27

ABX commonly used for ESBL producing negative-gram rods (E. coli, K. pneumoniae, P. mirabilis)

Answer 27

carbapenems ceftazadime/avibactam ceftolozane/tazobactam

Question 28

ABX commonly used for CRE

Answer 28

ceftazadime/avibactam colistimethate, polymixin B meropenem/vaborbactam imipenem/cilastatin/relebactam

Question 29

ABX commonly used for B. fragilis

Answer 29

Metronidazole Beta-lactam/beta-lactamase inhibitor cefotetan, cefoxitin carbapenems moxifloxacin (has reduced activity so not first choice)

Question 30

ABX commonly used for C. diff

Answer 30

PO vanco fidaxomicin metronidazole

Question 31

Storage requirements: which ABX can you NOT put in the fridge?

Answer 31

Cefdinir (suspension) Flagyl (IV) Moxifloxacin (IV)

Question 32

Storage requirements: which ABX do you put in the fridge after reconstitution?

Answer 32

Penicillin VK Ampicillin Amox/clav

Question 33

ABX that can cause a false-positive urine glucose test (4 drugs)

Answer 33

PCNs Cephalosporins Imipenem Isoniazid

Question 34

ABX that you can't use in G6PD deficiency (6 drugs)

Answer 34

Dapsone Chloroquine Nitrofurantoin Primaquine Probenecid SMX

Question 35

ABX that can cause DILE (3 drugs)

Answer 35

isoniazid minocycline terbinafine

Question 36

ABX that can cause a positive Coombs test

Answer 36

beta-lactamase inhibitors cephalosporins isoniazid nitrofurantoin PCNs quinine rifampin SMX