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Questions and Answers
Why is tigecycline contraindicated for treating bloodstream infections?
Why is tigecycline contraindicated for treating bloodstream infections?
- It does not achieve sufficient blood levels due to its lipophilic properties. (correct)
- It is rapidly metabolized in the bloodstream, leading to sub-therapeutic concentrations.
- It induces the production of beta-lactamases, promoting resistance in bloodstream pathogens.
- It primarily targets the 50S ribosomal subunit, rendering it ineffective against pathogens in the bloodstream.
A 6-year-old child is diagnosed with a complicated skin and soft tissue infection (SSTI) caused by MRSA. Which of the following antibiotics would be the MOST appropriate choice for treatment, considering potential adverse effects and contraindications?
A 6-year-old child is diagnosed with a complicated skin and soft tissue infection (SSTI) caused by MRSA. Which of the following antibiotics would be the MOST appropriate choice for treatment, considering potential adverse effects and contraindications?
- Tigecycline
- Vancomycin (correct)
- Doxycycline
- Ciprofloxacin
A patient with a severe intra-abdominal infection tests positive for ESBL-producing Klebsiella pneumoniae. Which antibiotic would be the MOST appropriate initial choice for empiric therapy, assuming susceptibility is unknown?
A patient with a severe intra-abdominal infection tests positive for ESBL-producing Klebsiella pneumoniae. Which antibiotic would be the MOST appropriate initial choice for empiric therapy, assuming susceptibility is unknown?
- Piperacillin-tazobactam
- Gentamicin
- Tigecycline (correct)
- Ceftriaxone
A patient is diagnosed with a complicated intra-abdominal infection and the culture results indicate the presence of Proteus mirabilis. Which of the following antibiotics would be LEAST effective in treating this infection?
A patient is diagnosed with a complicated intra-abdominal infection and the culture results indicate the presence of Proteus mirabilis. Which of the following antibiotics would be LEAST effective in treating this infection?
A patient is prescribed tigecycline for a complicated skin and soft tissue infection. Which of the following mechanisms of action BEST describes how tigecycline exerts its antibacterial effect?
A patient is prescribed tigecycline for a complicated skin and soft tissue infection. Which of the following mechanisms of action BEST describes how tigecycline exerts its antibacterial effect?
Flashcards
Glycylcyclines Mechanism
Glycylcyclines Mechanism
Binds to the 30S ribosomal subunit, inhibiting bacterial translation. Bacteriostatic in action.
Tigecycline Spectrum
Tigecycline Spectrum
Gram positives (including MRSA, VRE), Gram negatives (like E. coli, Klebsiella), Anaerobes; however, it does NOT cover Pseudomonas, Proteus, or Providencia.
Tigecycline Indications
Tigecycline Indications
Complicated skin infections, intra-abdominal infections, and community-acquired pneumonia.
Tigecycline Contraindications
Tigecycline Contraindications
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Tigecycline
Tigecycline
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Study Notes
- Glycylcyclines are a class of antibiotics, with tigecycline as a specific example, sharing structural similarities with tetracyclines.
- Glycylcyclines work by binding to the 30S subunit of the ribosome, which inhibits translation and exhibits bacteriostatic effects.
Spectrum of Activity
- Effective against a wide range of bacteria including gram-positive (MSSA, MRSA, VRE), gram-negative (E. coli, Enterobacter, H. influenzae, Klebsiella + BLP), anaerobes, SPACE organisms, ESBL, and CRE.
- Glycylcyclines lack activity against Pseudomonas, Proteus, and Providencia ("the three P’s").
- Glycylcyclines are indicated for complicated skin and soft tissue infections (SSTIs), complicated intra-abdominal infections, and community-acquired pneumonia.
Contraindications
- Should not be used in children under 8 years old, pregnant women, or breastfeeding women because it may cause permanent teeth discoloration and impair bone/teeth growth.
- Not suitable for bloodstream infections like sepsis because of its lipophilic properties, which prevent it from achieving sufficient blood levels.
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