Becoming Resistant to Beta-Lactam Antibiotics

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Questions and Answers

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?

<p>Different stereochemical configuration (A)</p> Signup and view all the answers

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

<p>Degradation of cephalosporins and carbapenems (B)</p> Signup and view all the answers

How are beta-lactamases typically encoded in bacteria?

<p>On DNA plasmids (A)</p> Signup and view all the answers

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

<p>It is a covalent inhibitor that acts via ring opening and is reversible (D)</p> Signup and view all the answers

What is the indication for Amoxicillin/Clavulanate?

<p>Acute Otitis Media where beta-lactamase - strains are likely (C)</p> Signup and view all the answers

What is the mechanism of Clavulanate?

<p>It can cause GI distress and is available in a fixed dose (C)</p> Signup and view all the answers

What is the indication for Ampicillin/Sulbactam?

<p>Surgical prophylaxis where bowel flora is a risk (A)</p> Signup and view all the answers

What is the characteristic of Penicillin G?

<p>Narrow spectrum, beta-lactamase susceptible (D)</p> Signup and view all the answers

What is the characteristic of Amoxicillin?

<p>It is stable in stomach acid and has a positive charge (B)</p> Signup and view all the answers

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

<p>Non-IgE-mediated mast cell degranulation (D)</p> Signup and view all the answers

What is the bactericidal activity of vancomycin dependent on?

<p>Plasma concentration being above minimum bactericidal concentration (A)</p> Signup and view all the answers

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

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

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

<p>Both a and b (A)</p> Signup and view all the answers

Why is vancomycin monitoring necessary?

<p>To monitor trough levels and ensure adequate drug clearance (C)</p> Signup and view all the answers

What is the comparative efficacy of telavancin to vancomycin?

<p>Telavancin is non-inferior to vancomycin (C)</p> Signup and view all the answers

What is the primary use of Fosfomycin in treatment?

<p>Treating uncomplicated lower UTI in women (D)</p> Signup and view all the answers

What is the mechanism of action of Cycloserine?

<p>Inhibiting the conversion of L-Ala to D-Ala and the D-Ala-D-Ala ligase (B)</p> Signup and view all the answers

What is the primary adverse effect of Bacitracin?

<p>Significant kidney, neurological, and bone marrow toxicity (A)</p> Signup and view all the answers

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

<p>It is a necessary lipid carrier for murein monomer synthesis and export (B)</p> Signup and view all the answers

Why is Bacitracin not absorbed orally?

<p>It remains in the gut lumen (B)</p> Signup and view all the answers

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

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

What is the mechanism of action of glycopeptides?

<p>Binding to D-Ala-D-Ala terminus of murine monomer unit (D)</p> Signup and view all the answers

Which of the following antibiotics is effective against Pseudomonas?

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

Why is cilastatin added to imipenem?

<p>To prevent deactivation by dipeptidase in renal brush border cells (B)</p> Signup and view all the answers

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

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

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

<p>Highly active against Enterobacteriaceae, Neisseria, and H.influenza (A)</p> Signup and view all the answers

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

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

What is the indication for ceftaroline?

<p>Acute bacterial skin and skin structure infections (C)</p> Signup and view all the answers

Which of the following is a characteristic of carbapenems?

<p>Resistant to many different beta-lactamases (D)</p> Signup and view all the answers

What is the concern with using ceftriaxone in neonates?

<p>Displacement of bilirubin (C)</p> Signup and view all the answers

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