Anti Fungals part 1

What is the difference between bacteriostatic and bactericidal?

Bacteriostatic inhibits growth (relies on host immunity to clear); bactericidal directly kills bacteria

What is the difference between empiric and definitive therapy?

Empiric = initial choice based on likely pathogens before cultures return. Definitive = narrowed, targeted therapy once culture/susceptibility results are known

What is MIC?

Minimum Inhibitory Concentration — the lowest antibiotic concentration that inhibits visible bacterial growth in vitro

Give an example of concentration-dependent vs time-dependent killing.

Concentration-dependent: aminoglycosides, fluoroquinolones (high dose, less frequent). Time-dependent: beta-lactams, vancomycin (frequent/continuous dosing)

What is Kirby-Bauer disk diffusion testing used for?

A method of antimicrobial susceptibility testing (AST) that determines organism susceptibility, allowing therapy to be narrowed or broadened based on results

What is first-line therapy for strep species and syphilis?

Natural penicillins (penicillin G/V)

Which agent is safe for gram-negative/Pseudomonas coverage in a patient with severe penicillin allergy?

Aztreonam (monobactam) — minimal cross-reactivity with other beta-lactams

What is "red man syndrome" with vancomycin?

An infusion-related reaction (not a true allergy) from rapid infusion — slowing the rate usually resolves it

Which beta-lactam combo is used for pseudomonal/hospital-acquired infections?

Piperacillin-tazobactam

Which cephalosporin generation covers Pseudomonas?

4th-generation (cefepime)

What class is reserved for severe/resistant infections including ESBL producers?

Carbapenems (meropenem, ertapenem, imipenem)

Is vancomycin or ceftaroline first-line for MRSA bacteremia?

Vancomycin remains first-line for MRSA bacteremia. Ceftaroline covers MRSA but is more of an alternative/specific-scenario option, not the default first-line

What serious interaction risk does linezolid carry?

Serotonin syndrome with serotonergic drugs (weak MAOI-like activity)

Which antibiotic class is classically highest-risk for C. difficile infection?

Clindamycin (lincosamide class)

What is the major toxicity of aminoglycosides?

Nephrotoxicity and irreversible ototoxicity — concentration-dependent, monitor peak/trough

Why avoid tetracyclines with dairy/antacids?

They chelate with divalent cations, reducing absorption

Is doxycycline the same as "tetracycline" as a term?

No — tetracycline is the drug class; doxycycline is the specific drug within that class most commonly used clinically. Not interchangeable as terms

What is rifampin's most clinically significant property?

Potent CYP450 inducer, causing many drug-drug interactions

What reaction does metronidazole cause with alcohol?

A disulfiram-like reaction

What common, less severe ADE does metronidazole cause besides the disulfiram-like reaction?

A metallic taste in the mouth

Which antibiotic class carries tendon rupture risk?

Fluoroquinolones

What is TMP-SMX used for, and its key ADR?

UTIs, PCP prophylaxis/treatment, MRSA skin/soft tissue infections; sulfa allergy, hyperkalemia, Stevens-Johnson syndrome risk