Antibiotics Lecture 2

Study Notes

ABX Notes

Antiobiogram - syndromes have site-specific sensitivities
Penicillin - 50% for MIC concentration
Carbapenems - 40% effective
Cephalosporins - 60% effective (better than penicillin and carbapenems based on MIC ranking).

Lecture 2

Beta-lactams: potential for neutropenia (long term), allergic reactions (AIN), and hepatotoxicity/renal failure
Penicillin + beta-lactam: diarrhea (for example, unasyn, augmentin, zosyn)
Long term beta-lactams: potential for thrombocytopenia
Natural penicillins (G & V forms): useful against various bacteria such as Actinomyces and Streptococcus
Penicillin: useful against syphilis, strep, and oral anaerobes. Don't use for syphilis
Penicillin-resistant penicillins: oxacillin, nafcillin, dicloxacillin (all are orally administered)
Effective for Staph endocarditis and cellulitis and are NOT effective against Gram-negative bacteria (GNR).
Aminopenicillins (ampicillin and amoxicillin): effective against Enterococcus, Group B Streptococcus (in labor), and Listeria monocytogenes (CNS). Amoxicillin is beneficial for dental prophylaxis and treatment of Lyme disease. Avoid when doxycycline is an option
Extended-spectrum penicillins: piperacillin/tazobactam (Zosyn). Effective against Pseudomonas
Penicillin good uses include joint, pleural, pericardial, bile fluid, but are contraindicated for prostatitis, eye infections and certain cases of diabetes and mouth infections
Penicillin + clavulanate: Augmentin. Useful against various mouth and throat bacteria, bites, and serious infections.
Unasyn: useful against aspiration-related infections, infections involving Acinetobacter, and similar serious cases
Treatment with aztreonam should be a last resort that is only used in serious cases of Pseudo infections
Cephalosporins: effective against various Gram-negative and Gram-positive infections
Ceftaroline: effective against MRSA and pneumonia
Carbapenems - imipenem, meropenem, ertapenem - effective against broader ranges of bacteria, in some cases if other options don't work.
- Important note: some have contraindications related to preventing seizures

Lecture 3

Nephrotoxic and/or ototoxic antibiotics should be used with caution in certain patient populations
Streptomycin is rarely used for specific infections.
Gentamicin effective against severe Gram-negative infections, and is helpful to treat various situations
Macrolides are effective against various infections, but are also associated with specific side effects.
Linezolid: useful against oxazolidene, VRSA, MRSA, pneumonia, and cellulitis. Caution required in certain cases.
Clindamycin: useful against infections but also has potential for certain adverse effects.
Macrolides (50s): effective against various infections.
Antibiotics for specific infections: (examples)
- bacterial infections of urinary tract
- infections including mycobacteria (bacterial cause for TB)
Doc: various bacterial infections requiring antibiotic therapy

Lecture 4

Tetracyclines: used to treat various bacterial infections.
Sarecycline: used specifically for acne or similar conditions.
Minocycline: another tetracycline effective against certain dermatological and other conditions, or various bacteria
Doxycycline: broad spectrum for both bacterial and parasitic infections.
Fluoroquinolones (cipro, norflox, levoflox, oflox, moniflox, gemi enoxacin): useful against various infections but have potential side effects
Penicillins, Cephalosporins, Carbapenems: effective against wide ranges of gram-positive and gram-negative and anaerobic bacteria
Pharyngitis (bacterial infection of the throat)
Tularemia: effective against bacterial infections (using specific antibiotics discussed in lecture 3)
Bacterial infections of various sites
CAP: for community-acquired pneumonia infections
HAP: for hospital-acquired pneumonia infections

Rheum/pharm

NSAIDS: adverse effects include ulcers/gastrointestinal distress/renal. Important to distinguish specific indications from more benign conditions
Specific inflammatory conditions (examples)