Antimicrobial Therapy and Resistance
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Questions and Answers

What is the primary skin reaction associated with rapid IV vancomycin infusion?

  • Erythema Multiforme
  • Toxic Epidermal Necrolysis
  • Red Man Syndrome (correct)
  • Stevens-Johnson Syndrome
  • Which class of antibiotics primarily inhibits protein synthesis?

  • Lincosamides
  • Tetracyclines (correct)
  • Glycopeptides
  • Fluoroquinolones
  • What is the purpose of checking serum drug levels in antibiotic treatment?

  • To determine the patient's infection type
  • To prevent allergic reactions
  • To enhance drug absorption
  • To monitor for toxicity (correct)
  • What does empiric therapy involve in the context of antibiotics?

    <p>Starting antibiotics before identifying the organism</p> Signup and view all the answers

    Which statement accurately describes bactericidal antibiotics?

    <p>They kill bacteria directly.</p> Signup and view all the answers

    What is the primary effect of nephrotoxicity?

    <p>Damage to the kidneys</p> Signup and view all the answers

    Which medication is associated with the side effect known as Blue Man Syndrome?

    <p>Amiodarone</p> Signup and view all the answers

    Which of the following substances decreased absorption of tetracyclines?

    <p>Milk products</p> Signup and view all the answers

    Which of the following aminoglycosides is NOT commonly used?

    <p>Streptomycin</p> Signup and view all the answers

    Which of the following is a common adverse effect of aminoglycosides?

    <p>Nephrotoxicity</p> Signup and view all the answers

    What is a serious risk associated with the use of fluoroquinolones?

    <p>Achilles tendon inflammation or rupture</p> Signup and view all the answers

    Which class of antibiotics has a higher chance of causing an allergic response?

    <p>Beta-lactams</p> Signup and view all the answers

    Which drug is an example of a fluoroquinolone?

    <p>Ciprofloxacin</p> Signup and view all the answers

    What should be monitored when administering Potassium Penicillin G?

    <p>K+ levels</p> Signup and view all the answers

    Which of the following is NOT a mild adverse effect of Ciprofloxacin?

    <p>Seizures</p> Signup and view all the answers

    What is the primary purpose of Glycopeptides in antibiotic treatment?

    <p>To inhibit cell wall synthesis</p> Signup and view all the answers

    What is the recommended alternative if metronidazole is ineffective for treating Clostridium difficile?

    <p>Vancomycin</p> Signup and view all the answers

    Which substances can reduce the absorption of Ciprofloxacin when taken together?

    <p>Aluminum antacids</p> Signup and view all the answers

    What implication does being allergic to one Beta-lactam antibiotic have on the use of another?

    <p>Allergic to all Beta-lactams</p> Signup and view all the answers

    Which population is particularly prone to specific adverse effects from Ciprofloxacin?

    <p>Older adult patients</p> Signup and view all the answers

    What is a common trait of cephalosporins compared to penicillins?

    <p>They are structurally similar.</p> Signup and view all the answers

    Which statement is true regarding 1st generation cephalosporins?

    <p>They cover PEK (Proteus, E.coli, Klebsiella) species.</p> Signup and view all the answers

    Which of the following is an example of a 2nd generation cephalosporin?

    <p>Cefuroxime</p> Signup and view all the answers

    What type of infections are 3rd generation cephalosporins primarily used to treat?

    <p>Serious gram-negative infections resistant to other beta-lactams.</p> Signup and view all the answers

    Which of the following cephalosporins is NOT administered orally?

    <p>Cefazolin</p> Signup and view all the answers

    Which is a characteristic feature of 2nd generation cephalosporins?

    <p>Increased activity against Haemophilus influenzae.</p> Signup and view all the answers

    What is the primary advantage of using beta-lactams like cephalosporins?

    <p>They have a low toxicity profile.</p> Signup and view all the answers

    Which of the following statements regarding ceftriaxone is accurate?

    <p>It is a 3rd generation cephalosporin used for serious infections.</p> Signup and view all the answers

    What is the function of penicillinase produced by bacteria?

    <p>It deactivates penicillin.</p> Signup and view all the answers

    Which situation would lead to the ruling out of a specific antibiotic?

    <p>Patient's kidney condition.</p> Signup and view all the answers

    What is the main reason for using prophylactic antibiotic therapy?

    <p>To prevent infections from occurring.</p> Signup and view all the answers

    Which of the following is NOT a combination that enhances penicillin's antimicrobial spectrum?

    <p>Cefazolin/clavulanic acid (Ceflin)</p> Signup and view all the answers

    Which of these organisms are generally treated with broad-spectrum penicillins?

    <p>E. coli, salmonella, shigella.</p> Signup and view all the answers

    What characteristic is notable about amoxicillin compared to ampicillin?

    <p>It has excellent oral absorption.</p> Signup and view all the answers

    What describes empiric antibiotic therapy?

    <p>Based on educated guess before lab results.</p> Signup and view all the answers

    Which of the following correctly defines the term 'sensitivity' in microbial culture?

    <p>The effectiveness of antibiotics against an organism.</p> Signup and view all the answers

    Study Notes

    Antimicrobial Therapy and Resistance

    • Selective Toxicity: Chemicals toxic to microbes, harmless to the host.
    • Acquired Resistance: Microorganisms develop resistance to drugs over time. This often occurs due to overuse of antibiotics, particularly in agriculture.
    • Suprainfection: Develops when broad-spectrum antibiotics eliminate normal flora organisms, not just the pathogens causing infection. Examples include C. diff, thrush, and vaginal infections.
    • Antibiotic Resistance: Resistance is evolving rapidly in many prokaryotic species due to overuse of antibiotics, particularly in agriculture.
    • Broad Spectrum Antibiotics: Effective against a wide variety of microbes.
    • Narrow Spectrum Antibiotics: Effective against only a few microorganisms.
    • C. difficile: Bacteria causing severe intestinal infections.
    • Penicillins: Antibiotics ending in "-cillin," generally low toxicity.
    • Beta-lactamases: Enzymes that inactivate penicillins. Methicillin-resistant Staphylococcus aureus (MRSA) is an example of a pathogen resistant to many antibiotics.
    • MRSA: Methicillin-resistant Staphylococcus aureus; an infection caused by a pathogen resistant to many antibiotics.
    • Ampicillin: A broad-spectrum penicillin used for various infections.

    Additional Antimicrobial Classes

    • Cephalosporins: Beta-lactam antibiotics similar to penicillins.
    • Vancomycin: Glycopeptide antibiotic for severe infections. Skin irritation, a reaction called "red man syndrome," can occur with rapid IV infusions.
    • Tetracyclines: Broad-spectrum antibiotics that inhibit protein synthesis.
    • Macrolides: Broad-spectrum antibiotics that inhibit protein synthesis.
    • Trimethoprim-Sulfamethoxazole: Combination antibiotic for urinary tract infections.
    • Ciprofloxacin: Fluoroquinolone, often a first choice for anthrax.

    Antimicrobial Treatment Strategies

    • Peak and Trough: Monitoring serum drug levels for toxicity.
    • Prophylactic Antibiotics: Prevent infection rather than treat established infections.
    • Empiric Therapy: Antibiotic treatment given before identifying the organism.
    • Penicillin Combinations: Combining penicillins with penicillinase-sensitive antibiotics to extend their antimicrobial spectrum. (e.g. Ampicillin/sulbactam, Amoxicillin/clavulanate, etc.)
    • Broad Spectrum Penicillins: Ampicillin and amoxicillin are good examples.

    Other Information

    • Bacteriostatic: Stops the multiplication of bacteria
    • Bactericidal: Kills bacteria directly.
    • Allergy Assessment: Evaluate for penicillin allergy before administration.
    • Drug Interactions: Check for interactions affecting antibiotic efficacy.
    • Patient Monitoring: Observe clinical responses and lab results.
    • Selection of Antibiotics: Criteria includes lab results (culture and sensitivity to identify the organism,drug sensitivity), allergies, and patient variables like liver/kidney function.

    Specific Antibiotic Considerations

    • Penicillin and Cephalosporin Cross-allergy: Important to know that a penicillin allergy often means an allergy to cephalosporins also.

    • Potassium Penicillin G: Water-soluble solution for immediate onset; least toxic; monitor potassium levels.

    • Glycopeptides: Structurally and functionally similar to penicillins; often treat severe infections.

    • Cephalosporins: Similar to penicillin structures and wide uses, but can display different toxicities.

    • 1st Generation Cephalosporins: Increased activity toward staphylococci; increased activity toward streptococci and gram-positive activity vs. 2nd/3rd generation.

    • 2nd Generation Cephalosporins: Gram-positive cocci, Haemophilus influenzae, etc.

    • 3rd Generation Cephalosporins: Effective against serious gram-negative infections.

    • 4th Generation Cephalosporins: Gram-negative and gram-positive organisms, with activity against Pseudomonas.

    • Drug Interactions: Cephalosporins may interfere with drugs that promote bleeding, and increase risk of nephrotoxicity when given with aminoglycosides, and increase risk of blood clots when given with anticoagulants. Alcohol can create a disulfiram-like reaction.

    • Vancomycin Adverse Effects: Nephrotoxicity (kidney damage), ototoxicity (ear damage), red man syndrome.

    • Tetracycline Adverse Effects: Gastrointestinal distress, interaction with other drugs, and blue man syndrome (discoloration of the skin).

    • Aminoglycoside Adverse Effects: Nephrotoxicity (kidney damage), ototoxicity (ear damage), allergies, hypersensitivity reactions, neuromuscular blockade, and blood dyscrasias.

    • Sulfonamide Adverse Effects: Hypersensitivity reactions (rash, Stevens-Johnson syndrome, and potentially fatal reactions), and interaction with other drugs.

    • Trimethoprim: Drug used to prevent DNA bacterial synthesis in conjunction with sulfa drugs (trimethoprim-sulfamethoxazole).

    • Fluoroquinolones adverse effects: Disrupt DNA replication; side effects include tendon rupture, especially the Achilles tendon.

    • Ciprofloxacin Adverse Effects: Nausea, vomiting, diarrhea, abdominal pain, dizziness, headache, confusion, and visual disturbances.

    • Drug and Food interactions of Cipro: Absorption reduced by aluminum or magnesium antacids, iron salts, zinc salts, sucralfate, and dairy/milk products.

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    Description

    Test your knowledge on antimicrobial therapy and the critical concepts of resistance in microorganisms. This quiz covers selective toxicity, suprainfection, and the roles of broad and narrow spectrum antibiotics. Delve into the complexities of antibiotic resistance and its implications for health.

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