Podcast
Questions and Answers
Why is tigecycline contraindicated for treating bloodstream infections?
Why is tigecycline contraindicated for treating bloodstream infections?
- It is rapidly metabolized in the bloodstream, leading to sub-therapeutic concentrations.
- It does not achieve sufficient blood levels due to its lipophilic nature. (correct)
- It induces the production of beta-lactamases, which degrade the antibiotic in the bloodstream.
- It primarily targets the 50S ribosomal subunit, which is ineffective against blood-borne pathogens.
A patient presents with a complicated skin and soft tissue infection (cSSTI) caused by vancomycin-resistant Enterococcus faecalis (VRE). Which antibiotic would be the MOST appropriate choice?
A patient presents with a complicated skin and soft tissue infection (cSSTI) caused by vancomycin-resistant Enterococcus faecalis (VRE). Which antibiotic would be the MOST appropriate choice?
- Gentamicin
- Ceftriaxone
- Aztreonam
- Tigecycline (correct)
Which mechanism describes how tigecycline inhibits bacterial growth?
Which mechanism describes how tigecycline inhibits bacterial growth?
- Disrupting the cell membrane by binding to lipopolysaccharides.
- Binding to the 30S ribosomal subunit and inhibiting translation. (correct)
- Interfering with DNA replication by inhibiting DNA gyrase.
- Inhibiting cell wall synthesis by binding to transpeptidases.
A 6-year-old child is diagnosed with a complicated intra-abdominal infection. Considering the information, which antibiotic would be LEAST appropriate for treatment?
A 6-year-old child is diagnosed with a complicated intra-abdominal infection. Considering the information, which antibiotic would be LEAST appropriate for treatment?
A patient with community-acquired pneumonia has a known allergy to beta-lactam antibiotics. The sputum culture reveals Klebsiella pneumoniae with confirmed extended-spectrum beta-lactamase (ESBL) production. Which of the following would be an appropriate treatment option?
A patient with community-acquired pneumonia has a known allergy to beta-lactam antibiotics. The sputum culture reveals Klebsiella pneumoniae with confirmed extended-spectrum beta-lactamase (ESBL) production. Which of the following would be an appropriate treatment option?
Why should tigecycline NOT be prescribed to a pregnant woman?
Why should tigecycline NOT be prescribed to a pregnant woman?
A patient is diagnosed with a mixed infection involving Escherichia coli, Enterobacter cloacae, and methicillin-resistant Staphylococcus aureus (MRSA). Which antibiotic would provide the broadest coverage for this polymicrobial infection?
A patient is diagnosed with a mixed infection involving Escherichia coli, Enterobacter cloacae, and methicillin-resistant Staphylococcus aureus (MRSA). Which antibiotic would provide the broadest coverage for this polymicrobial infection?
Which pathogens are NOT effectively treated by tigecycline?
Which pathogens are NOT effectively treated by tigecycline?
A 32-year-old female is diagnosed with a complicated intra-abdominal infection following a ruptured appendix. She is currently breastfeeding her 6-month-old infant. Which antibiotic should be avoided in this scenario?
A 32-year-old female is diagnosed with a complicated intra-abdominal infection following a ruptured appendix. She is currently breastfeeding her 6-month-old infant. Which antibiotic should be avoided in this scenario?
Compared to tetracyclines, what is the primary structural difference that contributes to tigecycline's enhanced activity against resistant bacteria?
Compared to tetracyclines, what is the primary structural difference that contributes to tigecycline's enhanced activity against resistant bacteria?
Flashcards
Glycylcycline example
Glycylcycline example
Tigecycline; related to tetracyclines.
Glycylcyclines mechanism
Glycylcyclines mechanism
Binds to the 30S ribosome subunit, inhibiting protein synthesis.
Glycylcyclines spectrum of activity
Glycylcyclines spectrum of activity
Broad spectrum against Gram-positive, Gram-negative, and anaerobic bacteria, including MRSA and VRE.
Glycylcyclines lack activity against...
Glycylcyclines lack activity against...
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Glycylcyclines are indicated for
Glycylcyclines are indicated for
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Contraindications for Glycylcyclines
Contraindications for Glycylcyclines
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DO NOT USE Glycylcyclines for...
DO NOT USE Glycylcyclines for...
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Study Notes
- Glycylcyclines are a class of antibiotics.
- Tigecycline is a specific antibiotic in this class and is structurally similar to tetracyclines.
- Glycylcyclines bind to the 30S subunit of the ribosome, inhibiting translation.
- This mechanism of action makes them bacteriostatic.
- They are effective against a broad spectrum of bacteria.
- This spectrum includes Gram-positive bacteria like MSSA, MRSA, and vancomycin-resistant Enterococcus faecalis (VRE).
- They are also effective against most other Gram-positive bacteria, Gram-negative bacteria.
- Effective against E. coli, Enterobacter, H. influenzae, Klebsiella + BLP, anaerobes, SPACE, ESBL, CRE.
- Glycylcyclines are not effective against Pseudomonas, Proteus, and Providencia.
- They are indicated for complicated skin and soft tissue infections (SSTIs), complicated intra-abdominal infections, and community-acquired pneumonia.
- Glycylcyclines are contraindicated in children under 8 years old, and in pregnant or breastfeeding women.
- Use in these populations may cause permanent teeth discoloration and impaired bone/teeth growth.
- Due to its lipophilic properties, tigecycline does not achieve sufficient blood levels.
- Glycylcyclines should not be used for bloodstream infections like sepsis.
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