ID2: Clinical Antibiotics

Question 1

Antimycobacterial - Dose Adjustment in Renal Insufficiency

Answer 1

INH possibly in slow acetylatorsPZAStreptomycinRifabutin if severeEthambutol

Question 2

Antimycobacterial - NO Dose Adjustment in Renal Insuffienciency

Answer 2

INH in rapid acetylatorsRifampin

Question 3

Antibacterials that cross BBB

Answer 3

All CCCats Die, Felines Like Meowing, Pretty Tomcats Value Zzs:AztreonamCarbapenems3rd Gen Cephalosporins (Ceftriaxone & Ceftazidine)ChloramphenicolDoxycyclineFluoroquinolonesLinezolidMetronidazolePenicillinsTMP-SMXVancomycin (w inflammation)Zosyn (Piperacillin-Tazobactam)

Question 4

Agents to treat PRSP

Answer 4

VeRy FLaT: (+CC)Vancomycin +/- RifampinFluoroquinolones (Respiratory - Levofloxin, Moxifloxacin)LinezolidTigecyclineCeftriaxoneCeftaroline

Question 5

Agents for VRE

Answer 5

DaptomycinQuinupristin/Dalfopristin (but not Enterococcus faecalis)LinezolidTigecycline

Question 6

Agents for MRSA

Answer 6

VancomycinCeftarolineLinezolidDaptomycinQuinupristin/DalfopristinTigecycline

Question 7

Agents for Anaerobic Bacterial Infections

Answer 7

some Penicillins v. some anaerobesCefoxitin & Cefotetan (2nd Gen)CarbapenemsBeta Lactamase Inhibitor - Beta Lactam combosSome Fluoroquinolones v. some anaerobesVancomycin (Gm + only)Telavancin (Gm + only)Dalfo/Quinu v. some anaerobesLinezolid v. some anaerobesTelithromycin v. some anaerobesClindamycinChlormaphenicolTetracyclinesTigecyclineMetronidazole

Question 8

Interact w CYP 450

Answer 8

Quinupristin/DalfopristinErythromycin & ClarithromycinTelithromycinChloramphenicolTMP/SMXFluoroquinolonesMetronidazoleIsoniazidRifampin

Question 9

Dose adjustment HEPATIC insufficiency (Antibacterials, antimycobacterials, antifungals)

Answer 9

CDN MET PIERICephalosporins (Cefoperazone, Ceftriaxone)ChloramphenicolClindamycinDalfopristin/QuinupristinNafcillinMetronidazoleErythromycinTigecyclinePZAItraconazoleEchinocandinsRifampinIsoniazid

Question 10

Antibacerial - Dose adjustment in RENAL insufficiency

Answer 10

“All BBoys Can Drive Fast = Motors Vehicle TTTragedies”AminoglycosidesBeta-lactams (except natural amino and extended spectrum penicillins)Beta-lactamase InhibitorsClarithromycinDaptomycinFluoroquinolonesMetronidazoleVancomycinTetracyclines (except Doxy, mino, tige)TelithromycinTrimethoprim/Sulfonamides

Question 11

Pseudomonas Aerginosa

Answer 11

Beta-lactam + AminoglycosideSpecifically:Piperacillin3rd Gen cephalosporins, 4th Gen (Cefepime)CarbapenemsAminoglycosidesQuinolonesColistin

Question 12

CA MRSA

Answer 12

TMP/SMXClindamycinLinezolid

Question 13

CRE/KPCCarbapenem Resistant Enterobacteriaceae/Klebsiella Pneumoniae Carbapenemase

Answer 13

• resistant to all beta-lactams + aminoglycosides, fluoroquinolonesTigecyclineColistinAztreonamRifampinFosfomycin

Question 14

CLABSI

Answer 14

Vancomycin

Question 15

CAP

Answer 15

3rd gen cephalosporin + macrolidequinolone (newer)

Question 16

Meningitis

Answer 16

Ceftriaxone or Cefotaxime + Vancomycin(+ampicillin if at risk for Listeria)

Question 17

Fever + Neutropenia

Answer 17

Anti-pseudomonal beta-lactams (cefepime, Piperacillin/Tazobactam, carbapenems)Vancomycin only if suspect MRSA, CVC infection, hypotension, HAP

Question 18

Inta-abdominal Infection

Answer 18

Ampicillin + Metronidazole + GentamycinBeta-lactamase InhibitorsCarbapenems3rd Gen cephalosporin + MetronidazoleCipro + MetronidazoleTigecycline

Question 19

Diabetic Foot Ulcers

Answer 19

Beta-Lactamase InhibitorsImipenemTigecycline

Question 20

Urethritis

Answer 20

(Treat both GC and Chlamydia trachomatis because often travel together)Ceftriaxone + DoxycyclineAzithromycinQuinolones

Question 21

Encapsulated organisms

Answer 21

“Some Killers Have Nice CAPSULES”Strep. pneumoniaeKlebsiellaH. influenzaeNeisseria