Name the 3 major side effects a/w vancomycin.
- Red man syndrome - Nephrotoxicity - Ototoxicity
Metronidazole is mainly used against what class of microbe?
What is the name of the carboxypenicillin?
Ticarcillin (not avail.)
Which AGs are effective against mycobacterial infections?
- Amikacin - Streptomycin
What is unique about the pharmacology of linezolid?
Which gens of cephalosporins are used for surgical prophylaxis?
1st and 2nd (2nd for more intense surgeries?)
How are macrolides used to treat MAC (mycobacterium avium complex)? I hope to god this doesn't come up
- Azithromycin for prophylaxis - Clarithromycin/ Azithromycin for tx
How is clindamycin administrated? What is the % absorption?
IV, PO (90% absorption, can switch b/w IV and PO)
What are the clinical uses of clindamycin?
- Anaerobic Infections OUTSIDE of the CNS: Pulmonary, intraabdominal, pelvic, diabetic foot and decubitus ulcer infections - Skin & Soft Tissue Infections: Good option for PCN-allergic patients and infections due to CA-MRSA - Alternative therapy: C. perfringens, PCP, Toxoplasmosis, malaria, bacterial vaginosis
What is the target organism for cipro and levo when targeting gram-negative aerobes?
Pseudomonas aeruginosa (NOT moxi)
What is another name for Trimethoprim-Sulfamethoxazole (TMP-SMX)? - How is the spectrum of activity/resistance affected when the drugs are combined?
Bactrim - Broader spectrum, decreased resistance
*Name the main target organisms of natural penicillins.
- Penicillin-susceptible S. pneumoniae - infections due to other streptococci - Neisseria meningitidis - Syphilis - Clostridium perfringens + tetani
Which FQ has good CSF penetration?
How does the activity of tobramycin differ from gentamycin?
Slightly weaker gram-neg activity but more effective against pseudomonas.
Explain the target organisms (only) of the broad-spectrum antibiotic TMP-SMX (Bactrim).
gram-pos: *staph aureus (MRSA, CA-MRSA) Gram-neg: - Stenotrophomonas maltophilia. Other: - Pneumocystis carinii. Plus many more (broad spectrum)
What are the relative levels of activity for the 3 macrolides against gram-negative aerobes?
ACE Azithro > Clarithro > Erythro (CEA for gram-pos)
What bacterium do macrolides importantly NOT have activity against?
Enterobacteriacea (gram-neg aerobe class)
What are the 3 macrolides we should know?
- Azithromycin - Clarithromycin - Erythromycin
What group of organisms is vancomycin capable of killing? (name the class and the 5 major targets)
Gram-pos ONLY - *MRSA, *MSSA, *coag-negative staph, *PRSP, *c-dif (clostridium spp.) - Also targets other strep pneumoniae, viridians strep, group strep, enterococcus, corynebacterium, bacillus, listeria, actinomyces, clostridium spp., peptococcus, peptostreptococcus.
What 2 drugs are contained in Timentin?
Which FQ(s) are useful against sinusitis/bronchitis?
Which of the 4 penicillinase-resistant penicillins can be given orally?
What are the 3 key concepts to consider regarding infection when considering antibiotic tx?
- Severity - Site - Organism
Does tigecyclin have a more or less broad spectrum of activity vs. tetracyclins? Which organism is tigecyline notably not active against?
- Broader * Pseudomonas
Name the 3 most important AGs. Which is a 4th that is less important?
- Gentamycin (gent) - Tobramycin (tobr) - Amikacin (amik) Streptomycin
What are some factors that influence PAE? (4, not too important)
- Organism - Drug concentration - Duration of drug exposure - Antimicrobial combinations
*What is the major adverse effect a/w daptomycin?
Myopathy and CPK elevation (must continually monitor them)
Distinguish the characteristics of the 5 types of E. coli.
o Enterotoxigenic E. coli (ETEC): Profuse watery diarrhea (Traveler’s diarrhea) o Enteropathogenic E. coli (EPEC): infants; diarrhea w/mucus but no gross blood o Enteroinvasive E. coli (EIEC): blood, mucus, and many leukocytes in stool o Enterohemorrhagic E. coli (EHEC): Bloody diarrhea w/o pyuria. May progress to HUS. ♣ Shiga-toxin producing E. coli (STEC) via E. coli O157:H7 o Enteroaggressive E. coli (EAggEC): Watery diarrhea w/blood and mucus
Although tetracyclines are cross-reactive, ____________ is resistant to this because it is in the tetracyclin derivative category known as ____________.
*Tigecycline - Glycylcylins
Does clindamycin penetrate the CSF?