Mechanisms of Antimicrobial Action and Resistance 3 Flashcards Preview

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Flashcards in Mechanisms of Antimicrobial Action and Resistance 3 Deck (22):
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Retapamulin (Altabax)

New drug class, product of fungi fermentation
Approved by FDA in 2007 for treatment of impetigo caused by S. pyogenes and Methicillin sensitive S. aureus
May be effective against MRSA
Topical ointment

1

Telavancin (Vibativ)

Glycopeptide derivative of vancomycin
Treatment of complicated skin infections by gram positives
Effective against MRSA but not VRSA or VRE
IV administration

2

Dalbavancin (Dalvance)

Lipoglycopeptide
Inhibits cell wall synthesis
For complicated skin infections and suture infections by gram positives
Effective against MRSA but not VRSA or VRE
IV admin

3

Tedizolid (Sivextro)

Oxazolidinone
Inhibits protein synthesis
Skin infections and suture infections by gram positives
MRSA but not VRSA or VRE
Oral/IV

4

Oritavancin (Orbactiv)

Oxazolidinone
Inhibits protein synthesis
Skin and skin suture infections by gram positives
MRSA but not VRSA or VRE
IV admin

5

Fidaxomicin (Dificid)

Macrolide
Clostridium difficile diarrhea in 18 years +
Oral admin with minimal systemic absorption

6

There have been no development of drugs to treat what kind of bacteria for almost 5 decades now?

Gram negative bacilli

7

MRSA infects and kills how many per year?

Infects greater than 94k
Kills greater than 19k

8

How much is antibiotic resistance costing us?

$21-34 billion a year

9

NDM-1 E. coli and Klebsiella

New Delhi metallo-beta-lactamase-1
Spread from India to UK/US
All strains resistant to all antibiotics except tigecycline or colistin (10% of strains are resistant to those too)

10

In general hospital sewers, what % of bacteria are resistant to streptomycin and tetracycline?

34.7%
32%

11

Shift in treatment of sore throats?

Less use of penicillin and erythromycin
More use of extended-spectrum macrolides and fluoroquinolones

12

What is the only cause of sore throat that is antibiotic warranted? What percent are penicillin sensitive?

Group A beta-hemolytic streptococci
Which is only cultured 5-17% of cases
85-95% are penicillin sensitive

13

Presentation of what symptoms are required for treatment WITHOUT TESTING for Group A beta-hemolytic streptococci?

Cough, runny nose, hoarse voice, diarrhea, mouth sores

14

Presentation with sudden onset of sore throat, painful swallowing, fever?

Should be tested with a rapid antigen test before prescribing antibiotics

15

What are 4 societal contributors to antibiotic resistance?

Antibiotic additives in stock feed
Chlorine treatment in water (bacteria that survive are resistant)
Mercury and other contaminants in water (same ^)
Antibacterial soaps

16

Two ways that we can maintain therapeutic levels?

Avoid use of drugs when MIC is at or only slightly below the attainable level
Prevent biofilms and treat them aggressively

17

3 novel antibacterial sources?

Peptides from higher organisms
Steroids from higher organisms
Inhibitors of additional pathways that block lipid A synthesis (important for gram negative outer membranes)

18

What is magainin?

Peptide from frogs, didn't make the cut

19

What is squalamine?

Steroids from sharks

20

What are the ESKAPE bacteria?

Enterococcus (VRE)
S. aureus (MRSA)
Klebsiella
Acinetobacter
Pseudomonas
ESBL (E. coli, enterobacter)

21

Of the ESKAPE bacteria, which three are resistant to almost all antibiotics? Which are resistant to all oral antibiotics?

Klebsiella, Acinetobacter, Pseudomonas
EBSL (E. coli, enterobacter)