Antimicrobials VII: Antimetabolites and Nucleic Acid Inhibitors

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Questions and Answers

What is the mechanism of action of sulfonamides?

  • Inactivating bacterial enzymes
  • Disrupting cell wall formation
  • Inhibiting protein synthesis
  • Blocking folic acid synthesis (correct)

Why can PABA in multivitamins cause therapy failure when taking sulfonamide antibiotics?

  • It competes with sulfonamides for their target (correct)
  • It increases bacterial resistance
  • It enhances the effect of antibiotics
  • It boosts the immune system against bacteria

Which of the following bacterial species is not susceptible to sulfonamides?

  • E. coli
  • Staphylococcus aureus (correct)
  • Chlamydia
  • Nocardia

Why are sulfonamides considered antimetabolites?

<p>They mimic metabolic substrates (C)</p> Signup and view all the answers

In which bacterial species would sulfonamides likely be effective due to their mechanism of action?

<p>Escherichia coli (D)</p> Signup and view all the answers

When tetracycline is combined with gentamicin, what is the expected result?

<p>Additivity (C)</p> Signup and view all the answers

What type of activity is exhibited when ampicillin is combined with vancomycin against E. coli?

<p>Antagonistic (D)</p> Signup and view all the answers

Based on the text, what is a resistant mechanism to cell wall or membrane agents?

<p>Modification enzymes (D)</p> Signup and view all the answers

In the context of phage therapy, what is the main characteristic of bacteriophages?

<p>They infect bacteria (A)</p> Signup and view all the answers

What was the outcome for the pediatric patient with cystic fibrosis who received a 3-phage cocktail for a Mycobacterium abscessus infection?

<p>Recovery to normal activities but infection not fully resolved (A)</p> Signup and view all the answers

How did the personalized phage treatment for a patient with P. aeruginosa prosthetic joint infection differ from standard treatment?

<p>It combined phage treatment with synergistic antibiotics (D)</p> Signup and view all the answers

What is the percentage of E.coli isolates in the UK resistant to fluoroquinolones in the years 2001-2006?

<p>20% (D)</p> Signup and view all the answers

Which antibiotic is cited as the first choice against Legionella pneumophila?

<p>Moxifloxacin (B)</p> Signup and view all the answers

Which fluoroquinolone has been recommended by 5 ID specialists as of December 2023?

<p>Gemifloxacin (A)</p> Signup and view all the answers

What condition can Clostridioides difficile infection potentially lead to?

<p>Severe colon damage and death (D)</p> Signup and view all the answers

Which condition accounted for the most estimated unnecessary fluoroquinolone prescriptions in medical offices and EDs in 2014?

<p>Colds and bronchitis (D)</p> Signup and view all the answers

Which pathogen has developed resistance to many fluoroquinolones?

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

What can fluoroquinolone use lead to besides resistance?

<p>Tendon damage (B)</p> Signup and view all the answers

Which setting saw nearly 32 million fluoroquinolone prescriptions dispensed from U.S. outpatient pharmacies?

<p>Medical offices and EDs (C)</p> Signup and view all the answers

Which statement about fluoroquinolones is true?

<p>They are not the first-line treatment for UTIs but were the most prescribed for this condition. (A)</p> Signup and view all the answers

What is a common side effect associated with fluoroquinolones?

<p>Skin rash (B)</p> Signup and view all the answers

What is the mechanism of action of Trimethoprim?

<p>Blocks reduction of dihydrofolate to tetrahydrofolate (B)</p> Signup and view all the answers

Which antibiotic is recommended by IDSA guidance for the management of initial C.difficile episodes?

<p>Fidaxomicin (A)</p> Signup and view all the answers

What is the main adverse reaction associated with Sulfonamides?

<p>Exfoliative dermatitis (D)</p> Signup and view all the answers

What is the mode of action of Fidaxomicin?

<p>Interferes with RNA polymerase (C)</p> Signup and view all the answers

Why should fluoroquinolones be reserved for important uses according to IDSA guidelines?

<p>Rapid resistance development (C)</p> Signup and view all the answers

Which antibiotic is indicated for anaerobic or mixed intra-abdominal infections?

<p>Metronidazole (D)</p> Signup and view all the answers

What is the primary target of Rifampin's mechanism of action?

<p>Bacterial RNA polymerase (A)</p> Signup and view all the answers

What is the primary target for Quinolones (Q) and Fluoroquinolones (FQs)?

<p>Type II topoisomerases (A)</p> Signup and view all the answers

What is the mechanism of killing associated with Aminoglycosides and Fluoroquinolones?

<p>Inhibition of DNA synthesis (D)</p> Signup and view all the answers

Which enzyme is responsible for adding negative supercoils to DNA?

<p>DNA gyrase (B)</p> Signup and view all the answers

What was the first plasmid-mediated Fluoroquinolone resistance reported in?

<p>Klebsiella pneumoniae (B)</p> Signup and view all the answers

Which of the following is a mechanism that provides low-level protection against Fluoroquinolones?

<p>Decreased membrane permeability (A)</p> Signup and view all the answers

What do multiple copies of qnr genes confer resistance to in the absence of chromosomal mutations?

<p>Topoisomerase inhibitors (C)</p> Signup and view all the answers

What factor affects the resistance rates of uncomplicated ESBL positive E.coli isolates to Fluoroquinolones?

<p>ESBL production (B)</p> Signup and view all the answers

Which region of the topoisomerases is associated with resistance to Quinolones and Fluoroquinolones?

<p>'Resistance-determining' region (B)</p> Signup and view all the answers

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