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Questions and Answers
What is a major cause of preterm birth?
What is a major cause of preterm birth?
What is the purpose of prescribing antibiotics to women with preterm prelabour rupture of membranes?
What is the purpose of prescribing antibiotics to women with preterm prelabour rupture of membranes?
What are the agents of first choice in pregnancy?
What are the agents of first choice in pregnancy?
What is the risk associated with using most antibiotics in pregnancy?
What is the risk associated with using most antibiotics in pregnancy?
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What is the concept of selective toxicity?
What is the concept of selective toxicity?
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What is the pivot of chemotherapy?
What is the pivot of chemotherapy?
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What is the reason why a drug can be highly toxic to microbes but harmless to the host?
What is the reason why a drug can be highly toxic to microbes but harmless to the host?
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What are biochemical processes critical to microbial well-being that do not take place in mammalian cells?
What are biochemical processes critical to microbial well-being that do not take place in mammalian cells?
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What is the main difference between antimicrobials and antineoplastic agents?
What is the main difference between antimicrobials and antineoplastic agents?
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What is the term for the ability of an antibiotic to inhibit the growth of bacteria?
What is the term for the ability of an antibiotic to inhibit the growth of bacteria?
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What is the characteristic of Gram-positive bacteria?
What is the characteristic of Gram-positive bacteria?
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Who is known as the 'Father of Chemotherapy'?
Who is known as the 'Father of Chemotherapy'?
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What is the term for the phenomenon of antibiosis?
What is the term for the phenomenon of antibiosis?
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What is the term for the destruction or dissolution of bacterial cells?
What is the term for the destruction or dissolution of bacterial cells?
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When was penicillin discovered?
When was penicillin discovered?
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What is the term for antibiotics that are produced from microbes?
What is the term for antibiotics that are produced from microbes?
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What is one of the prophylactic applications of penicillin G?
What is one of the prophylactic applications of penicillin G?
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What is the route of elimination of penicillin from the body?
What is the route of elimination of penicillin from the body?
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What is the main mechanism of renal excretion of penicillin?
What is the main mechanism of renal excretion of penicillin?
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What is the half-life of penicillin in older children and adults?
What is the half-life of penicillin in older children and adults?
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What happens to the half-life of penicillin in patients with renal impairment?
What happens to the half-life of penicillin in patients with renal impairment?
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Why was probenecid used concurrently with penicillin in the past?
Why was probenecid used concurrently with penicillin in the past?
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What is the main difference between penicillin G and penicillin V?
What is the main difference between penicillin G and penicillin V?
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When is monitoring of kidney function recommended for patients taking penicillin?
When is monitoring of kidney function recommended for patients taking penicillin?
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What is an alternative to penicillins in patients with penicillin allergy?
What is an alternative to penicillins in patients with penicillin allergy?
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How many carbapenems are available?
How many carbapenems are available?
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What is the mechanism of action of imipenem?
What is the mechanism of action of imipenem?
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Why is imipenem effective against anaerobic bacteria?
Why is imipenem effective against anaerobic bacteria?
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How is imipenem administered?
How is imipenem administered?
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What is the role of cilastatin in imipenem therapy?
What is the role of cilastatin in imipenem therapy?
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What happens to imipenem when it is employed alone?
What happens to imipenem when it is employed alone?
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What is the primary route of elimination of imipenem?
What is the primary route of elimination of imipenem?
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What is unique about vancomycin compared to other drugs discussed?
What is unique about vancomycin compared to other drugs discussed?
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What is vancomycin typically used to treat?
What is vancomycin typically used to treat?
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Why is vancomycin used as an alternative to penicillins and cephalosporins?
Why is vancomycin used as an alternative to penicillins and cephalosporins?
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What is a common adverse effect of vancomycin infusion?
What is a common adverse effect of vancomycin infusion?
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Why is vancomycin administered slowly?
Why is vancomycin administered slowly?
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What is red man syndrome?
What is red man syndrome?
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What can increase the risk of ototoxicity when using vancomycin?
What can increase the risk of ototoxicity when using vancomycin?
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What is bacitracin used for?
What is bacitracin used for?
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Study Notes
Infection and Pregnancy
- Infection is a major cause of preterm birth
- Antibiotic prophylaxis has not proven useful in preventing preterm birth, but prescribing antibiotics to women with preterm prelabour rupture of membranes can delay delivery and reduce the incidence of infection
- Penicillins and cephalosporins are generally considered the agents of first choice in pregnancy, as they are associated with lower risks of fetal malformation
Antimicrobials and Chemotherapy
- Selective toxicity is the pivot of chemotherapy, referring to the ability of a drug to be toxic to parasites or unwanted cells while leaving the host or environment relatively unharmed
- Chemotherapeutic agents act selectively against microbes or malignant cells, without affecting body cells
- Antimicrobials are used to treat infectious diseases, and can be classified into different types based on their chemical structure, mechanism, and spectrum
Mechanisms of Action
- Bacteriostatic agents stop the growth of bacteria
- Bactericidal agents kill bacteria
- Bacteriolytic agents cause the destruction or dissolution of bacterial cells
Gram Positive and Gram Negative Bacteria
- Gram positive bacteria have a thick cell wall and peptidoglycan directly accessible from the environment
- Gram negative bacteria have a thin cell wall, surrounded by inner and outer membranes, and are resistant to diffusion of antibiotics
Historical Perspectives
- Louis Pasteur discovered the phenomenon of antibiosis in 1877
- Paul Ehrlich coined the term "chemotherapy" in 1906 and is considered the father of chemotherapy
- Gerhard Domagk discovered sulfonamides in 1935
- Alexander Fleming, Ernst Chain, and Howard Florey discovered penicillin in 1929, 1939, and 1941
- Selman Waksman discovered streptomycin and coined the term "antibiotic" in 1944
Antimicrobial Classification
- Antimicrobials can be classified based on their chemical structure, mechanism, and spectrum
- Examples of antimicrobial classes include:
- Penicillins
- Cephalosporins
- Aminoglycosides
- Chloramphenicol
- Tetracyclines
- Macrolides
- Glycopeptides
- Rifamycins
- Nitroimidazoles
- Quinolones
- Trimethoprim
- Oxazolidinones
- Lipopeptides
Penicillin
- Penicillin is a bactericidal agent that inhibits bacterial cell wall synthesis
- Penicillin G has important prophylactic applications, including preventing syphilis and recurrent attacks of rheumatic fever
- Penicillin distributes well to most tissues and body fluids, but penetration into the meninges and into fluids of joints and the eyes is poor in the absence of inflammation
- Penicillin undergoes minimal metabolism and is eliminated by the kidneys, primarily as the unchanged drug
- Renal impairment can cause the half-life of penicillin to increase dramatically and may necessitate a reduction in dosage
Vancomycin
- Vancomycin is a bactericidal agent that inhibits bacterial cell wall synthesis
- Vancomycin should be reserved for serious infections, and is the drug of choice for infections caused by MRSA or Staph. epidermidis
- Vancomycin is also used to treat severe Clostridium difficile infections
- Common adverse effects of vancomycin include:
- Ototoxicity
- Red man syndrome (flushing, rash, pruritus, urticaria, tachycardia, and hypotension)
- Thrombophlebitis
- Nephrotoxicity
Carbapenems
- Carbapenems are beta-lactam antibiotics with a broad antimicrobial spectrum
- Examples of carbapenems include:
- Imipenem
- Meropenem
- Ertapenem
- Doripenem
- Carbapenems are active against most bacterial pathogens, including organisms resistant to other antibiotics
- Imipenem is supplied in fixed-dose combinations with cilastatin, which inhibits destruction of imipenem by renal enzymes
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Description
This quiz covers the use of antimicrobials in pregnancy, specifically the prescription of antibiotics to women with preterm prelabour rupture of membranes. Learn about the impact of infection on preterm birth and the role of antibiotics in delaying delivery.
