Becoming Resistant to Beta-Lactam Antibiotics

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What is the main mechanism by which bacteria become resistant to beta-lactam antibiotics?

Increased production of antibiotic-binding proteins

Changes in the bacterial cell wall

Production of beta-lactamases (correct)

Mutation of the beta-lactam ring

What is the purpose of adding beta-lactamase inhibitors to penicillin?

To increase the absorption of penicillin

To enhance the bactericidal activity of penicillin

To prevent degradation of penicillin by beta-lactamases (correct)

To reduce the allergic reactions to penicillin

Which of the following beta-lactam antibiotics is most susceptible to inactivation by amidases and lactamases?

Cephalosporins

Penicillins (correct)

Carbapenems

Monobactams

What is the characteristic of the lactam ring in carbapenems that makes them resistant to most common beta-lactamases?

Different stereochemical configuration Signup and view all the answers

What is the consequence of the emergence of ESBL and carbapenemases?

Degradation of cephalosporins and carbapenems Signup and view all the answers

How are beta-lactamases typically encoded in bacteria?

On DNA plasmids Signup and view all the answers

What is a characteristic of Avibactam, a beta-lactamase inhibitor?

It is a covalent inhibitor that acts via ring opening and is reversible Signup and view all the answers

What is the indication for Amoxicillin/Clavulanate?

Acute Otitis Media where beta-lactamase - strains are likely Signup and view all the answers

What is the mechanism of Clavulanate?

It can cause GI distress and is available in a fixed dose Signup and view all the answers

What is the indication for Ampicillin/Sulbactam?

Surgical prophylaxis where bowel flora is a risk Signup and view all the answers

What is the characteristic of Penicillin G?

Narrow spectrum, beta-lactamase susceptible Signup and view all the answers

What is the characteristic of Amoxicillin?

It is stable in stomach acid and has a positive charge Signup and view all the answers

What is the primary mechanism of vancomycin's adverse effect of red man syndrome?

Non-IgE-mediated mast cell degranulation Signup and view all the answers

What is the bactericidal activity of vancomycin dependent on?

Plasma concentration being above minimum bactericidal concentration Signup and view all the answers

Which of the following is NOT an adverse effect of telavancin?

Anaphylaxis Signup and view all the answers

What is the primary mechanism of telavancin's antibacterial activity?

Both a and b Signup and view all the answers

Why is vancomycin monitoring necessary?

To monitor trough levels and ensure adequate drug clearance Signup and view all the answers

What is the comparative efficacy of telavancin to vancomycin?

Telavancin is non-inferior to vancomycin Signup and view all the answers

What is the primary use of Fosfomycin in treatment?

Treating uncomplicated lower UTI in women Signup and view all the answers

What is the mechanism of action of Cycloserine?

Inhibiting the conversion of L-Ala to D-Ala and the D-Ala-D-Ala ligase Signup and view all the answers

What is the primary adverse effect of Bacitracin?

Significant kidney, neurological, and bone marrow toxicity Signup and view all the answers

What is the function of bactoprenyl diphosphate in murein monomer synthesis?

It is a necessary lipid carrier for murein monomer synthesis and export Signup and view all the answers

Why is Bacitracin not absorbed orally?

It remains in the gut lumen Signup and view all the answers

Which of the following antibiotics is safe to use in severe beta-lactam allergy?

Aztreonam Signup and view all the answers

What is the mechanism of action of glycopeptides?

Binding to D-Ala-D-Ala terminus of murine monomer unit Signup and view all the answers

Which of the following antibiotics is effective against Pseudomonas?

Ceftazidime Signup and view all the answers

Why is cilastatin added to imipenem?

To prevent deactivation by dipeptidase in renal brush border cells Signup and view all the answers

Which of the following antibiotics is not effective against atypical pneumonia and Legionella?

Carbapenems Signup and view all the answers

What is the spectrum of activity of 3rd generation cephalosporins?

Highly active against Enterobacteriaceae, Neisseria, and H.influenza Signup and view all the answers

Which of the following antibiotics is used orally for C.difficile infections?

Vancomycin Signup and view all the answers

What is the indication for ceftaroline?

Acute bacterial skin and skin structure infections Signup and view all the answers

Which of the following is a characteristic of carbapenems?

Resistant to many different beta-lactamases Signup and view all the answers

What is the concern with using ceftriaxone in neonates?

Displacement of bilirubin Signup and view all the answers