FINAL 01 - Antibacterials Flashcards by Juan Carlos Cornelio

Staphylococcus (G+ or G-)

G+

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Streptococcus (G+ or G-)

G+

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Bacillus (G+ or G-)

G+

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Clostridium (G+ or G-)

G+

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Listeria (G+ or G-)

G+

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Lactobacillus (G+ or G-)

G+

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Actinomyces (G+ or G-)

G+

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Mycobacterium (G+ or G-)

G+

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Klebsiella (G+ or G-)

G-

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Escherichia coli (G+ or G-)

G-

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Enterobacter (G+ or G-)

G-

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Proteus (G+ or G-)

G-

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Serratia (G+ or G-)

G-

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Color on gram stain - purple (G+ or G-)

G+

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Color on gram stain - pink/red (G+ or G-)

G-

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Cell wall - thick peptidoglycan (G+ or G-)

G+

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Cell wall - thin peptidoglycan + outer membrane (G+ or G-)

G-

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Lipopolysaccharide (LPS) - absent (G+ or G-)

G+

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Lipopolysaccharide (LPS) - present (endotoxin) (G+ or G-)

G-

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Teichoic acid - present (G+ or G-)

G+

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Teichoic acid - absent (G+ or G-)

G-

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Susceptible to penicillin - more likely (G+ or G-)

G+

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Susceptible to penicillin - less likely, due to outer membrane (G+ or G-)

G-

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Skin infections (Likely gram type)

G+

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Staph aureus and Strep pyogenes are common causes of __________

Skin infections

UTI (Likely gram type)

G-

E. coli, proteus, and klebsiella are common causes of _________

UTI

Pneumonia (Likely gram type)

Both (G+ and G-)

Strep pneumoniae (G+), H. influenzae, and mycoplasma (atypical) are common causes of __________

Pneumonia

Sepsis in hospitals (Likely gram type)

G- (more severe)

E. coli, klebsiella, and pseudomonas are common causes of __________

Sepsis in hospitals

Beta-lactams and vancomycin target the __________

Cell wall

Aminoglycosides, macrolides, tetracyclines, and clindamycin target __________

Protein synthesis

FQ, rifampicin, and metronidazole target __________

DNA/RNA synthesis

TMP-SMX target _________

Folate pathway

Daptomycin and polymyxins target __________

Membrane

Includes beta-lactams, such as penicillins, cephalosporins, carbapenems, and monobactams (Types of antibacterials)

Cell wall synthesis inhibitors

Inhibit transpeptidase (penicillin-binding proteins), blocking peptidoglycan cross-linking (Types of antibacterials)

Cell wall synthesis inhibitors

Uses are broad; depends on generation and type; includes skin, respiratory, UTI, intra-abdominal, and meningitis (Types of antibacterials)

Cell wall synthesis inhibitors

SEs include allergy, GI upset, C. difficile infection, seizures (Types of antibacterials)

Cell wall synthesis inhibitors

Includes penicillin, amoxicillin, flucloxacillin, piperacillin (Classes of cell wall synthesis inhibitors)

Penicillins

Narrow to extended spectrum (Classes of cell wall synthesis inhibitors)

Penicillins

Includes cephalexin (1st), cefuroxime (2nd), ceftriaxone (3rd), and cefepime (4th) (Classes of cell wall synthesis inhibitors)

Cephalosporins

↑ Gram-negative coverage with ↑ generation (Classes of cell wall synthesis inhibitors)

Cephalosporins

Includes meropenem and imipenem (Classes of cell wall synthesis inhibitors)

Carbapenems

Broad spectrum, resistant to most beta-lactamases (Classes of cell wall synthesis inhibitors)

Carbapenems

Includes aztreonam (Classes of cell wall synthesis inhibitors)

Monobactams

For gram-negative only (Classes of cell wall synthesis inhibitors)

Monobactams

Includes Pen G and Pen V (Types of penicillins)

Penicillins (Natural)

Used for streptococcal infections, syphilis, and rheumatic fever prophylaxis (Types of penicillins)

Penicillins (Natural)

Narrow spectrum; mostly gram-positive and anaerobes (Types of penicillins)

Penicillins (Natural)

Includes flucloxacillin, nafcillin, and dicloxacillin (Types of penicillins)

Antistaphylococcal penicillins (Penicillinase-resistant)

Used for MSSA infections: skin, bone, endocarditis (Types of penicillins)

Antistaphylococcal penicillins (Penicillinase-resistant)

Not effective against MRSA or gram-negatives (Types of penicillins)

Antistaphylococcal penicillins (Penicillinase-resistant)

Includes amoxicillin, amoxicillin-clavulanate, ampicillin (Types of penicillins)

Aminopenicillins (Extended-spectrum)

Used for otitis media, sinusitis, bronchitis, UTIs, enterococcal infections, and polymicrobial infections, dog/cat bites (for amoxicillin-clavulanate) (Types of penicillins)

Aminopenicillins (Extended-spectrum)

A beta-lactamase inhibitor that expands gram negative and anaerobic coverage

Clavulanate

Also known as middle ear infection

Otitis media

Most common cause of otitis media; G+ diplococcus (Causes of otitis media)

Streptococcus pneumoniae

Non-typeable; G- (Causes of otitis media)

Haemophilus influenzae

G- diplococcus (Causes of otitis media)

Moraxella catarrhalis

2 less common causes of otitis media (SS)

Streptococcus pyogenes, Staphylococcus aureus

Treatment for otitis media

Amoxicillin (high-dose)

Used for resistant/treatment failure in otitis media (AC)

Amoxicillin-clavulanate

E. coli, S. saprophyticus (in young women), K. pneumoniae, P. mirabilis, E. faecalis are the most common causes of __________

Uncomplicated UTI

Pseudomonas aeruginosa, enterobacter, serratia are the most common causes of __________

Complicated UTI (Catheter-associated)

Most common cause of enterococcal infections

Enterococcus faecalis

Cause of enterococcal infection; more resistant; may be VRE

Enterococcus faecium

__________ are naturally resistant to many beta-lactams and aminoglycosides

Enterococcal infections

For enterococcal infections, use __________ or _________ (AVG)

Ampicillin, Vancomycin ± gentamicin

For VRE, use __________ or __________ (LD)

Linezolid, Daptomycin

Cause of pharyngitis (bacterial/strep throat)

Streptococcus pyogenes

First line antibiotics for pharyngitis (PA)

Penicillin V, Amoxicillin

2 antibiotics to be used for pharyngitis if penicillin-allergic (CA)

Cephalexin (if mild allergy), Azithromycin (if severe allergy)

Includes piperacillin-tazobactam (Tazocin) (Types of penicillins)

Antipseudomonal penicillins

Broad-spectrum for severe hospital-acquired infections (Types of penicillins)

Antipseudomonal penicillins

Antipseudomonal penicillins are active against _________

Pseudomonas aeruginosa

Antipseudomonal penicillins are often used empirically in hospitals; __________ protects against beta-lactamases

Tazobactam

3 antibiotics for acute bronchitis (only if pertussis or atypical suspected) (ACD)

Azithromycin, Clarithromycin, Doxycycline (alternative)

Most common cause of pertussis (whooping cough)

Bordetella pertussis

First-line antibiotic for pertussis in children

Azithromycin

First-line antibiotic for pertussis in adults (CT)

Clarithromycin, TMP-SMX

Includes cephalexin (PO), cefazolin (IV) (Generations of cephalosporins)

1st Generation

Used for gram positive (Staph, Strep); limited gram-negative (Proteus, E. coli, Klebsiella = "PEK") (Generations of cephalosporins)

1st Generation

Used for skin and soft tissue infections, surgical prophylaxis (cefazolin), and UTIs (uncomplicated) (Generations of cephalosporins)

1st Generation

Includes cefuroxime (IV/PO), cefaclor (PO), cefoxitin and cefotetan (IV-cephamycins) (Generations of cephalosporins)

2nd Generation

Used more for gram-negative (H. influenzae, Enterobacter, Neisseria = "HEN"); continued gram-positive (Generations of cephalosporins)

2nd Generation

Used for respiratory infections (otitis media, sinusitis), PID (cefoxitin + doxycycline), surgical prophylaxis in abdominal surgery (Generations of cephalosporins)

2nd Generation

__________ such as cefoxitin and cefotetan have anaerobic activity (2nd generation cephalosporins)

Cephamycins

Includes ceftriaxone (IV), cefotaxime (IV), ceftazidime (IV), cefixime, cefdinir (PO) (Generations of cephalosporins)

3rd Generation

Broad gram-negative, reduced gram-positive (Generations of cephalosporins)

3rd Generation

Long half-life, once-daily dosing (3rd Generation Cephalosporins)

Ceftriaxone

Used for meningitis, gonorrhea, CAP, sepsis (3rd generation cephalosporins)

Ceftriaxone

Used for pediatric meningitis (3rd generation cephalosporins)

Cefotaxime

Used for pseudomonal infections (3rd generation cephalosporins)

Ceftazidime

Includes cefepime (IV) (Generations of cephalosporins)

4th Generation

Used for broad gram-positive and gram-negative including Pseudomonas; more resistant to beta-lactamases (Generations of cephalosporins)

4th Generation

Includes ceftaroline (IV) and ceftobiprole (not widely available in all countries) (Generations of cephalosporins)

5th Generation

Similar gram-negative to 3rd gen; MRSA coverage (binds PBP2a); no pseudomonas activity (Generations of cephalosporins)

5th Generation

Used for community-acquired pneumonia and MRSA skin infections (Generations of cephalosporins)

5th Generation

Vancomycin is administered __________ for systemic infections (Glycopeptides)

Vancomycin is administered orally for __________ colitis (not absorbed systematically) (Glycopeptides)

Clostridioides difficile

Inhibits bacterial cell wall synthesis by binding to the D-Ala-D-Ala terminal of peptidoglycan precursors (Glycopeptides)

Vancomycin (IV, PO)

Used for gram-positive only, including MRSA, Enterococcus spp. (except VRE), Streptococcus spp., Clostridium difficile (oral) (Glycopeptides)

Vancomycin (IV, PO)

Vancomycin causes __________, especially with high trough levels or with aminoglycosides (Glycopeptides)

Nephrotoxicity

Syndrome caused by vancomycin; histamine-mediated flushing during rapid infusion (Remedy: slow the rate)

Red man syndrome

Similar to vancomycin, but longer half-life, once-daily dosing, less monitoring required, used as vancomycin alternative in some hospitals (Glycopeptides)

Teicoplanin (IV/IM)

Inhibits bacterial cell wall synthesis by binding to penicillin-binding proteins (Cell wall synthesis inhibitors)

Carbapenems

Resistant to most beta-lactamases (including ESBLs) (Cell wall synthesis inhibitors)

Carbapenems

Includes meropenem (IV), imipenem-cilastatin (IV), ertepenem (IV) (Cell wall synthesis inhibitors)

Carbapenems

__________ is co-administered with imipenem to prevent its renal degradation and protect against nephrotoxicity (Carbapenems)

Cilastatin

__________ is rapidly inactivated in the renal tubules by an enzyme called dehydropeptidase I (DHP-I) (Carbapenems)

Imipenem

Is very broad-spectrum, including gram-positive (Streptococci, MSSA), gram-negative (including ESBL-producing organisms), anaerobes (Cell wall synthesis inhibitors)

Carbapenems

Meropenem, imipenem, and doripenem are carbapenems that has __________ activity

Pseudomonas

__________ is a carbapenem that has no activity vs. Pseudomonas, Acinetobacter, Enterococcus

Ertapenem

Most common ESBL-producer globally (ESBL-producing organisms)

Escherichia coli

Important cause of hospital-acquired infections (ESBL-producing organisms)

Klebsiella pneumoniae

Less common but possible (ESBL-producing organisms) (PES)

Proteus mirabilis, Enterobacter spp., Serratia

Used for severe HAI, empiric therapy for MDR organisms, meningitis (meropenem), and polymicrobial infections (Cell wall synthesis inhibitors)

Carbapenems

S/Es include seizures (especially imipenem), GI upset, rash, hypersensitivity (Cell wall synthesis inhibitors)

Carbapenems

Beta-lactam antibiotic but structurally different; contains a monocyclic beta-lactam ring (Cell wall synthesis inhibitors)

Monobactams (Aztreonam)

Inhibits bacterial cell wall synthesis by binding to penicillin-binding protein 3 (PBP-3) in gram-negative bacteria (Cell wall synthesis inhibitors)

Monobactams (Aztreonam)

Is bactericidal; only active against aerobic gram-negative bacilli (E. coli, Klebsiella, Pseudomonas aeruginosa, Enterobacter); no activity against gram-positives or anaerobes (Cell wall synthesis inhibitors)

Monobactams (Aztreonam)

Aztreonam is safe in __________

Penicillin allergy

Bactericidal; inhibits MurA (enolpyruvyl transferase) - the first step in peptidoglycan synthesis (Cell wall synthesis inhibitors)

Fosfomycin

Blocks formation of N-acetylmuramic acid from UDP-N-acetylglucosamine (Cell wall synthesis inhibitors)

Fosfomycin

Is broad spectrum; for gram-positive and gram-negative, including E. coli, Enterococcus, MDR pathogens (Cell wall synthesis inhibitors)

Fosfomycin

Used for uncomplicated UTI (oral single dose treatment) and often used when there is antibiotic resistance (Cell wall synthesis inhibitors)

Fosfomycin

Fosfomycin is available as an oral sachet as __________

Fosfomycin trometamol

Structural analog of D-alanine; inhibits alanine racemase and D-alanine-D-alanine ligase (Cell wall synthesis inhibitors)

Cycloserine

Blocks synthesis of D-Ala-D-ala dipeptide and inhibits peptidoglycan cross-linking (Cell wall synthesis inhibitors)

Cycloserine

May be bacteriostatic or bactericidal (dose-dependent) (Cell wall synthesis inhibitors)

Cycloserine

Broad gram-positive and gram-negative activity, but mainly used for Mycobacterium tuberculosis (Cell wall synthesis inhibitors)

Cycloserine

2nd line agent for drug-resistant tuberculosis (MDR-TB); rarely used outside of TB programs (Cell wall synthesis inhibitors)

Cycloserine

Cycloserine may be co-administered with __________ to reduce neurotoxicity

Vitamin B6 (Pyridoxine)

Aminoglycosides, tetracyclines (Ribosomal subunit)

30S

Macrolides, lincosamides (clindamycin), chloramphenicol, oxazolidinones (linezolid), streptogramins (Ribosomal subunit)

50S

Includes gentamicin, tobramycin, amikacin, neomycin (Protein synthesis inhibitors - 30S)

Aminoglycosides

Irreversibly binds to 30S; bactericidal (Protein synthesis inhibitors - 30S)

Aminoglycosides

Used for aerobic gram-negative bacilli; synergy with beta-lactams for gram-positives (Protein synthesis inhibitors - 30S)

Aminoglycosides

Used for sepsis, endocarditis, resistant UTIs, pseudomonas infections (Protein synthesis inhibitors - 30S)

Aminoglycosides

S/Es include nephrotoxicity, ototoxicity, neuromuscular blockade (Protein synthesis inhibitors - 30S)

Aminoglycosides

Require drug level monitoring (has narrow therapeutic index) (Protein synthesis inhibitors - 30S)

Aminoglycosides

Most nephrotoxic aminoglycoside

Neomycin

High (vestibular) ototoxicity; moderate nephrotoxicity; used for TB, tularemia (Aminoglycosides)

Streptomycin

High (vestibular and cochlear) ototoxicity; high nephrotoxicity; used for sepsis, endocarditis, intra-abdominal (Aminoglycosides)

Gentamicin

Moderate (cochlear) ototoxicity; moderate nephrotoxicity; used for pseudomonas, CF (Aminoglycosides)

Tobramycin

Lower (relative) ototoxicity; lower nephrotoxicity; used for MDR TB, resistant G- (Aminoglycosides)

Amikacin

Rarely ototoxic; very high nephrotoxicity; topical/oral only (Aminoglycosides)

Neomycin

Includes doxycycline, tetracycline, minocycline (Protein synthesis inhibitors - 30S)

Tetracyclines

Reversibly bind to 30S; bacteriostatic (Protein synthesis inhibitors - 30S)

Tetracyclines

Used for G+, G-, intracellular organisms (Rickettsia, Chlamydia, Mycoplasma) (Protein synthesis inhibitors - 30S)

Tetracyclines

Used for acne, atypical pneumonia, STIs, Lyme disease, malaria prophylaxis (Protein synthesis inhibitors - 30S)

Tetracyclines

S/Es include teeth discoloration, photosensitivity, GI upset, hepatotoxicity, reduced absorption with calcium/iron (Protein synthesis inhibitors - 30S)

Tetracyclines

Includes azithromycin, clarithromycin, erythromycin (Protein synthesis inhibitors - 50S)

Macrolides

Inhibits translocation by binding 50S; bacteriostatic (Protein synthesis inhibitors - 50S)

Macrolides

Used for URTIs, CAP, STIs, pertussis, H. pylori (clarithromycin) (Protein synthesis inhibitors - 50S)

Macrolides

1st line macrolide for whooping cough

Azithromycin

S/Es include CYP3A4 inhibition (erythromycin, clarithromycin), GI upset (erythromycin), QT prolongation (Protein synthesis inhibitors - 50S)

Macrolides

Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis are __________ pathogens that cause CAP

Typical

Mycoplasma pneumoniae, Chlamydia pneumoniae, Legionella pneumophila are _________ pathogens that cause CAP

Atypical

1st line for outpatient (mild) CAP (CAP drugs) (DA)

Doxycycline, Amoxicillin

Moderate CAP (Hospital) (CAP drugs) (ID,CA)

IV benzylpenicillin + doxycycline, Ceftriaxone + azithromycin

Severe CAP (ICU) (CAP drugs) (IA)

IV ceftriaxone + azithromycin

Meaning of CAP

Community acquired pneumonia

Meaning of HAP

Hospital acquired pneumonia

Meaning of VAP

Ventilator associated pneumonia

Pseudomonas aeruginosa, Staphylococcus aureus (MRSA), Enterobacteriaceae (Klebsiella, E. coli), Acinetobacter baumannii causes _________ and _________ (HV)

Hospital acquired pneumonia (HAP), Ventilator associated pneumonia (VAP)

3 drugs for HAP/VAP (PCM)

Piperacillin-tazobactam, Cefepime, Meropenem

For HAP/VAP, add __________ or __________ if MRSA risk (VL)

Vancomycin, Linezolid

Includes clindamycin (Protein synthesis inhibitors - 50S)

Lincosamides

50S binding; inhibits peptide transfer (Protein synthesis inhibitors - 50S)

Lincosamides

Used for aspiration pneumonia, dental infections, anaerobic infections, skin infections (including MRSA) (Protein synthesis inhibitors - 50S)

Lincosamides

S/Es include high risk of C. difficile colitis and GI upset (Protein synthesis inhibitors - 50S)

Lincosamides

Includes linezolid (Protein synthesis inhibitors - 50S)

Oxazolidinones

Binds 50S; blocks formation of initiation complex (Protein synthesis inhibitors - 50S)

Oxazolidinones

Used for gram-positive, including MRSA, VRE (Protein synthesis inhibitors - 50S)

Oxazolidinones

S/Es include myelosuppression (thrombocytopenia with prolonged use), serotonin syndrome (with SSRIs), peripheral and optic neuropathy (long term use) (Protein synthesis inhibitors - 50S)

Oxazolidinones

50S binding; inhibits peptidyl transferase (Protein synthesis inhibitors - 50S)

Chloramphenicol

Used for meningitis in developing countries and Rickettsial infections if tetracyclines contraindicated (Protein synthesis inhibitors - 50S)

Chloramphenicol

S/Es include aplastic anemia (rare, idiosyncratic) and grey baby syndrome (due to immature glucuronidation in neonates) (Protein synthesis inhibitors - 50S)

Chloramphenicol

Mnemonics for ribosomal subunits of protein synthesis inhibitors

Buy AT 30, CCELL at 50 (30S = aminoglycosides, tetracyclines; 50S = chloramphenicol, clindamycin, erythromycin, linezolid

Includes ciprofloxacin and norfloxacin (mostly urinary) and levofloxacin and moxifloxacin (respiratory) (DNA/RNA synthesis inhibitors)

Fluoroquinolones

Inhibits DNA gyrase (topoisomerase II) and topoisomerase IV; prevent supercoiling (DNA/RNA synthesis inhibitors)

Fluoroquinolones

Broad; for gram-negatives; some gram-positives and atypicals (DNA/RNA synthesis inhibitors)

Fluoroquinolones

Strong gram negative activity (e.g. Pseudomonas) (Fluoroquinolones)

Ciprofloxacin

Better gram positive and atypical coverage (Fluoroquinolones) (LM)

Levofloxacin, Moxifloxacin

Used for UTIs, prostatitis, CAP, atypical pneumonia, traveller's diarrhea, bone/joint infections (DNA/RNA synthesis inhibitors)

Fluoroquinolones

S/Es include QT prolongation, tendon rupture/tendinitis, photosensitivity (DNA/RNA synthesis inhibitors)

Fluoroquinolones

MDR UTI or pyelonephritis (Fluoroquinolone used)

Ciprofloxacin

Pseudomonas aeruginosa infections in cystic fibrosis (Fluoroquinolone used)

Ciprofloxacin

Post exposure prophylaxis for inhalational anthrax (Fluoroquinolone used)

Ciprofloxacin

Shigella, Salmonella, or Campylobacter (if resistant to others) (Fluoroquinolone used)

Ciprofloxacin

Severe typhoid fever (resistant strains) (Fluoroquinolone used)

Ciprofloxacin

Prodrug; forms free radicals; no aerobic activity (DNA/RNA synthesis inhibitors)

Metronidazole

Used for anaerobes (Bacteroides, Clostridium spp.) and protozoa (Giardia, Trichomonas, Entamoeba) (DNA/RNA synthesis inhibitors)

Metronidazole

Used for C. difficile colitis (alternative to vancomycin) (DNA/RNA synthesis inhibitors)

Metronidazole

S/Es include metallic taste, disulfiram-like reaction, peripheral neuropathy (DNA/RNA synthesis inhibitors)

Metronidazole

Includes rifampicin (RNA synthesis inhibitors)

Rifamycins

Binds bacterial DNA-dependent RNA polymerase; blocks transcription (RNA synthesis inhibitors)

Rifamycins

1st line drug for tuberculosis

Rifamycins (Rifampicin)

Used for tuberculosis, leprosy (with dapsone, clofazimine), prophylaxis for meningococcal and H. influenzae exposure, prosthetic joint infections (RNA synthesis inhibitors)

Rifamycins

S/Es include hepatotoxicity, potent CYP450 inducer, orange-red discoloration of body fluids (RNA synthesis inhibitors)

Rifamycins

These antibiotics inhibit bacterial folate metabolism, which is essential for DNA synthesis (Types of antibacterials)

Folate synthesis inhibitors

Includes sulfamethoxazole (Folate synthesis inhibitors)

Sulfonamides

Competitive inhibitor of dihydropteroate synthase (DHPS) (Folate synthesis inhibitors)

Sulfonamides

Inhibits dihydrofolate reductase (DHFR) (Folate synthesis inhibitors)

Trimethoprim

Synergistic; blocks two steps in folate synthesis; bactericidal together but bacteriostatic individually (Folate synthesis inhibitors)

Trimethoprim + Sulfamethoxazole (TMP-SMX) (Co-trimoxazole)

1st line unless resistance or sulfa allergy (Indications for TMP-SMX)

Uncomplicated UTI

Especially community-acquired (Indications for TMP-SMX)

MRSA skin infections

Treatment and prophylaxis in immunocompromised patients (Indications for TMP-SMX)

Pneumocystis jirovecii pneumonia (PCP)

DOC (Indications for TMP-SMX)

Nocardiosis

DOC for nocardiosis

Trimethoprim + Sulfamethoxazole (TMP-SMX) (Co-trimoxazole)

Good penetration (Indications for TMP-SMX)

Prostatitis

Especially in HIV patients (Indications for TMP-SMX)

Toxoplasmosis (alternative)

Rash, urticaria, Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TMP-SMX - system affected)

Dermatologic

Megaloblastic anemia, leukopenia, thrombocytopenia (TMP-SMX - system affected)

Hematologic

Crystalluria, hyperkalemia, interstitial nephritis (TMP-SMX - system affected)

Renal

Photosensitivity, kernicterus in neonates (TMP-SMX - system affected)

Others

TMP-SMX is contraindicated in __________ due to risk of neural tube defects and kernicterus

Pregnancy (especially 3rd trimester)

TMP-SMX is contraindicated in _________ due to immature liver

Neonates <2 months

These agents disrupt the bacterial cell membrane, leading to loss of membrane integrity, leakage of contents, and cell death; this mechanism is rapidly bactericidal (Types of antibacterials)

Membrane disruptors

Includes polymyxin B and E (colistin) (Membrane disruptors)

Polymyxin

Polymyxin E is also known as __________

Colistin

Binds to LPS (lipopolysaccharide) and phospholipids in the outer membrane of gram-negative bacteria (Membrane disruptors)

Polymyxins

For gram-negative only, including MDR bacteria, including Pseudomonas aeruginosa, Acinetobacter baumannii, Klebsiella pneumoniae (Membrane disruptors)

Polymyxins

Used as salvage therapy for MDR infections and topical use in combination creams (Membrane disruptors)

Polymyxins

S/Es include nephrotoxicity (dose-dependent, reversible) and neurotoxicity (paresthesia, dizziness, neuromuscular blockade) (Membrane disruptors)

Polymyxins

Includes daptomycin (Membrane disruptors)

Lipopeptides

Inserts into gram-positive bacterial membranes in a calcium-dependent manner (Membrane disruptors)

Lipopeptides

Causes depolarization and potassium efflux; inhibition of protein, DNA, and RNA synthesis (Membrane disruptors)

Lipopeptides

Used for gram-positive bacteria only, including MRSA, VRE, Streptococcus, Staphylococcus (Membrane disruptors)

Lipopeptides

Meaning of VRE

Vancomycin-resistant Enterococcus

Used for bacteremia, endocarditis, bone/joint infections (Membrane disruptors)

Lipopeptides

Lipopeptides are not for pneumonia; inactivated by __________

Lung surfactant

S/Es include myopathy and eosinophilic pneumonia (rare) (Membrane disruptors)

Lipopeptides

Topical use only; disrupts cation permeability (Other membrane agents)

Gramicidin

Found in tyrocidine-containing topical formulations (Other membrane agents)

Tyrocidine

Also affects membrane transport; used topically only (Other membrane agents)

Bacitracin

Target spectrum - gram-negative (Membrane disruptors)

Polymyxins

Target spectrum - gram-positive (Membrane disruptors)

Daptomycin

Target spectrum - topical use only (Membrane disruptors)

Gramicidin

MOA - disrupt outer membrane (LPS) (Membrane disruptors)

Polymyxins

MOA - depolarizes membrane (Membrane disruptors)

Daptomycin

MOA - alters membrane ion transport (Membrane disruptors)

Gramicidin

Used for MDR gram-negative infections (Membrane disruptors)

Polymyxins

Used for MRSA, VRE, bacteremia (Membrane disruptors)

Daptomycin

Used as topical antiseptic (Membrane disruptors)

Gramicidin

Key side effects - nephrotoxicity, neurotoxicity (Membrane disruptors)

Polymyxins

Key side effects - myopathy, eosinophilic pneumonia (Membrane disruptors)

Daptomycin

Key side effects - irritation if systemic (Membrane disruptors)

Gramicidin

Example of acid fast bacteria

Mycobacterium

Staphylococcus (Bacteria shape)

G+ cocci

Streptococcus (Bacteria shape)

G+ cocci

Enterococcus (Bacteria shape)

G+ cocci

Bacillus (Bacteria shape)

G+ rods

Clostridium (Bacteria shape)

G+ rods

Listeria (Bacteria shape)

G+ rods

Corynebacterium (Bacteria shape)

G+ rods

Neisseria (Bacteria shape)

G- cocci

Klebsiella (Bacteria shape)

G- rods

E. coli (Bacteria shape)

G- rods

Pseudomonas (Bacteria shape)

G- rods

Proteus (Bacteria shape)

G- rods

Salmonella (Bacteria shape)

G- rods

Shigella (Bacteria shape)

G- rods

FINAL 01 - Antibacterials Flashcards

(266 cards)