Antibacterial Agents

Use, PK parameters Toxicities

Glycopeptides

• Use

• PK

  • parameter

  • t1/2

  • Excretion

• Toxicities

Glycopeptides

• Use

  • C. diff (PO)

• PK

  • parameter: AUC/MIC

  • t1/2:

    • Dal/orita (long t1/2)

  • Excretion

    • urine (dose adjustement)

• Toxicities

  • nephrotoxic

  • infusion-related rxns

  • Telavancin = QTc prolongation

Anti-MRSA agents

Daptomycin

• What can it not be used for?

• DDI

• ADEs

• What can it not be used for?

  • pneumonia

• DDI

  • statins

• ADEs

  • CPK elevations

  • Rhabdomyolysis

Linezolid

• DDI

• ADE

• DDI

  • MAO-I inhibitors

• ADEs

  • Bone marrow suppression

Clindamycin

• ADE

• ADE

  • C. diff colitis

Fluorquinolones

• Use

• ADEs

• BBW

• DDI

• Use

  • Meninigitis

  • Intra-abdominal infections

  • HAP/VAP & UTI

    • Ciprofloxacin

    • Levofloxacin

  • CAP

    • Moxifloxacin

    • Levofloxacin

• ADEs

  • C. diff colitis

  • tendonitis

  • psychiatric rxns

  • QTc prolongation

    • NOT delfloxacin

• BBW

  • serious ADEs last line agent

• DDI

  • multivalent cations

What fluoroquinolone does not require a renal DA

Moxifloxacin

• metabolized hepatically

Aminoglycosides

• Use (general)

• PK

• DDI

• ADEs (rank)

• Use (general)

  • Serious MDR Gram (-) infections

    • (Last lines)

  • Synergy for Gram (+) infections

    • Gentamicin

• PK

  • Cmax/MIC or AUC/MIC

  • postantibiotic effect

• DDI

  • Additive toxicity with other nephrotoxins

• ADEs (rank)

  • Nephrotoxicity

    • Gent>Tobra>Amikacin>Plazomicin

  • Ototoxicity

Tetracyclines

• Use

• PK (Vd)

• DDI

• ADEs

  • Class-wide

  • Tetra/Doxy/Mino

  • Tige

• BBW

• Use

  • Doxy - lyme disease

  • Tetracycline - H. pylori

• PK (Vd & hepatic dysfunction)

  • Tige, Erava

• DDI

  • Chelation

  • Multivalent cations

  • Warfarin

    • ALL EXCEPT: tige & Erava

• ADEs

  • Class

    • Tooth discoloration

    • Enamel hypoplasia

  • Tetra/Doxy/Mino

    • Photosensitivity

    • Azotemia

    • Esophageal ulceration

  • Tige

    • GI

• BBW

  • mortality risk

Macrolides

• Use

• High intracellular/ tissue concentration

• DDIs

• ADEs

• Use

  • Fidaxomycin

    • C. diff ONLY

• High intracellular/ tissue concentration

  • Azithromycin, clarithromycin

• DDIs

  • CYP3A4

    • Clarithromycin, Erythromycin

• ADEs (ALL except fidaxomycin)

  • GI

  • QTC

Rifampamycin

• Use

• DDI

• ADEs

• Use

  • TB

  • Synergy for S. aureus

• DDI

  • CYP450

• ADEs

  • Red-orange discoloration

Metronidazole

• Use

• ADEs

• Use

  • Anaerobes (GOLD STANDARD)

  • Atypicals

• ADEs

  • Metallic taste

  • peripheral neuropathy

  • GI

Nitrofurantoin

• Use

• Use

  • Uropathogens

    • UTI (cystitis only - bladder)

Polymixins

• Drugs

• Use

• Drugs

  • Polymixin B

  • Colistin

• Use

  • MDR Gram (-) infections

Fosfomycin

• Use

• Use

  • UTI