Antimicrobials IV Other Cell-Wall Active Agents
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Questions and Answers

Which of the following statements about vancomycin is correct?

  • It is primarily excreted through the hepatobiliary system.
  • It is a narrow-spectrum antibiotic that targets only Gram-positive bacteria. (correct)
  • It can penetrate the porins of Gram-negative organisms.
  • It is active against methicillin-susceptible Staphylococcus aureus (MSSA).

    • What is the mechanism of action of glycopeptide antibiotics like vancomycin?

  • They inhibit bacterial DNA synthesis by inhibiting topoisomerase enzymes.
  • They disrupt the bacterial cell membrane by forming pores.
  • They inhibit bacterial protein synthesis by binding to the 50S ribosomal subunit.
  • They inhibit bacterial cell wall synthesis by binding to the D-alanine-D-alanine residues of peptidoglycan precursors. (correct)

    • Which of the following statements about the distribution of vancomycin is correct?

  • It is primarily distributed to the liver and has poor penetration into other tissues.
  • It is widely distributed in the body, including the CSF, with CSF levels ranging from 7-30% of serum levels. (correct)
  • It achieves high concentrations in the cerebrospinal fluid (CSF).
  • It does not cross the blood-brain barrier and has poor penetration into the CSF.

    • Which of the following statements about the clinical uses of vancomycin is correct?

    <p>It can be used for the treatment of Clostridium difficile infections when administered orally.</p> Signup and view all the answers

    Which of the following statements about the lipoglycopeptides (e.g., oritavancin, telavancin, dalbavancin) is correct?

    <p>They are active against vancomycin-resistant Enterococci (VRE).</p> Signup and view all the answers

    Which of the following statements about the pharmacokinetics of vancomycin is correct?

    <p>It has a prolonged half-life in patients with renal impairment, which can reach 6-10 days in anuric patients.</p> Signup and view all the answers

    What is the primary mechanism of action of vancomycin?

    <p>Inhibiting peptidoglycan crosslinking by binding to D-Ala-D-Ala</p> Signup and view all the answers

    Which antibiotic is used specifically for the treatment of Clostridium difficile infection?

    <p>Oral vancomycin</p> Signup and view all the answers

    Which adverse effect of vancomycin is associated with histamine release?

    <p>Red man syndrome</p> Signup and view all the answers

    Which antibiotic is active against vancomycin-resistant enterococci (VRE) and vancomycin-resistant Staphylococcus aureus (VRSA)?

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

    What is the primary mechanism of action of fosfomycin?

    <p>Inhibiting cell wall synthesis by blocking MurA</p> Signup and view all the answers

    Which antibiotic is used primarily for the treatment of tuberculosis?

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

    Which antibiotic is only used topically due to its high nephrotoxicity when administered systemically?

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

    Which antibiotic is a lipopeptide with activity against most gram-negative bacteria, including Acinetobacter spp. and Pseudomonas spp.?

    <p>Polymyxin B</p> Signup and view all the answers

    Which antibiotic binds to the peptidoglycan pentapeptide chain and has a strict requirement for two alanines?

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

    Which administration method of vancomycin is associated with a lower risk of nephrotoxicity and ototoxicity compared to intermittent infusion?

    <p>Continuous intravenous infusion</p> Signup and view all the answers

    Which antibiotic is a lipopeptide that acts on the bacterial membrane?

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

    For which type of bacteria is vancomycin bactericidal?

    <p>Staphylococci (MRSA)</p> Signup and view all the answers

    Which antibiotic is primarily excreted by glomerular filtration?

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

    What is the main clinical use of vancomycin?

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

    Which antibiotic has a strict requirement for two alanines in its mechanism of action?

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

    Among the listed antibiotics, which one has activity against VRE (vancomycin-resistant enterococci)?

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

    What is the main target of fosfomycin's antibacterial activity?

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

    Which antibiotic is known for its inability to penetrate the porins of Gram-negative organisms?

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

    For which type of organisms is vancomycin specifically active?

    <p>Gram-positive bacteria only</p> Signup and view all the answers

    What makes glycopeptides like vancomycin unable to penetrate the porins of Gram-negative organisms?

    <p>Their bulky nature</p> Signup and view all the answers

    Which of the following statements about vancomycin resistance is correct?

    <p>Resistance emerged in enterococci due to acquired van genes responsible for altered target.</p> Signup and view all the answers

    Which of the following statements about daptomycin is incorrect?

    <p>It is effective in the treatment of pneumonia due to its ability to penetrate pulmonary surfactants.</p> Signup and view all the answers

    What is the primary mechanism of action of fosfomycin?

    <p>Inhibition of the cytoplasmic enzyme enolpyruvate transferase (MurA), blocking the first step in the formation of N-acetylmuramic acid.</p> Signup and view all the answers

    Which of the following statements about cycloserine is correct?

    <p>It is a structural analog of D-alanine that inhibits the incorporation of D-alanine into the peptidoglycan pentapeptide.</p> Signup and view all the answers

    Which of the following statements about vancomycin is correct?

    <p>It binds to the D-Ala-D-Ala residues of the peptidoglycan pentapeptide chain, inhibiting transglycosylase and preventing peptidoglycan elongation and crosslinking.</p> Signup and view all the answers

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