Intro to Antibiotics

selective toxicity definition

ability of drug to injure target cells wo injury to host

bacteriostatic definition

stops growth but does not kill

bactericidal

kills bacteria

what are the five medications to avoid for pregnancy and lactation

1. aminoglycosides

2. tetracyclines

3. sulfonamides

4. folate antagonists

5. fluoroquinolones

why are aminoglycosides avoided in pregnancy?

ototoxicity and nephrotoxicity

why are tetracyclines avoided in pregnancy?

bone growth suppression, tooth taining

why are sulfonamides generally avoided in pregnancy?

kernicterus (jaundice) in nursing infants

why are fluoroquinolones avoided in pregnancy

toxic to developing cartilage

what antibiotic groups are cell wall targets?

beta lactams

glycopeptides

what is the main SE of penicillins

1. allergic reactions

2. rash

3. diarrhea

what antibiotic is safe for pregnancy?

penicillin

if a patient is penicillinase resistant, what -cillin medication would you prescribe?

dicloxacillin, nafcilin

what are the parenteral forms of beta lactams?

penicillin G, penicillin benzathine (IM only), and penicillin G procaine

vancomycin

1st generation cephalosporin (2 examples), and what is its coverage?

cefazolin, cephalexin

gram (+) coverage, skin and soft tissue infections

2nd generation cephalosporin (3 examples), and what is its coverage?

cefoxitin, cefuroxime, cefaclor

gram (+) with enhanced gram (-) coverage, respiratory and UTI infections

3rd generation cephalosporin (3 examples), and what is its coverage?

ceftraixone, cefotaxime, cefdinir

broad gram (+) and gram (-) coverage, pneunonia, meningitis

4th generation cephalosporin (1 example), and what is its coverage?

cefeprime

expanded gram (-) coverage, pseudomonal infections

what are beta lactamase inhibitors? what does it do the antibiotic spectrum?

prevents beta lactamase resistance; can’t be prescribed by themselves

expands spectrum against beta lactamase producing bacteria

3 types of beta lactamase inhibitors:

clavulanic acid, sulbactam, tazobactam

what are beta lactamase inhibitors with beta lactams, used for? (4)

1. URI

2. skin and soft tissue infections

3. intra-abdominal infections

4. complicated UTIs

what are the major side effects of beta lactamase inhibitors? (3)

1. allergic reactions

2. C. diff infection

3. diarrhea

what class is vancomycin, and what is its spectrum and clinical use?

glycopeptide class

spectrum and clinicak use: broad gram (+) coverage INCLUDING MRSA

major side effects of vancomycin (3)

1. nephrotoxicity

2. red man syndrome

3. ototoxicity

macrolides target gram ___ and ____ bacteria. what are some examples?

1. gram (+)

2. atypical bacteria

3. Azithromycin, Clarithromycin, Erythromycin

uses for macrolides? (4)

1. rsepiratory infections

2. pertussis

3. atypical or community acquired pneumonia

4. chlamydia

what is a major SE of macrolides?

1. QT prolongation

2. GI upset

3. hepatotoxicity

what are fluoroquinolones spectrum overage

broad spectrum including gram (+)/(-) bacteria

most fluoroquinolones can be taken orally and parenterally EXCEPT

gemifloxacin (oral ONLY)

spectrum of tetracyclines and use?

broad spectrum including gram (+)/(-), and atypical bacteria

use:

1. acne

2. Lyme

3. rocky mountain spotted fever

4. atypical pneumonia

what antibiotic should be avoided for children <8 yo and avoid in women who are breastfeeding?

tetracyclines

clindamycin coverage and use?

coverage: gram (+) and anaerobic coverage

use:

1. skin infections

2. dental abscesses

3. anaerobic infections

4. MRSA

major SE of clindamycin:

1. C. diff

2. bacteria

metronidazole spectrum and use?

spectrum: anaerobic bacteria and protozoa

Use:

1. giardia

2. C. diff

3. H. pylori

4. bacterial vaginosis

5. trichomoniasis

metronidazole major SE:

1. disulfiram like reaction with alcohol, metallic taste peripheral neuropathy

aminoglycosides coverage and examples?

primarily gram (-) coverage

Amikacin, Gentamicin, Neomycin, Plazomicin, Streptomycin, Tobramycin

uses for aminoglycosides

1. SEVERE INFECTIONS (sepsis, endocarditis)

2. complicated UTIs

3. common topical uses for skin and eyes

MAINLY USED TOPICALLY ON SKIN AND EAR/EYE DROPS

major SE of aminoglycosides

1. nephrotoxicity

2. ototoxicity

3. neuromuscular blockade

TMP SMX use

1. UTIs

2. pneumocystitis

3. jirvecii pneumonia

4. shigellosis

5. toxoplasma

6. MRSA skin infection

7. prostatitis

major SE of TMP SMZ (3)

1. SJS

2. hyperkalemia

3. folate deficiency

nitrofurantoin only achieves therapeutic levels only in ____ ____, with limited systemic distribution

urinary tract

spectrum of nitrofuratoin

gram (+) and gram (-) bacteria (E. coli, staph, saprophyticus, enterococcus faecalis)

carbapenems coverage and use

coverage: braod spectrum for gram (+)/(-), anaerobic bacteria

used for severe hospital acquired infections, sepsis, multidrug resistance

carbapenems major SE

seizures, GI

linezolid coverage and usage?

gram (+) including MRSA and VRE

use:

1. MRSA

2. VRE

3. complicated skin infections

4. pneumonia

5. bacteremia

bacitracin, polymyxin B coverage and usage

coverage: gram (+) and some gram (-)

usage:

1. superficial skin infections

2. ophthalmic

3. otic

bacitracin and polymyxin B major SE

1. contact dermatitis

2. nephrotoxic

3. neurotoxic