199 Questions
What is the primary factor to consider when selecting antibiotic treatment?
Identity of the organism
Which type of bacteria has a thicker layer of peptidoglycan and no outer lipid layer?
Gram Positive
What makes Gram negative bacteria more resistant to certain antibiotics?
Presence of LPS in the outer lipid layer
What legislation allows midwives to prescribe drugs for various conditions?
Midwifery Drug Legislation 884/93
What is the primary purpose of the All Purpose Nipple Ointment mentioned in the text?
Treatment of nipple pain
What is the main factor influencing the selection of antibiotic treatment according to the text?
Identity of the organism
Which condition is NOT mentioned as one for which midwives may prescribe drugs?
Influenza
What is the primary factor influencing the susceptibility of the organism to a given microbial agent?
Identity of the organism
What type of bacteria has an outer lipid layer that makes it harder for antibiotics to penetrate?
Gram Negative
What is the main factor influencing the safety of the agent when selecting antibiotic treatment?
Susceptibility of the organism to a given microbial agent
Which of the following is a common cause of mastitis?
Blocked milk ducts
What organism almost always causes bacterial breast infection leading to mastitis?
Staphylococcus aureus
Which type of milk is associated with infected breast milk in the case of mastitis?
Green
What is the onset of symptoms for mastitis?
Gradual - usually from d3-d5 postpartum
What is the location of inflammation in the case of mastitis?
Unilateral
What is the characteristic of pain experienced in mastitis?
Intense and diffuse
What is the common cause of unresolved engorgement or plugged duct in mastitis?
Improper latching
What may lead to an abscess that needs to be surgically drained if left untreated in mastitis?
Bacterial breast infection
What is the characteristic of heat in the affected area in mastitis?
Intense heat
What may be the cause of infections that don’t resolve with antibiotics within 24h in mastitis?
Candida albicans
Which type of bacteria are associated with bacterial vaginosis?
Gram-variable bacteria
What is a key factor contributing to the emergence of 'superbugs' like MRSA?
Rapidly increasing antibiotic resistance
What is a recommended way to avoid antibiotic resistance?
Appropriate use of antibiotics and completing the entire course of treatment
What is essential for determining the most effective antibiotic for treatment?
Culture and sensitivity tests
What are the mechanisms of antibiotic resistance?
Enzymatic inactivation of antibiotics, decreased antibiotic uptake, increased antibiotic efflux, and modification of antibiotic targets
What are the two main types of antibiotic action?
Bacteriocidal and bacteriostatic
Which type of antibiotics inhibit cell wall synthesis by targeting the peptidoglycan cell wall?
Penicillin G, amoxicillin, and cephalosporins
Which antibiotics bind to the 50s ribosomal subunit, preventing translocation of amino acids?
Clindamycin and erythromycin
Which enzymes do DNA synthesis inhibitors like fluoroquinolones target?
DNA gyrase
What do bacteria use to make their own folic acid?
P-aminobenzoic acid (PABA)
What is the primary factor influencing the selection of antibiotic treatment?
Identity of the organism
What is the characteristic of heat in the affected area in mastitis?
Warm to the touch
Which type of bacteria are associated with bacterial vaginosis?
Anaerobic
What is the common cause of unresolved engorgement or plugged duct in mastitis?
Yeast Infection
What do bacteria use to make their own folic acid?
PABA
What is the main factor influencing the safety of the agent when selecting antibiotic treatment?
Client factors
What is the primary purpose of the All Purpose Nipple Ointment mentioned in the text?
To treat nipple pain
What is a recommended way to avoid antibiotic resistance?
Taking antibiotics only when necessary
What is essential for determining the most effective antibiotic for treatment?
Susceptibility testing
What is the location of inflammation in the case of mastitis?
Mammary glands
What is the characteristic of pain experienced in mastitis?
Intense but often diffuse
What is the onset of symptoms for mastitis?
Sudden – from 7d to several weeks postpartum
What organism almost always causes bacterial breast infection leading to mastitis?
Staphylococcus aureus
Which type of milk is associated with infected breast milk in the case of mastitis?
Green milk
What may lead to an abscess that needs to be surgically drained if left untreated in mastitis?
Bacterial breast infection
Which of the following is a common cause of mastitis?
Improper latching
What may be the cause of infections that don’t resolve with antibiotics within 24h in mastitis?
Candida albicans infection
What is a recommended way to avoid antibiotic resistance?
Using antibiotics only when necessary
What is the location of inflammation in the case of mastitis?
Unilateral
What type of bacteria has a thicker layer of peptidoglycan and no outer lipid layer?
Gram-positive bacteria
Which of the following is a method to avoid antibiotic resistance?
Completing the entire course of antibiotic treatment
What is the primary target of protein synthesis inhibitors like clindamycin and erythromycin?
50s ribosomal subunit
What is the primary mechanism of antibiotic resistance due to alterations in bacterial DNA?
Horizontal gene transfer
Which type of bacteria are associated with bacterial vaginosis?
Gram-positive bacteria
Which enzyme do DNA synthesis inhibitors like fluoroquinolones target?
DNA gyrase
What is the primary characteristic of bacteriostatic antibiotics?
They stop the growth or division of bacteria
Which antibiotics inhibit cell wall synthesis by targeting the peptidoglycan cell wall?
Amoxicillin
What is the primary cause of the emergence of 'superbugs' like MRSA?
Overuse of broad-spectrum antibiotics
What is the primary target of fluoroquinolones, a type of DNA synthesis inhibitor?
DNA gyrase
What is the primary purpose of culture and sensitivity tests in antibiotic treatment?
To identify the bacteria causing the infection
What is the primary factor to consider when selecting antibiotic treatment?
Identity of the organism
Which type of bacteria has an outer lipid layer that makes it harder for antibiotics to penetrate?
Gram-negative bacteria
What is the primary purpose of the All Purpose Nipple Ointment mentioned in the text?
To treat nipple pain and inflammation
What legislation allows midwives to prescribe drugs for various conditions?
Midwifery Drug Legislation 884/93
What makes Gram-negative bacteria more resistant to certain antibiotics?
Outer lipid layer with LPS
What is essential for determining the most effective antibiotic for treatment?
Identity of the organism
What may lead to an abscess that needs to be surgically drained if left untreated in mastitis?
Unresolved infection
Which enzyme do DNA synthesis inhibitors like fluoroquinolones target?
DNA gyrase/topoisomerase
What is the primary characteristic of bacteriostatic antibiotics?
They inhibit bacterial growth
What do bacteria use to make their own folic acid?
Dihydropteroate synthase
What is the primary cause of mastitis?
Bacterial breast infection
What may lead to an abscess that needs to be surgically drained if left untreated in mastitis?
Bacterial breast infection
What is the characteristic of pain experienced in mastitis?
Intense but often diffuse
What is the onset of symptoms for mastitis?
Gradual - from 7d to several weeks postpartum
What type of bacteria are almost always associated with bacterial breast infection causing mastitis?
Staphylococcus aureus
What is the common cause of unresolved engorgement or plugged duct in mastitis?
Improper latching
Which type of milk is associated with infected breast milk in the case of mastitis?
Green liquid
What is the characteristic of heat in the affected area in mastitis?
Hot, red, and swollen
What is a recommended way to avoid antibiotic resistance in the context of mastitis treatment?
Proper antibiotic selection based on culture and sensitivity testing
What may be the cause of infections that don’t resolve with antibiotics within 24 hours in mastitis?
Candida albicans
What are the primary mechanisms of antibiotic resistance?
Enzymatic inactivation of antibiotics, decreased antibiotic uptake, increased antibiotic efflux, and modification of antibiotic targets
Which type of antibiotics inhibit cell wall synthesis by targeting the peptidoglycan cell wall?
Penicillin G, amoxicillin, and cephalosporins
What is the primary target of fluoroquinolones, a type of DNA synthesis inhibitor?
DNA gyrase
What do bacteria use to make their own folic acid?
P-aminobenzoic acid (PABA)
What are the modes of antibiotic action mentioned in the text?
Cell wall synthesis inhibitors, protein synthesis inhibitors, and DNA synthesis inhibitors
What is the primary characteristic of bacteriostatic antibiotics?
Stopping bacterial growth or division
What is essential for determining the most effective antibiotic for treatment?
Culture and sensitivity tests
What may lead to an abscess that needs to be surgically drained if left untreated in mastitis?
Infections that don’t resolve with antibiotics within 24h
What is the primary cause of the emergence of 'superbugs' like MRSA?
Rapidly increasing antibiotic resistance
What is a recommended way to avoid antibiotic resistance?
Appropriate use of antibiotics, starting with narrow-spectrum antibiotics, and completing the entire course of treatment
What percentage of breastfeeding women experience infective mastitis?
10%
Why is mastitis typically assumed to be of bacterial origin?
It is difficult to distinguish between infective and noninfective mastitis
What is the primary treatment for infective mastitis?
Oral antibiotics
Why is breastfeeding encouraged during mastitis treatment?
To prevent milk stasis
When is breastfeeding not encouraged during mastitis treatment?
When the mother is at less than three months postpartum
What is Amoxicillin–Clavulanic Acid?
A combination of penicillin and clavulanic acid
Why is culturing of milk considered difficult?
Milk has normal colonization of bacteria
When would therapy for infective mastitis likely commence?
Before the laboratory results of the culture and sensitivity tests are received
When is culturing of milk useful in mastitis treatment?
When antibiotic resistance is possible
What is a key part of mastitis treatment?
Frequent draining of the breast through feeding or pumping
Why is it difficult to distinguish between infective and noninfective mastitis?
They have similar symptoms
What is the primary cause of mastitis?
Bacterial infection
Which antibiotic may be used as an alternative if clindamycin cannot be used for infective mastitis treatment?
Ciprofloxacin
What is the primary source of bacterial resistance in infective mastitis, justifying the use of clavulanic acid with amoxicillin?
β-lactamase made by Staphylococcus
What is the contraindication associated with sulfamethoxazole-trimethoprim in the context of infective mastitis treatment?
Contraindicated during the first three months of breastfeeding
What is the primary factor that justifies the use of clavulanic acid in combination with amoxicillin for infective mastitis treatment?
Extended spectrum of amoxicillin
Which antibiotic is a suitable alternative for patients allergic to penicillins in the context of infective mastitis treatment?
Cephalexin
What is the primary factor that justifies the use of cloxacillin for infective mastitis treatment?
Resistance to β-lactamase
In which situation is Clindamycin a preferred option for infective mastitis treatment?
Patients with serious hypersensitivity reactions to β-lactam antibiotics
What is the primary characteristic of All Purpose Nipple Ointment (APNO) used for nipple infections in the context of mastitis treatment?
Contains mupirocin, betamethasone valerate, and miconazole
Which antibiotic is mentioned as more effective than erythromycin for infective mastitis treatment?
Clindamycin
What is the primary characteristic of Cephalexin in the context of infective mastitis treatment?
First-generation oral cephalosporin
What is the primary factor that justifies the use of amoxicillin monotherapy for infective mastitis treatment?
Effectiveness
What is the primary reason for treating mastitis as of bacterial origin?
Due to the difficulty in distinguishing between infective and noninfective mastitis
When is breastfeeding not encouraged during infective mastitis treatment?
When the mother is at less than three months postpartum
What is the main reason for encouraging breastfeeding during mastitis treatment?
To reduce the risk of abscess formation in the breast
What is the primary component of Amoxicillin–Clavulanic Acid?
Amoxicillin and clavulanic acid
When is culturing of milk useful in infective mastitis treatment?
When antibiotic resistance is possible
What is the characteristic of pain experienced in mastitis?
Dull, diffuse pain
What is the common cause of unresolved engorgement or plugged duct in mastitis?
Poor breastfeeding technique
What is the primary factor to consider when selecting antibiotic treatment for mastitis?
The severity of the infection
What may lead to an abscess that needs to be surgically drained if left untreated in mastitis?
Untreated infection
What is the primary characteristic of Cephalexin in the context of infective mastitis treatment?
It is safe for breastfeeding mothers
What is the primary cause of infective mastitis?
Bacterial infection
What is the primary reason for treating infective mastitis with oral antibiotics before receiving culture and sensitivity test results?
Due to the difficulty in distinguishing between infective and noninfective mastitis
Which antibiotic is often used in combination with clavulanic acid to treat infective mastitis?
Amoxicillin
What is the main source of bacterial resistance in infective mastitis, justifying the use of clavulanic acid?
β-lactamase made by Staphylococcus
Which antibiotic can be used as an alternative for patients allergic to penicillins in the context of infective mastitis treatment?
Cephalexin
Which antibiotic is used to treat infective mastitis when there are serious hypersensitivity reactions to β-lactam antibiotics?
Clindamycin
Which antibiotic may be effective for antibiotic-resistant Staphylococcus aureus infective mastitis, but is contraindicated during the first three months of breastfeeding?
Sulfamethoxazole-trimethoprim
What is the primary characteristic of amoxicillin in the context of infective mastitis treatment?
Extended-spectrum penicillin
What is the primary characteristic of cloxacillin in the context of infective mastitis treatment?
β-lactamase resistant
What is the primary characteristic of cephalexin in the context of infective mastitis treatment?
First-generation oral cephalosporin
What is the primary reason for using clindamycin to treat infective mastitis?
Serious hypersensitivity reactions to β-lactam antibiotics
What is the primary reason for not using ciprofloxacin as the preferred choice for treating infective mastitis?
Poor activity against Staphylococcus aureus
What is the primary characteristic of sulfamethoxazole-trimethoprim in the context of infective mastitis treatment?
Contraindicated during the first three months of breastfeeding
Which type of bacteria has an outer lipid layer that makes it harder for antibiotics to penetrate?
Gram-negative
What is the most common mechanism of antibiotic resistance?
Enzymatic inactivation of antibiotic
How do Gram-negative organisms resist some antibiotics?
Decrease number of porins
Which type of gene transfer involves bacteriophages?
Transduction
What is the primary way in which drug resistance genes are often coded?
Plasmid DNA
Which antibiotic resistance mechanism involves energy-dependent pumps transporting the drug out of cells?
Increased antibiotic efflux
Which type of bacteria stains pink in the Gram stain?
Gram-negative
What type of gene transfer involves pieces of DNA taken up from the external environment?
Transformation
Which antibiotic resistance mechanism involves receptors for drugs, target molecules, and enzymes being modified?
Modification of antibiotic targets
What is the primary characteristic of Gram-positive bacteria?
Thick layer of peptidoglycan
Which antibiotic inhibits the formation of peptide cross-bridges in the peptidoglycan cell wall of bacteria?
Amoxicillin
Which antibiotic is a prodrug that, when activated by susceptible bacteria, inhibits bacterial DNA synthesis?
Nitrofurantoin
Which antibiotic binds at the 50s ribosomal subunit, preventing the translocation of amino acids?
Erythromycin
Which antibiotic works by inhibiting the enzyme responsible for relaxing/uncoiling DNA so it can be replicated?
Ciprofloxacin
Which antibiotic is best for Gram+ cocci, followed by Gram- like N. gonorrheae, and then others like Treponema pallidum?
Amoxicillin
Which antibiotic has similar activity to Penicillin G, plus E. coli and Klebsiella pneumoniae, and some others?
Cephalexin
Which antibiotic does not have the beta-lactam ring but is also a cell wall synthesis inhibitor?
Vancomycin
Which antibiotic is contraindicated during the first three months of breastfeeding?
Ciprofloxacin
Which antibiotic is a beta-lactam antibiotic and is best for Gram+ cocci, followed by Gram- like N. gonorrheae, and then others like Treponema pallidum?
Penicillin G
Which antibiotic is good for some Gram- (like bacilli) and has similar activity to Penicillin G?
Amoxicillin
Which antibiotic is an intermediate spectrum antibiotic similar to Penicillin G?
Amoxicillin
What is the primary characteristic of LPS in Gram-negative bacteria?
It has an outer lipid layer that makes it harder for antibiotics to penetrate
Which type of gene transfer involves direct cell-to-cell contact via a pilus?
Conjugation
What is the most common mechanism of antibiotic resistance?
Enzymatic Inactivation of Antibiotic
Which mechanism of antibiotic resistance involves energy-dependent pumps transporting the drug out of cells?
Increased Antibiotic Efflux
What is the primary characteristic of Gram-positive bacteria?
They have a thick layer of peptidoglycan
Which type of bacteria are resistant to some antibiotics due to the inability of drugs to penetrate their outer cell membrane?
Gram-negative organisms
Which type of bacteria are more susceptible to certain antibiotics like penicillin?
Gram-positive bacteria
Which antibiotic resistance mechanism involves the modification of antibiotic targets such as receptors, target molecules, and enzymes?
Modification of Antibiotic Targets
What is the primary characteristic of Gram-negative bacteria in the context of Gram staining?
They have an outer lipid layer that makes them harder for antibiotics to penetrate
Which antibiotic resistance mechanism involves bacteria making enzymes that metabolize antibiotics?
Enzymatic Inactivation of Antibiotic
Which enzyme do beta-lactam antibiotics like penicillins and cephalosporins inhibit?
Transpeptidase
Which antibiotic is a cell wall synthesis inhibitor but does not have the beta-lactam ring?
Vancomycin
Which antibiotic is best for Gram-positive cocci like Streptococcus and Staphylococcus spp?
Amoxicillin
Which antibiotic inhibits DNA synthesis by getting inside bacteria via porins and inhibiting DNA gyrase?
Ciprofloxacin
Which antibiotic is a prodrug that inhibits bacterial DNA synthesis by producing reactive intermediates when activated by susceptible bacteria?
Nitrofurantoin
Which antibiotic binds at the 50s ribosomal subunit and inhibits the growth of peptides by preventing the translocation of amino acids?
Clindamycin
Which antibiotic is good for some Gram-negative bacteria like E. coli and Klebsiella pneumoniae, in addition to having similar activity to Penicillin G?
Cephalexin
Which antibiotic is a cell wall synthesis inhibitor that does not have the beta-lactam ring and can work against bacteria when resistance to other antibiotics has developed?
Vancomycin
Which antibiotic is best for Gram-positive cocci like Streptococcus and Staphylococcus spp, and then for Gram-negative bacteria like N. gonorrheae?
Amoxicillin
Which antibiotic inhibits protein synthesis by blocking tRNA synthesis?
Mupirocin
Which antibiotic inhibits the formation of peptide cross-bridges in the peptidoglycan cell wall of bacteria?
Amoxicillin
What is the primary target of beta-lactam antibiotics like penicillins and cephalosporins?
Inhibit cell wall synthesis
Which antibiotic is a cell wall synthesis inhibitor and is effective against Gram-positive cocci like Streptococcus and Staphylococcus species?
Amoxicillin
Which antibiotic inhibits DNA synthesis by targeting DNA gyrase, the enzyme responsible for relaxing/uncoiling DNA in bacteria?
Ciprofloxacin
Which antibiotic blocks protein synthesis by binding at the 50s ribosomal subunit and preventing the translocation of amino acids?
Erythromycin
Which antibiotic is not a beta-lactam antibiotic but still functions as a cell wall synthesis inhibitor and can work against antibiotic-resistant bacteria?
Vancomycin
Which enzyme do fluoroquinolones like ciprofloxacin inhibit to prevent bacterial DNA synthesis?
DNA gyrase
Which antibiotic is preferred for infective mastitis treatment due to its activity against Gram-positive cocci and some Gram-negative bacteria like E. coli and Klebsiella pneumoniae?
Cefazolin
Which antibiotic is a protein synthesis inhibitor that works by blocking tRNA synthesis?
Mupirocin
Which antibiotic is a prodrug that, when activated, inhibits bacterial DNA synthesis by producing reactive intermediates with multiple functions?
Nitrofurantoin
Which class of antibiotics inhibits the formation of the peptide cross-bridges in the peptidoglycan cell wall of bacteria?
Beta-lactams
Which antibiotic is suitable for infective mastitis treatment and is a cell wall synthesis inhibitor that does not have the beta-lactam ring?
Vancomycin
What is the primary difference between Gram-negative and Gram-positive bacteria in terms of cell wall structure?
Gram-negative bacteria have a thin layer of peptidoglycan and an outer lipid layer, while Gram-positive bacteria have a thick layer of peptidoglycan but no outer lipid layer.
Which mechanism of antibiotic resistance involves bacteria making enzymes that metabolize antibiotics?
Enzymatic inactivation of antibiotic
How do Gram-negative organisms resist some antibiotics?
By decreasing the number of porins, which reduces antibiotic uptake
In which type of gene transfer are pieces of DNA taken up from the external environment?
Transformation
What is the primary way in which drug resistance genes are often coded?
On plasmid DNA
Which antibiotic resistance mechanism involves energy-dependent pumps transporting the drug out of cells?
Increased antibiotic efflux
Which antibiotic is an example of a β-lactamase inhibitor?
Clavulanic acid
What is the primary method of gene transfer when bacteriophages perform the gene transfer?
Transduction
Which antibiotic inhibits protein synthesis by blocking tRNA synthesis?
Clindamycin
What is the most common mechanism by which microbes become antibiotic resistant?
Taking on DNA from another, drug-resistant strain
Study Notes
Understanding Antibiotic Resistance
- Gram-variable bacteria like Mobiluncus spp. and Gardnerella vaginalis are associated with bacterial vaginosis.
- Antibiotic resistance is rapidly increasing, leading to the emergence of "superbugs" such as MRSA.
- Ways to avoid antibiotic resistance include appropriate use of antibiotics, starting with narrow-spectrum antibiotics, and completing the entire course of treatment.
- Culture and sensitivity tests are essential for determining the most effective antibiotic for treatment.
- Antibiotic resistance occurs due to alterations in bacterial DNA, including mutations and horizontal gene transfer.
- Resistance mechanisms include enzymatic inactivation of antibiotics, decreased antibiotic uptake, increased antibiotic efflux, and modification of antibiotic targets.
- Antibiotics can be bacteriocidal, directly killing bacteria, or bacteriostatic, stopping their growth or division.
- Modes of antibiotic action include cell wall synthesis inhibitors like beta-lactam antibiotics, protein synthesis inhibitors, and DNA synthesis inhibitors like fluoroquinolones.
- Antibiotics such as penicillin G, amoxicillin, and cephalosporins inhibit cell wall synthesis by targeting the peptidoglycan cell wall.
- Protein synthesis inhibitors like clindamycin and erythromycin bind to the 50s ribosomal subunit, preventing translocation of amino acids.
- DNA synthesis inhibitors, such as fluoroquinolones, inhibit DNA synthesis by targeting enzymes like DNA gyrase.
- Folate synthesis inhibitors target the same principle as in humans, but bacteria make their own folic acid using p-aminobenzoic acid (PABA).
Understanding Antibiotic Resistance
- Gram-variable bacteria like Mobiluncus spp. and Gardnerella vaginalis are associated with bacterial vaginosis.
- Antibiotic resistance is rapidly increasing, leading to the emergence of "superbugs" such as MRSA.
- Ways to avoid antibiotic resistance include appropriate use of antibiotics, starting with narrow-spectrum antibiotics, and completing the entire course of treatment.
- Culture and sensitivity tests are essential for determining the most effective antibiotic for treatment.
- Antibiotic resistance occurs due to alterations in bacterial DNA, including mutations and horizontal gene transfer.
- Resistance mechanisms include enzymatic inactivation of antibiotics, decreased antibiotic uptake, increased antibiotic efflux, and modification of antibiotic targets.
- Antibiotics can be bacteriocidal, directly killing bacteria, or bacteriostatic, stopping their growth or division.
- Modes of antibiotic action include cell wall synthesis inhibitors like beta-lactam antibiotics, protein synthesis inhibitors, and DNA synthesis inhibitors like fluoroquinolones.
- Antibiotics such as penicillin G, amoxicillin, and cephalosporins inhibit cell wall synthesis by targeting the peptidoglycan cell wall.
- Protein synthesis inhibitors like clindamycin and erythromycin bind to the 50s ribosomal subunit, preventing translocation of amino acids.
- DNA synthesis inhibitors, such as fluoroquinolones, inhibit DNA synthesis by targeting enzymes like DNA gyrase.
- Folate synthesis inhibitors target the same principle as in humans, but bacteria make their own folic acid using p-aminobenzoic acid (PABA).
Understanding Antibiotic Resistance
- Gram-variable bacteria like Mobiluncus spp. and Gardnerella vaginalis are associated with bacterial vaginosis.
- Antibiotic resistance is rapidly increasing, leading to the emergence of "superbugs" such as MRSA.
- Ways to avoid antibiotic resistance include appropriate use of antibiotics, starting with narrow-spectrum antibiotics, and completing the entire course of treatment.
- Culture and sensitivity tests are essential for determining the most effective antibiotic for treatment.
- Antibiotic resistance occurs due to alterations in bacterial DNA, including mutations and horizontal gene transfer.
- Resistance mechanisms include enzymatic inactivation of antibiotics, decreased antibiotic uptake, increased antibiotic efflux, and modification of antibiotic targets.
- Antibiotics can be bacteriocidal, directly killing bacteria, or bacteriostatic, stopping their growth or division.
- Modes of antibiotic action include cell wall synthesis inhibitors like beta-lactam antibiotics, protein synthesis inhibitors, and DNA synthesis inhibitors like fluoroquinolones.
- Antibiotics such as penicillin G, amoxicillin, and cephalosporins inhibit cell wall synthesis by targeting the peptidoglycan cell wall.
- Protein synthesis inhibitors like clindamycin and erythromycin bind to the 50s ribosomal subunit, preventing translocation of amino acids.
- DNA synthesis inhibitors, such as fluoroquinolones, inhibit DNA synthesis by targeting enzymes like DNA gyrase.
- Folate synthesis inhibitors target the same principle as in humans, but bacteria make their own folic acid using p-aminobenzoic acid (PABA).
Treatment Options for Infective Mastitis
- Amoxicillin is often used in combination with the β-lactamase inhibitor clavulanic acid to treat infective mastitis, as it is an extended-spectrum penicillin.
- The addition of clavulanic acid extends the spectrum of amoxicillin, although it may increase the likelihood of gastrointestinal upset.
- Amoxicillin monotherapy is often effective, but the main source of bacterial resistance is a β-lactamase made by Staphylococcus, justifying the use of clavulanic acid.
- Cloxacillin, a penicillin that is β-lactamase resistant and has a narrow spectrum of action, can also be used to treat mastitis.
- Cephalexin, a first-generation oral cephalosporin, is a suitable alternative for patients allergic to penicillins, with a moderately broad spectrum of action.
- Clindamycin is an option for individuals with serious hypersensitivity reactions to β-lactam antibiotics, although it may cause more gastrointestinal side effects.
- Ciprofloxacin may be used as an alternative if clindamycin cannot be used, but it is not the preferred choice due to its poor activity against Staphylococcus aureus and streptococci.
- Sulfamethoxazole-trimethoprim may be effective for antibiotic-resistant Staphylococcus aureus infective mastitis, but is contraindicated during the first three months of breastfeeding.
- All Purpose Nipple Ointment (APNO) containing mupirocin, betamethasone valerate, and miconazole can be prescribed for nipple infections, and ibuprofen powder can be added.
- Amoxicillin, like ampicillin, is an extended-spectrum penicillin, and gastrointestinal upset can be expected.
- Cephalexin is an oral drug similar to cefazolin, which is given intravenously, and has the same side effects and drug interactions.
- Clindamycin is used to treat infective mastitis when there are serious hypersensitivity reactions to β-lactam antibiotics and is more effective than erythromycin, to which there is widespread bacterial resistance.
Treatment Options for Infective Mastitis
- Amoxicillin is often used in combination with the β-lactamase inhibitor clavulanic acid to treat infective mastitis, as it is an extended-spectrum penicillin.
- The addition of clavulanic acid extends the spectrum of amoxicillin, although it may increase the likelihood of gastrointestinal upset.
- Amoxicillin monotherapy is often effective, but the main source of bacterial resistance is a β-lactamase made by Staphylococcus, justifying the use of clavulanic acid.
- Cloxacillin, a penicillin that is β-lactamase resistant and has a narrow spectrum of action, can also be used to treat mastitis.
- Cephalexin, a first-generation oral cephalosporin, is a suitable alternative for patients allergic to penicillins, with a moderately broad spectrum of action.
- Clindamycin is an option for individuals with serious hypersensitivity reactions to β-lactam antibiotics, although it may cause more gastrointestinal side effects.
- Ciprofloxacin may be used as an alternative if clindamycin cannot be used, but it is not the preferred choice due to its poor activity against Staphylococcus aureus and streptococci.
- Sulfamethoxazole-trimethoprim may be effective for antibiotic-resistant Staphylococcus aureus infective mastitis, but is contraindicated during the first three months of breastfeeding.
- All Purpose Nipple Ointment (APNO) containing mupirocin, betamethasone valerate, and miconazole can be prescribed for nipple infections, and ibuprofen powder can be added.
- Amoxicillin, like ampicillin, is an extended-spectrum penicillin, and gastrointestinal upset can be expected.
- Cephalexin is an oral drug similar to cefazolin, which is given intravenously, and has the same side effects and drug interactions.
- Clindamycin is used to treat infective mastitis when there are serious hypersensitivity reactions to β-lactam antibiotics and is more effective than erythromycin, to which there is widespread bacterial resistance.
Test your knowledge of antibiotic resistance with this quiz covering topics such as bacterial vaginosis, superbugs like MRSA, ways to avoid resistance, resistance mechanisms, modes of antibiotic action, and specific antibiotics and their targets.
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