Podcast
Questions and Answers
Which type of bacterial infections are indicated for use of natural penicillins?
Which type of bacterial infections are indicated for use of natural penicillins?
- Anthrax and gas gangrene (correct)
- Skin infections caused by fungi
- Genital infections
- Upper respiratory tract infections
What is the primary use of aminopenicillins?
What is the primary use of aminopenicillins?
- Prophylaxis of bacterial endocarditis
- Infections due to Pseudomonas aeruginosa
- Managing meningitis with H.influenzae (correct)
- Treating syphilis
Which aminoglycosides are commonly used in combination with carboxypenicillins for nosocomial infections?
Which aminoglycosides are commonly used in combination with carboxypenicillins for nosocomial infections?
- Streptomycin and tetracycline
- Neomycin and spectinomycin
- Gentamicin and amikacin (correct)
- Chloramphenicol and erythromycin
Which of the following is a common indication for semisynthetic penicillins?
Which of the following is a common indication for semisynthetic penicillins?
What distinguishes the use of oxacillin group semisynthetic penicillins?
What distinguishes the use of oxacillin group semisynthetic penicillins?
What type of bacteria do aminoglycosides primarily target?
What type of bacteria do aminoglycosides primarily target?
Which infection is treated with natural penicillins in high doses as monotherapy?
Which infection is treated with natural penicillins in high doses as monotherapy?
Which microorganism is associated with the use of aminoglycosides in combination with carboxypenicillins?
Which microorganism is associated with the use of aminoglycosides in combination with carboxypenicillins?
What is a primary indication for Cefazolin?
What is a primary indication for Cefazolin?
Which bacterial infection is Ceftriaxone indicated for?
Which bacterial infection is Ceftriaxone indicated for?
What condition is Ceftazidime mainly used to treat?
What condition is Ceftazidime mainly used to treat?
Which generation of cephalosporins is Cefixime classified under?
Which generation of cephalosporins is Cefixime classified under?
Cefoperazone is primarily utilized for treating what types of infections?
Cefoperazone is primarily utilized for treating what types of infections?
Cephalexin is an alternative treatment for which condition?
Cephalexin is an alternative treatment for which condition?
What is one of the suggested usages for second generation cephalosporins in parenteral forms?
What is one of the suggested usages for second generation cephalosporins in parenteral forms?
For which infection type is Cefixime indicated?
For which infection type is Cefixime indicated?
What is a potential consequence of long-term treatment with high doses of tetracyclines in children?
What is a potential consequence of long-term treatment with high doses of tetracyclines in children?
Which adverse effect is specifically associated with photosensitivity due to tetracyclines?
Which adverse effect is specifically associated with photosensitivity due to tetracyclines?
What condition may result from the combination of tetracyclines and diuretics?
What condition may result from the combination of tetracyclines and diuretics?
What is the primary disorder linked to nephrotoxic effects of tetracyclines?
What is the primary disorder linked to nephrotoxic effects of tetracyclines?
Which of the following is a key reason why tetracyclines are contraindicated in pregnant women?
Which of the following is a key reason why tetracyclines are contraindicated in pregnant women?
What type of discoloration can tetracyclines cause in developing teeth?
What type of discoloration can tetracyclines cause in developing teeth?
Which adverse effect is most likely from the intravenous administration of tetracyclines?
Which adverse effect is most likely from the intravenous administration of tetracyclines?
What is a primary indication for chloramphenicol use?
What is a primary indication for chloramphenicol use?
Which of the following is NOT an adverse effect associated with amphenicols?
Which of the following is NOT an adverse effect associated with amphenicols?
What is a common gastrointestinal adverse effect associated with tetracyclines?
What is a common gastrointestinal adverse effect associated with tetracyclines?
In which condition might chloramphenicol be used as an alternative treatment?
In which condition might chloramphenicol be used as an alternative treatment?
Which of the following severe infections is chloramphenicol indicated for?
Which of the following severe infections is chloramphenicol indicated for?
What is a potential neurological adverse effect of amphenicols?
What is a potential neurological adverse effect of amphenicols?
Which organism is specifically mentioned as being susceptible to chloramphenicol treatment?
Which organism is specifically mentioned as being susceptible to chloramphenicol treatment?
What condition is a risk factor for hemolytic anemia when using amphenicols?
What condition is a risk factor for hemolytic anemia when using amphenicols?
What is a common symptom of gray baby syndrome linked to chloramphenicol?
What is a common symptom of gray baby syndrome linked to chloramphenicol?
Which condition is NOT treated with ansamycins?
Which condition is NOT treated with ansamycins?
What is a potential adverse effect of ansamycins?
What is a potential adverse effect of ansamycins?
Which type of infections are glycopeptides commonly used to treat?
Which type of infections are glycopeptides commonly used to treat?
In combination with which antibiotic is glycopeptide used for treating infective endocarditis caused by E.faecalis?
In combination with which antibiotic is glycopeptide used for treating infective endocarditis caused by E.faecalis?
Which is NOT a recommended use of ansamycins?
Which is NOT a recommended use of ansamycins?
Which adverse effect is associated with ansamycins rather than glycopeptides?
Which adverse effect is associated with ansamycins rather than glycopeptides?
Which infection is NOT typically treated with glycopeptides?
Which infection is NOT typically treated with glycopeptides?
What is an indication for the use of ansamycins?
What is an indication for the use of ansamycins?
Which condition is NOT treated with Lincosamides?
Which condition is NOT treated with Lincosamides?
What is one of the main adverse reactions associated with Aminoglycosides?
What is one of the main adverse reactions associated with Aminoglycosides?
Which drug is indicated for tuberculosis treatment among the Aminoglycosides?
Which drug is indicated for tuberculosis treatment among the Aminoglycosides?
Which infection is treated with Lincosamides in association with pyrimethamine?
Which infection is treated with Lincosamides in association with pyrimethamine?
What type of lesions can Aminoglycosides cause?
What type of lesions can Aminoglycosides cause?
Which combination is NOT commonly used for enterococcal infections?
Which combination is NOT commonly used for enterococcal infections?
Which skin condition can Lincosamides be used to treat topically?
Which skin condition can Lincosamides be used to treat topically?
What is a significant risk of Aminoglycoside use in patients with fever and leukopenia?
What is a significant risk of Aminoglycoside use in patients with fever and leukopenia?
Flashcards
Gram-positive cocci
Gram-positive cocci
Bacteria that stain purple in the Gram stain and are spherical in shape.
Gram-negative cocci
Gram-negative cocci
Bacteria that stain pink in the Gram stain, spherical in shape.
Aminoglycosides
Aminoglycosides
A class of antibiotics that are effective against various bacteria, often used in combination.
Penicillins (natural)
Penicillins (natural)
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Semisynthetic Penicillins
Semisynthetic Penicillins
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Broad-spectrum antibiotics
Broad-spectrum antibiotics
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Nosocomial infections
Nosocomial infections
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Indications for penicillin
Indications for penicillin
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Cefazolin indication
Cefazolin indication
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Cephalexin indication
Cephalexin indication
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2nd generation cephalosporins, parenteral
2nd generation cephalosporins, parenteral
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2nd generation cephalosporins, peroral
2nd generation cephalosporins, peroral
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3rd generation cephalosporins: Cefotaxime, ceftriaxone - outpatient
3rd generation cephalosporins: Cefotaxime, ceftriaxone - outpatient
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3rd generation cephalosporins: Cefotaxime, ceftriaxone - severe outpatient and nosocomial
3rd generation cephalosporins: Cefotaxime, ceftriaxone - severe outpatient and nosocomial
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3rd generation cephalosporins: Ceftazidime, cefoperazona
3rd generation cephalosporins: Ceftazidime, cefoperazona
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3rd generation cephalosporins: Cefixime, ceftibuten
3rd generation cephalosporins: Cefixime, ceftibuten
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Tetracycline Adverse Effects: Liver
Tetracycline Adverse Effects: Liver
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Tetracycline Adverse Effects: Kidney
Tetracycline Adverse Effects: Kidney
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Tetracycline Adverse Effects: Bones & Teeth
Tetracycline Adverse Effects: Bones & Teeth
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Tetracycline Contraindications
Tetracycline Contraindications
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Tetracycline Adverse Effects: Photosensitivity
Tetracycline Adverse Effects: Photosensitivity
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Tetracycline Adverse Effects: Vestibular System
Tetracycline Adverse Effects: Vestibular System
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Tetracycline Adverse Effects: Local Toxicity
Tetracycline Adverse Effects: Local Toxicity
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Tetracycline Adverse Effects: Other
Tetracycline Adverse Effects: Other
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Lincosamides: What are they used for?
Lincosamides: What are they used for?
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Lincosamides: What is a potential side effect?
Lincosamides: What is a potential side effect?
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Aminoglycosides: Their key roles
Aminoglycosides: Their key roles
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Aminoglycosides: When are they often combined?
Aminoglycosides: When are they often combined?
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Aminoglycosides: Potential side effects?
Aminoglycosides: Potential side effects?
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Streptomycin: What is its primary use?
Streptomycin: What is its primary use?
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Aminoglycosides: Intestinal decontamination?
Aminoglycosides: Intestinal decontamination?
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Aminoglycosides: Type of damage caused?
Aminoglycosides: Type of damage caused?
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Chloramphenicol Use
Chloramphenicol Use
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Chloramphenicol Side Effects
Chloramphenicol Side Effects
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Gray Baby Syndrome
Gray Baby Syndrome
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Ansamycins Spectrum
Ansamycins Spectrum
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Ansamycins: Gram-Positive
Ansamycins: Gram-Positive
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Ansamycins: Gram-Negative
Ansamycins: Gram-Negative
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Ansamycins: Mycobacterium
Ansamycins: Mycobacterium
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Ansamycins: Gram-Positive Bacilli
Ansamycins: Gram-Positive Bacilli
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Ansamycins: What are they used for?
Ansamycins: What are they used for?
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What are some adverse effects of Ansamycins?
What are some adverse effects of Ansamycins?
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Glycopeptides: Main uses?
Glycopeptides: Main uses?
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When are Glycopeptides used for MRSA?
When are Glycopeptides used for MRSA?
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Glycopeptides for Enterococci?
Glycopeptides for Enterococci?
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What is the role of Glycopeptides in infective endocarditis?
What is the role of Glycopeptides in infective endocarditis?
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Glycopeptides: Role in severe infections?
Glycopeptides: Role in severe infections?
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Glycopeptides: Other important uses?
Glycopeptides: Other important uses?
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Study Notes
Antibiotics
- Antibiotics are natural byproducts of fungi, actinomycetes, and bacteria, or semisynthetic/synthetic derivatives that selectively kill or inhibit bacterial growth in a diluted form.
Beta-Lactama Antibiotics
-
Biosynthetic Penicillins:
-
Benzylpenicillin
-
Benzathine benzylpenicillin (extencilline, retarpen)
-
Procaine benzylpenicillin (bicilinele)
-
Phenoxymethylpenicillin (ospen)
-
Semisynthetic Penicillins:
-
Isozaxolyl penicillin (antistaphylococcal antibiotics)
-
oxacillin
-
cloxacillin
-
flucloxacillin
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dicloxacillin
-
nafcillin
-
Aminopenicillins:
-
ampicillin
-
amoxicillin
-
Carboxypenicillins:
-
Carbenicillin
-
Carfecillin
-
Carindacillin
-
Ticarcillin
-
Ureidopenicillins:
-
Mezlocillin
-
Azlocillin
-
Piperacillin
-
Other Beta-lactams:
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Mecillinam
-
Pivmecillinam
-
Temocillin
Cephalosporins
-
First-generation:
-
Cefazolin
-
Cefalexin
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Cefadroxil
-
Second-generation:
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Cefaclor
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Cefuroxime
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Cefamandole
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Cefotetan
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Cefotiam
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Cefonicid
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Cefoxitin
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Loracarbef
-
Third-generation:
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Ceftriaxone
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Cefotaxime
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Ceftazidime
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Cefoperazone
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Cefodizime
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Ceftizoxime
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Cefsulodin
-
Latamoxef
-
Fourth-generation:
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Cefepime
-
Cefpirome
-
Fifth-generation:
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Ceftobiprole
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Ceftaroline
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Ceftolozane
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Cefditoren
Other Antibiotic Classes
-
Aminoglycosides:
-
Generation I: Streptomycin, Neomycin, Kanamycin, Paromomycin
-
Generation II: Gentamicin, Tobramycin, Sisomicin
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Generation III: Amikacin, Netilmicin, Isepamicin
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Lincosamides:
-
Clindamycin
-
Lincomycin
-
Macrolides:
-
With 14-membered lactone rings: erythromycin, clarithromycin, roxithromycin, flurithromycin, davercin
-
With 15-membered lactone rings (azalides): azithromycin
-
With 16-membered lactone rings: spiramycin, josamycin, midecamycin, rokitamycin
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Ketolides: telithromycin
-
Tetracyclines:
-
Generation I: Tetracycline, Oxytetracycline, Rolitetracycline
-
Generation II: Doxycycline, Metacycline, Minocycline
-
Amphenicols:
-
Chloramphenicol
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Chloramphenicol hemisuccinate
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Tiamphenicol
-
Polymyxins:
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Polymyxin M
-
Colistin
-
Ansamycins:
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Rifampicin
-
Rifaximin
-
Rifamycin
-
Rifabutin
-
Glycopeptides:
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Vancomycin
-
Ristomycin
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Teicoplanin
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Lipoglycopeptides: Dalbavancin, oritavancin, telavancin, daptomycin
-
Others:
-
Nystatin
-
Levorin
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Amphotericin B
-
Griseofulvin
-
Natamycin
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Cycloserine
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Capreomycin
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Fosfomycin
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Fuzafungine
-
Bacitracin
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Mupirocin
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Gramicidin
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Fusidic acid
Classification of Antibiotics by Mechanism of Action
- I. Cell wall inhibitors: Beta-lactams, glycopeptides
- II. Membrane-active antibiotics: Polymyxins
- III. Protein synthesis inhibitors (30S subunit): Tetracyclines
- III. Protein synthesis inhibitors (50S subunit): Chloramphenicol, macrolides, lincosamides
- IV. Nucleic acid synthesis inhibitors: Ansamycins
Classification according to Spectrum of Action
- I. More potent influence on gram-positive flora
- II. More potent influence on gram-negative flora
- III. Broad spectrum
- IV. Ultra-broad spectrum
Classification According to Bactericidal/Bacteriostatic Effects
-
I. Bactericidal (irreversible intoxication of microbial germs)
-
II. Bacteriostatic (inhibition of germs multiplication)
Indications for Combination Antibiotic Therapy
- Empirical treatment: Unknown pathogen
- Polymicrobial infections
- Potentiation of the antibacterial effect: certain pathogens
- Prevention of bacterial resistance
Combination Antibiotic Therapy
- Most effective and recommended: Beta-lactams + aminoglycosides
- Allowed for spectrum extension:
- Beta-lactamics + macrolides, lincosamides
- Aminoglycosides + fluoroquinolones
- Macrolides, lincosamides + fluoroquinolones
- Tetracyclines + chloramphenicol + macrolides
- Tetracyclines + chloramphenicol + fluoroquinolones
- Aminoglycosides + tetracyclines
- Beta-lactams + fluoroquinolones
- Antagonistic combinations (not recommended)
- Prohibited combinations
Adverse Reactions of Antibiotics
- Site of administration: oral, i/m; i/v
- Toxic: nephrotoxicity, hepatotoxicity, ototoxicity
- Allergic: general, cutaneous-mucous, pulmonary
- Biological: dysmicrobisms, superinfections
- Bacteriological: Herxheimer's Phenomenon
- Metabolic: dysmetabolism, vitamin deficiency
- Embryo/fetotoxicity: in newborns & children
- Immunological Interference: relapses, reinfections, chronicity
- Drug interactions: with solvents & other antibiotics
- Other: "Red Man Syndrome"
Microbial Resistance
- Natural and acquired: Streptomycin, Penicillin
- Mechanisms of resistance
- Enzyme production
- Altered permeability
- Change in action site of the antibiotic
- Enzyme modification
- Efflux pumps.
Ways to Decrease Bacterial Resistance
- Use new enzyme-resistant antibiotics
- Synthesis of bacterial enzymes to inactivate substances
- Synthesis of new classes of antibiotics
- Use higher doses
- Exclusion of antibiotic use for a period
- Prohibition of unjustified antibiotic use
WHO Pathogens with Dangerous Resistance
- I. Very high: Acinetobacter, Pseudomonas, Enterobacteria
- II. High degree: Enterococcus, Staphylococcus, Helicobacter, Campylobacter, Salmonella
- III. Moderate: Streptococcus, Haemophilus, Shigella
Antistaphylococcal Antibiotics
- Sensitive to methicillin: Ist-line: oxacillin, dicloxacillin, flucloxacillin
- Reserve group: Vancomycin, IIIrd-IVth generation cephalosporins
- Resistant to methicillin: Ist line: Vancomycin
- Reserve group: teicoplanin, fluoroquinolones (levofloxacin, moxifloxacin)
Antibiotics Effective in Gram-Negative Infections
-
Pseudomonas: Ist-line: antipseudomonas penicillins, cephalosporins, third/fourth generation penicillins
-
Hemophilus influenzae: Ist-line: Ceftriaxone, cefotaxime, cloramfenicol, amoxicillin-clavulanate
-
Enterobacter: Ist-line: Aminoglycosides, imipenem, extended spectrum penicillin
-
Proteus, vulgaris: Ist -line: aminoglycosides; IIIrd generation cephalosporins
-
Serratia: Ist-line: Imipenem, cefoxitin, cefotetan or cefalosporin gen III
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