Antimicrobial Deck 3 Flashcards

1
Q

Gram + Cocci

A

SSE

staph, strep, enterococcus

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2
Q

Gram - Cocci

A

H.Flu
Neisseria
Moxaxella

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3
Q

Gram - Bacilli

A

EKP
ESP

Escherichia coli
Klebsiella pnemonaie, Klebsiella oxytoca
Proteus mirabilis

Enterobacter sp.
Serratia marcescens
Providencia stuartii
Salmonella enteritis
Shigella sp.
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4
Q

Psudomonas

A

Psudomonas

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5
Q

Anaerobes

A

Bacteroides

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6
Q

Mycoplasms

A

– Mycoplasma: CAP
– Ureaplasma: GU

community acquired pneumona

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7
Q

Chlamydia

A

– GU
– Respiratory
– Eye

dies when outside of the cell

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8
Q

Ricketssias

A

• Ricketssias
– Ricketssia: Rocky Mountain Spotted fever
– Ehrlichia: tick‐borne

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9
Q

• Acid‐fast

A

– Mycobacterium tuberculosis

– Nocardia

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10
Q

• Fungal‐like

A

– Actinomyces

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11
Q

Spirochetes

A
Borrelia burgdorferie (Lyme Disease)
Treponema P llid a um (S hili ) (Syphilis)
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12
Q

• Borrelia burgdorferie (Lyme Disease) treatment

A

– Doxycycline, Amoxicillin

– Cephalosporin 3rd/4th Gen

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13
Q

Treponema P llid a um (S hili ) (Syphilis) treatment

A

– Pen G 2.4 million units
– PCN Allergy: Doxy/Tetracycline
– Azithromycin but multiple resistant strains

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14
Q

Gram Positive

A

thick peptidoglycan layer in the cell - purple

thicker cell wall
no porin channels
simpler organism

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15
Q

Gram negative

A

does not have a peptidoglycan layer - pink

thinner cell wall
lipopoysaccharide outer membrane
porin channels
more complex

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16
Q

Staph clinical associations

A

skin, soft tissue

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17
Q

Strep clincial associations

A

respiratory

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18
Q

enterococcus clinical manifications

A

GI/GU

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19
Q

H.Flu Clinical Associations

A

AOM, sinusitis, bronchitis

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20
Q

Neisseria clinical associations

A

Meningitis

GU

21
Q

Morxella clinical associations

A

AOM, sinusitis, bronchitis

22
Q

EKP clinical associations

A

Infection: UTI, GI

23
Q

ESP clinical associations

A

GI

24
Q

Salmonella, shigella clinical associations

A

GI

25
Q

Pseudomonas clinical associations

A

pneumonia, various

26
Q

Bacteroides clinical associations

A

GI, Aspiration pneumonia

27
Q

Goal of Using the Simplified Pathogen

List

A

Match the drug to the bug
• Identify the most likely pathogen
• Describe the spectrum of activity of an antibiotic (or
antibiotic class)
• Develop a simplified “drugs of choice” list

28
Q

• Gram + activity

A

Staph, Strep

29
Q

• Some Gr‐ activity

A

EKP(E. coli, Klebsiella, Proteus)

30
Q

• Good Gr – activity

A

ESP
(Enterobacter Enterobacter, Serratia Serratia, Providencia Providencia)
• +/‐ pseudomonas

31
Q

Anaerobic activity

A

Bacteroides

32
Q

Factors to Consider When Prescribing

Antimicrobials

A
  • Site of Infection
  • Pathogen
  • Extent of Infection
  • Purpose
  • Host
33
Q

Host Criteria

A
– Immune status
– Comorbidities
– Age
– Genetic Factors
– Allergies
– Pregnancy and Lactation
34
Q

Systematic Approach for Selecting

Antimicrobial Agents

A

Confirm the presence of infection
Identification of the likely pathogen
Selection of presumptive therapy
Monitor therapeutic response

35
Q

Broad Spectrum

A

• Broad activity
against Gram + and
Gram – Organisms

36
Q

Examples of broad

A
• Tetracyclines,
phenicols,
fluoroquinolones,
“third‐generation”
and “fourth‐
generation”
cephalosporins
37
Q

Narrow Spectrum

A

• Limited activity and are primarily
only useful against particular
species of microorganisms

38
Q

Narrow Glycopeptides PCNs are mainly affective

A

against Gram+ bacteria

39
Q

Narrow polymixins are usually only effective against

A

Gram‐ bacteria

40
Q

Narrow aminoglycosides and sulfonamides are mainly effective against

A

aerobic organisms

41
Q

Narrow nitroimidazoles are generally only effective

A

for anaerobes

42
Q
Penicillin
Ampicillin
Amoxicillin
Penicillin G
Treats
A

Gram + (SSE)
Strep, Staph, Enterococcus

Skin, soft tissue, respiratory

43
Q

Penicillin Extended
Spectrum

Treats

A

Less Gr+, more Gr‐ (EKP, ESP)
E‐coli, Shigella, Salmonella,
Proteus
β lactamase Gr +

GU
G
Skin/soft tissue, resp y iratory

44
Q

Tetracyclines
Doxycycline
Minocycline

Treats

A
Gr –
Atypicals, MRSA
chlamydiae, mycoplasmas, and
rickettsiae, and protozoan
parasites
Propionibacterium acnes
Gr+ Strep pneumonaie
Skin
GU/GI
Respiratory
Sulfonamide
TMP‐SMX
Gr‐ E coli, Proteus, Klebsiel
45
Q

Cephalosporins
1st Generation
cephadroxil
Cephalexin

Treats

A

Gram + Staph, Strep,
Enterococcus (SSE)

Resp, skin/soft tissue

46
Q
Cephalosporins
2nd Generation
cefprozil
cefaclor
cefuroxime

Treats

A

Gr+, weak Gr‐
Staph, Strep, Enterococcus
(SSE)

Resp

47
Q
3rd Generation
cefotaxime
cefpodoxime
cefdinir
ceftazidime
ceftriazone

Treats

A
Weak Gr+, Gr‐
β lactamase
H‐Flu, E‐coli, Klebsiella,
Proteus (EKP)
ESP

Resp, GU, GI

48
Q

4th Generation
Cefepime

Treats

A

β lactamase
Enhanced Gr‐, polymicrobial
infections (ESP, EKP, SSE)

Resp, GI, GU

49
Q

5th Generation
Ceftaroline

Treats

A

Gr+, Gr‐
MRSA , DRSP

GI, GU, Skin, Resp