Exploring the Synergy of Penicillin and Aminoglycosides in Combination Therapy
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Questions and Answers

What is the mechanism of action of erythromycin?

Erythromycin is a protein synthesis inhibitor that binds to the 23S ribosomal RNA component of the 50S subunit of the bacterial ribosome, inhibiting chain elongation.

What are the gram-positive aerobic bacteria that erythromycin is active against?

Erythromycin has limited activity against gram-positive aerobic bacteria and is not the drug of choice for these infections.

What are the gram-positive anaerobic bacteria that erythromycin is active against?

Erythromycin has decent activity against gram-positive anaerobic bacteria.

What is the MOA of clarithromycin?

<p>Clarithromycin is a protein synthesis inhibitor that binds to the 23S ribosomal RNA component of the 50S subunit of bacterial ribosome at the peptide exit tunnel.</p> Signup and view all the answers

What is the primary difference between clarithromycin and azithromycin?

<p>The primary difference between clarithromycin and azithromycin is their spectrum of coverage. Azithromycin has broader coverage compared to clarithromycin.</p> Signup and view all the answers

What is the preferred agent for treating C. diff infections?

<p>Fidaxomicin is the preferred agent for treating C. diff infections.</p> Signup and view all the answers

What are the potential side effects of tetracyclines?

<p>Potential side effects of tetracyclines include teeth and bone deposits, photosensitivity, and hyperpigmentation.</p> Signup and view all the answers

What are the three causes of tuberculosis?

<p>M. tuberculosis, M. bovis, M. africanum</p> Signup and view all the answers

What are the risk factors for tuberculosis?

<p>location, place of birth, ethnicity, age, HIV, immunocompromised, close contact, crowded living conditions</p> Signup and view all the answers

What are the symptoms of tuberculosis?

<p>fever, weight loss, night sweats, loss of appetite/energy</p> Signup and view all the answers

Why are mycobacteria intrinsically resistant to most antibiotics?

<p>due to their slow growth and intracellular pathogens</p> Signup and view all the answers

What is the mechanism of action for sulfonamides?

<p>Sulfonamides inhibit bacterial growth by interfering with microbial folic acid synthesis and act as a PABA mimic.</p> Signup and view all the answers

What is the primary excretion route for levofloxacin?

<p>Levofloxacin is primarily excreted by the kidneys.</p> Signup and view all the answers

What is the most lipophilic drug in the tetracycline class?

<p>Minocycline is the most lipophilic drug in the tetracycline class.</p> Signup and view all the answers

What is the category of pregnancy risk for fluoroquinolones?

<p>Fluoroquinolones are classified as Category X in pregnancy, indicating that they are contraindicated due to potential harm to the fetus.</p> Signup and view all the answers

What are the potential adverse effects of aminoglycosides?

<p>The potential adverse effects of aminoglycosides include nephrotoxicity, ototoxicity (cochlear and vestibular toxicity), and rare neuromuscular blockade.</p> Signup and view all the answers

What is the recommended dosing regimen for penicillin when used in combination therapy?

<p>Penicillin is recommended to be administered once daily at a high dose in combination therapy.</p> Signup and view all the answers

Which aminoglycoside has shown to have less nephrotoxicity and ototoxicity than others?

<p>Plazomicin has shown to have less nephrotoxicity and ototoxicity than other aminoglycosides.</p> Signup and view all the answers

What is the coverage of polymyxins against Gram-positive bacteria?

<p>Polymyxins have no coverage against Gram-positive bacteria.</p> Signup and view all the answers

What are the clinical uses of levofloxacin?

<p>UTIs, intra-abdominal infections, CAP, mycobacterial infections, bone and joint infections</p> Signup and view all the answers

What is the gram positive aerobic coverage of ciprofloxacin?

<p>less gram positive activity compared to levofloxacin, generally poor activity to all, not a respiratory FQ due to lack of S. pneumoniae</p> Signup and view all the answers

What is the gram negative aerobic coverage of moxifloxacin?

<p>Considered the least active against Enterobacteriaceae. Not good urinary penetration so it’s not used for UTIs. Good for CAP associated (H. influenzae and M. catarrhalis) Limited to no activity against non-fermenters, and the only fluoroquinolone that has no activity against P. aeruginosa</p> Signup and view all the answers

What is the gram positive anaerobic coverage of levofloxacin?

<p>Somewhat active against P. acnes and Peptostreptococcus</p> Signup and view all the answers

What is the mechanism of action of metronidazole?

<p>The mechanism of action of metronidazole is inhibition of DNA synthesis and DNA degradation leading to cell death.</p> Signup and view all the answers

What are the clinical uses of delafloxacin?

<p>The clinical uses of delafloxacin include UTIs, intra-abdominal infections, CAP, Mycobacteria infections, bone and joint infections, and skin and soft tissue infections.</p> Signup and view all the answers

What are the adverse effects of metronidazole?

<p>The adverse effects of metronidazole include nausea, headache, diarrhea, dry mouth, metallic taste, dark/red brown urine, aseptic meningitis, ataxia, dysarthria, encephalopathy, diabetic neuropathy, seizure, vertigo, and hypersensitivity reactions.</p> Signup and view all the answers

What are the clinical uses of aminoglycosides?

<p>The clinical uses of aminoglycosides include bacterial infections caused by organisms such as enterococci, viridans streptococci, and S. pneumoniae.</p> Signup and view all the answers

Which of the following is NOT a macrolide antibiotic?

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

What is the mechanism of action of erythromycin?

<p>Inhibits protein synthesis</p> Signup and view all the answers

Which of the following is NOT a gram-positive aerobic bacteria that erythromycin is active against?

<p>Moraxella catarrhalis</p> Signup and view all the answers

Which of the following antibiotics has the best activity against gram-positive bacteria, including MRSA and Streptococcus?

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

Which antibiotic is the preferred alternative to oral vancomycin for the treatment of C. diff infections?

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

Which antibiotic has activity against atypical organisms and is active against UTI and CAP pathogens?

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

Which antibiotic is the most effective against gram-negative anaerobes and is commonly used in combination therapy for intra-abdominal infections?

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

Which of the following aminoglycosides has the best activity against acinetobacter baumannii?

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

Which of the following aminoglycosides is commonly associated with urinary tract infections (UTIs) and can be used as monotherapy for UTIs?

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

Which of the following aminoglycosides has less nephrotoxicity and ototoxicity compared to others?

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

Which of the following aminoglycosides is given intravenously or intramuscularly, with poor bioavailability in other formulations?

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

Which drug in the tetracycline class is excreted less in the kidneys compared to tetracycline?

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

Which drug is the treatment of choice for Nocardia spp. and penicillin allergic patients with Listeria monocytogenes?

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

Which drug has improved activity against all gram positive aerobes, including MRSA?

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

Which drug is primarily excreted by the kidneys and requires dose adjustments, while another drug is not excreted by the kidneys and does not have good penetration for UTIs?

<p>Levofloxacin and Moxifloxacin</p> Signup and view all the answers

Which fluoroquinolone has the highest risk for causing QTc prolongation and should be avoided in patients taking amiodarone, sotalol, quinidine, procainamide, erythromycin, or in patients with cardiomyopathy, bradycardia, hypokalemia, or hypomagnesemia?

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

Which fluoroquinolone is the only oral agent that covers Pseudomonas?

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

Which fluoroquinolone is considered the most active against Gram-negative bacteria and is considered first-line treatment for UTIs caused by E. coli, Proteus, and Klebsiella?

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

Which fluoroquinolone has the best activity against Gram-positive anaerobic bacteria, including Propionibacterium acnes and Peptostreptococcus?

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

Which of the following is true about the activity of polymyxins against Gram-negative bacteria?

<p>Polymyxins have no activity against Pseudomonas aeruginosa</p> Signup and view all the answers

Which of the following is true about the metabolism and excretion of fosfomycin?

<p>Fosfomycin is excreted in the urine</p> Signup and view all the answers

Which of the following is a potential adverse effect of nitrofurantoin?

<p>Pulmonary fibrosis</p> Signup and view all the answers

Which of the following is true about the spectrum of activity of methenamine hippurate?

<p>Methenamine hippurate has activity against virtually all fungi and bacteria</p> Signup and view all the answers

Which macrolide has the best coverage against Mycobacteria?

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

Which macrolide is more acid stable than erythromycin and does not have adverse GI effects?

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

Which macrolide is excreted entirely in the feces and is a preferred agent for C. diff infections?

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

Which class of antibiotics has the highest activity against bacteria that cause urogenital infections?

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

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