Antibacterial Drug Resistance & Adverse Effects

common resistant bacteria strains

VRSA, MRSA, VRE, PRSP

resistance to antibacterial drug mechanisms

develop drug-destroying enzymes, alter/mask drug binding site, change enzymes targeted by drugs, ↓ drug penetration, develop drug efflux pumps

beta-lactamase destroys

penicillin & structurally similar drugs

prevention of bacterial resistance

ovoid overuse, use more narrow spectrum drugs

how to tx bacterial resistance

provide 2nd drug to overcome resistance (beta-lactamase inhibitor)

antibacterial adverse effects/rehab concerns

headache, GI distress, hypersensitivity, allergic reactions (rashes, difficulty breathing), UV sensitivity (tetracycline), ototoxicity (aminoglycosides), tendinopathy/pain

antibacterial drugs that risk tendon damage/rupture

fluoroquinolones (flox in name)

fluoroquinolone tendon damage occurs in

WB tendons, older pts, renal failure pts, pts taking glucocorticoids, hx of tendinopathy

fluoroquinolone tendon damage may arise from

oxidative damage at cellular level (free radicals)

fluoroquinolone related tendon damage occurs w/in how long?

2hrs, 85% in 1st month (discontinue drug if occurs)