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Flashcards in this deck (70)
  • Antibiotic action can be classified as either bactericidal (kills bacteria) or bacteriostatic (inhibits growth).

    pharmacology antibiotics
  • Beta-lactams, including Penicillins, Cephalosporins, Carbapenems, and Monobactams, inhibit cell wall synthesis by binding to Penicillin-Binding Proteins (PBPs).

    pharmacology beta-lactams
  • Beta-lactamase inhibitors like clavulanate, sulbactam, tazobactam, and avibactam protect the beta-lactam ring from hydrolysis by bacterial beta-lactamases.

    pharmacology beta-lactamase
  • Vancomycin is a glycopeptide that binds to the D-Ala-D-Ala precursor, preventing peptidoglycan polymerization.

    pharmacology vancomycin
  • Daptomycin disrupts cell membrane integrity by creating pores through calcium-dependent binding, leading to depolarization and cell death.

    pharmacology daptomycin
  • Polymyxins, such as Colistin and Polymyxin B, act as cationic detergents and disrupt membrane integrity by binding to lipid A of LPS in gram-negative bacteria.

    pharmacology polymyxins
  • Sulfamethoxazole (SMX) is a competitive inhibitor of dihydropteroate synthase, blocking PABA incorporation in the folic acid pathway.

    pharmacology sulfamethoxazole
  • Trimethoprim (TMP) inhibits dihydrofolate reductase (DHFR), preventing the production of tetrahydrofolate (THF).

    pharmacology trimethoprim
  • Metronidazole creates reactive oxygen species (ROS) that damage DNA after being reduced by anaerobic bacteria.

    pharmacology metronidazole
  • Fluoroquinolones, such as Ciprofloxacin, Levofloxacin, and Moxifloxacin, inhibit DNA gyrase and topoisomerase IV, preventing DNA supercoiling and replication.

    pharmacology fluoroquinolones
  • Rifampin inhibits mRNA synthesis by binding to the RNA polymerase beta-subunit, preventing chain elongation.

    pharmacology rifampin
  • Protein synthesis inhibitors target bacterial ribosome subunits, such as the 50S ribosomal subunit, which is bacteriostatic.

    pharmacology protein_synthesis
  • Macrolides such as Azithromycin, Erythromycin, and Clarithromycin bind to 23S rRNA, blocking peptide chain elongation.

    pharmacology antibiotics
  • Clindamycin binds to 23S rRNA, blocking peptide bond formation.

    pharmacology antibiotics
  • Chloramphenicol inhibits peptidyl transferase.

    pharmacology antibiotics
  • Linezolid binds to 23S rRNA, preventing initiation complex formation.

    pharmacology antibiotics
  • Aminoglycosides are bactericidal and bind to 30S rRNA, causing misreading of mRNA.

    pharmacology antibiotics
  • Tetracyclines such as Doxycycline and Tetracycline bind to 30S rRNA, blocking tRNA binding.

    pharmacology antibiotics
  • For Gram Positive coverage, MSSA can be treated with Nafcillin/Oxacillin and Clindamycin.

    pharmacology antibiotics gram_positive
  • MRSA can be treated with Vancomycin, Daptomycin, and Linezolid.

    pharmacology antibiotics gram_positive
  • Streptococcus pneumoniae can be treated with Penicillin and Aminopenicillins if sensitive.

    pharmacology antibiotics gram_positive
  • For Gram Negative coverage, HENS-PECK includes Haemophilus influenzae, Escherichia coli, and Klebsiella pneumoniae.

    pharmacology antibiotics gram_negative
  • ESBL producing Enterobacteriaceae can be treated with Carbapenems such as Meropenem.

    pharmacology antibiotics gram_negative
  • For anaerobic coverage, Metronidazole and Carbapenems are effective below the diaphragm.

    pharmacology antibiotics anaerobes
  • Atypical pathogens like Mycoplasma pneumoniae can be treated with Fluoroquinolones and Macrolides.

    pharmacology antibiotics atypical
  • Doxycycline is recommended for tick-borne bacteria such as Borrelia and Rickettsia.

    pharmacology antibiotics tick_borne
  • Empiric antibiotic recommendations for common infections are common choices and not absolute requirements by guidelines.

    pharmacology antibiotics
  • For Community-Acquired Pneumonia (CAP), the recommended treatment is Beta-Lactam (Ceftriaxone, Ceftaroline) + Macrolide (Azithromycin) or Doxycycline.

    medicine pneumonia cap
  • In Hospital-Acquired Pneumonia (HAP), treatment includes Vancomycin (MRSA coverage) + Anti-Pseudomonal Beta-Lactam (Piperacillin-Tazobactam, Cefepime, Ceftazidime) or Carbapenem (Meropenem).

    medicine pneumonia hap
  • For gastrointestinal infections, one treatment option is Carbapenem OR Antipseudomonal PCN + MTZ +/-FQ'S (Ciprofloxacin).

    medicine gastrointestinal infections
  • For skin and soft tissue infections caused by MSSA + Strep A, the oral treatments include Dicloxacillin, Cephalexin.

    medicine skin infections
  • For acute cystitis, the recommended treatments are TMP-SMX (if local resistance is low), Nitrofurantoin, Fosfomycin.

    medicine urinary infections
  • In bacterial meningitis (community), the treatment is Ceftriaxone + Vancomycin to cover resistant Streptococcus pneumoniae.

    medicine cns infections
  • Key adverse drug reactions include Neurotoxicity from drugs like Cefepime and Carbapenems.

    medicine adverse reactions
  • For nephrotoxicity, which antibiotics are of concern? Aminoglycosides, Vancomycin, Polymyxins (Colistin).

    medicine adverse nephrotoxicity
  • Fluoroquinolones and Macrolides are associated with QT Prolongation.

    medicine adverse qt_prolongation
  • Broad-spectrum antibiotics, especially Clindamycin, Fluoroquinolones, Carbapenems, Cephalosporins, can lead to C. difficile infection.

    medicine adverse c._difficile
  • A high number of antibiotics can result in high level interactions. Always check on current drugs patients may be on.

    medicine drug_interactions safety
  • Bacteria develop resistance through multiple mechanisms, including Reduced Permeability, Increased Efflux Pumps, Decreased Target Binding, and Increased Inactivating Enzymes.

    microbiology antibiotic_resistance
  • Local antibiotic choice can depend on specific resistance common in those areas, thus it's important to be aware of the Local Antibiogram.

    microbiology antibiotic_resistance
  • For septic shock with an undifferentiated source, the recommended regimen includes Piperacillin-Tazobactam plus Vancomycin or Linezolid.

    clinical_guidelines icu septic_shock
  • In cases of suspected ESBL or CRE, change the regimen to Meropenem plus Polymyxin B or Colistin.

    clinical_guidelines icu septic_shock
  • For nosocomial pneumonia, the goals include covering MRSA, Pseudomonas aeruginosa, and other MDR gram-negatives.

    clinical_guidelines icu pneumonia
  • Intra-abdominal infections require broad coverage for gram-negative and anaerobic bacteria.

    clinical_guidelines icu intra-abdominal_infection
  • The recommended regimen for severe infections includes Piperacillin-Tazobactam (4.5 g IV q8h prolonged infusion) or Cefepime (2 g IV q8h).

    antibiotics infection
  • For complicated urinary tract infections, consider Vancomycin for MRSA coverage.

    uti mrsa
  • In Central Line-Associated Bloodstream Infections, the goals are to cover gram-positive cocci such as MRSA and coagulase-negative staph.

    clabsi infection
  • The recommended regimen for meningitis includes Ceftriaxone 2g IV q12h + Vancomycin AND Ampicillin for Listeria coverage.

    meningitis antibiotics
  • Before initiating antibiotics, it is crucial to obtain appropriate cultures and Gram Stain.

    guidelines antibiotics
  • For beta-lactams, consider using prolonged or continuous infusions to improve T>MIC.

    pharmacology infusion
  • Adjust antibiotic dosing based on renal function.

    dosing renal
  • Once culture data is available, you should de-escalate to the narrowest spectrum agent appropriate for the identified pathogen.

    de-escalation antibiotics
  • Implement appropriate source control measures such as abscess drainage and device removal.

    source_control guidelines
  • Adhere to institutional antimicrobial stewardship guidelines to minimize resistance development.

    stewardship guidelines
  • For MSSA (Methicillin-Sensitive Staphylococcus aureus), the preferred antibiotic is Cefazolin.

    antibiotics icu mssa
  • For MRSA (Methicillin-Resistant Staphylococcus aureus), the preferred antibiotics include Vancomycin and Linezolid.

    antibiotics icu mrsa
  • The preferred antibiotic for Penicillin-Susceptible Streptococcus pneumoniae is Penicillin.

    antibiotics icu streptococcus_pneumoniae
  • For Penicillin-Resistant Streptococcus pneumoniae, the preferred antibiotic is Ceftaroline.

    antibiotics icu streptococcus_pneumoniae
  • For Enterococcus faecalis (Vancomycin-Susceptible), the preferred antibiotics are Ampicillin and Piperacillin-Tazobactam.

    antibiotics icu enterococcus_faecalis
  • For Vancomycin-Resistant Enterococcus (VRE), the preferred antibiotics include Daptomycin and Linezolid.

    antibiotics icu vre
  • For Listeria monocytogenes, the preferred antibiotic is Ampicillin.

    antibiotics icu listeria_monocytogenes
  • For Enterobacteriaceae, the preferred antibiotics include Ceftriaxone and Piperacillin-Tazobactam.

    antibiotics icu enterobacteriaceae
  • For ESBL-Producing Enterobacteriaceae, the preferred antibiotics are Carbapenems and Ceftazidime-Avibactam.

    antibiotics icu esbl
  • For Carbapenem-Resistant Enterobacteriaceae (CRE), the preferred antibiotics include Polymyxins and Ceftazidime-Avibactam.

    antibiotics icu cre
  • For treating Pseudomonas aeruginosa, always use dual coverage of antibiotics due to high mutation potential.

    bacteria treatment pseudomonas
  • The preferred antibiotics for Pseudomonas aeruginosa are Piperacillin-Tazobactam, Cefepime, Ceftazidime + Aminoglycoside or Fluoroquinolone.

    bacteria antibiotics pseudomonas
  • For Stenotrophomonas maltophilia, the main treatment starts with Doxycycline.

    bacteria treatment stenotrophomonas
  • Finding effective antibiotics for Acinetobacter baumannii is very difficult, so always check the antibiogram.

    bacteria treatment acinetobacter
  • All anaerobic bacteria will be treated with Metronidazole, Carbapenems, Piperacillin-Tazobactam, or Clindamycin.

    bacteria anaerobic treatment
  • For atypical coverage, the preferred antibiotics for organisms like Mycoplasma pneumoniae, Chlamydia pneumoniae, and Legionella pneumophila are Doxycycline, Macrolides, and Fluoroquinolones.

    bacteria atypical treatment