10 Questions
Which are examples of Gram Positive bacterial organisms? (Select all that apply)
Streptococci
Name one type of Anaerobe bacterial organism.
Clostridia
Match the antibiotic with its class: Amoxicillin, Gentamicin, Linezolid, Ciprofloxacin
Amoxicillin = B-Lactams Gentamicin = Aminoglycosides Linezolid = Oxazolidinones Ciprofloxacin = Quinolones
Penicillins are mainly effective against Staph infections.
False
Beta-Lactam antibiotics inhibit bacterial cell wall synthesis by binding to ____________.
penicillin-binding proteins
What are the examples of medications classified under Traditional antibiotics?
Penicillin, Ampicillin, Amoxicillin, Ampicillin
Which generation of antibiotics does Ceftaroline belong to?
5th Generation
Tetracyclines are suitable for use in pediatric patients under 8 years old.
False
Tigecycline, a Glycylcycline antibiotic, is reserved for treating ______________ infections.
MRSA
Match the following antibiotics with their examples:
Aminoglycosides = Gentamicin, Tobramycin, Amikacin Nitrofurantoin = Nitrofurantoin Traditional Antibiotics = Penicillin, Ampicillin, Amoxicillin
Study Notes
Bacterial Organisms
- 4 main classes of bacteria:
- Gram Positive: MRSA, Staphylococci, Streptococci, Enterococcus
- Gram Negative: E.coli, Haemophilus Influenza, Moraxella Catarrhalis, Pseudomonas, Atypicals, ESBL
- Anaerobes: Streptococci (Gram +), Clostridia (Gram +), Bacteroides (Gram -)
- Atypical: Mycoplasma, Chlamydia, Rickettsia, Legionella, Mycobacteria
Antibiotic Agents and Class
- B-Lactams: penicillin, cephalosporin, penicillin beta-lactamase
- Penicillins: amoxicillin, ampicillin, dicloxacillin, nafcillin, oxacillin, penicillin G, penicillin V, piperacillin
- Cephalosporins: first generation (cefazolin, cefadroxil, cephalexin), second generation (cefaclor, cefoxitin, cefotetan), third generation (cefotaxime, ceftriaxone), fourth generation (cefepime)
- Penicillin/Beta-lactamase: amoxicillin/clavulanate, piperacillin/tazobactam
- Other classes: Nitrofurans, Aminoglycosides, Nitroimidazole, Quinolones, Tetracycline, Sulfonamides, Macrolides, Oxazolidinones, Lincosamide, Glycopeptides
Mechanisms of Action
- Inhibition of Cell Wall Synthesis: PCN, Cephalosporins, Imipenem, Meropenem, Aztreonam, Vancomycin
- Inhibition of Bacterial Protein Synthesis: Aminoglycosides, Macrolides, Tetracycline, Linezolid, Clindamycin
- Inhibition of Nucleic Acid Synthesis: Fluoroquinolones, Rifampin
- Inhibition of Folic Acid Synthesis: Sulfonamides, Trimethoprim
- Inhibition of Free Radical Formation: Metronidazole
Mechanisms of Resistance
- Enzymatic Inactivation: Beta-Lactamases, Aminoglycoside-Modifying Enzymes
- Alteration of Target Site: changes to Ribosomes, Penicillin-Binding Proteins (PBPs), DNA gyrase, Topoisomerase
- Decreased Permeability: decreased ability of antibiotic to enter bacterial cell, Porin Channels, Efflux pumps
Antibiotic Adverse Side Effects
- Majority: Nausea/Vomiting/Diarrhea/Rash/Thrush (GI side effects)
- Specific effects:
- Penicillins: Hypersensitivity/Skin Reactions
- Cephalosporins: C.Difficile Colitis
- Macrolides: GI Side Effects/Hepatitis/QT Interval Prolongation
- Quinolones: QT Prolongation/Tendonitis/Convulsions
- Aminoglycosides: Nephrotoxicity/Ototoxicity
- Vancomycin: "Red Man" Syndrome
- Clindamycin: C.Difficile Colitis
- Tetracyclines: Hepatotoxicity/Stained Teeth/Photosensitivity/Dysphagia
- Nitrofurantoin: Peripheral Neuropathy
- Sulfonamides: Stevens-Johnsons Syndrome (skin type reaction, hypodynamic instability)/Blood Dyscrasias
Antibiotic Drug Interactions
- Enzyme Inhibitors: Erythromycin, Clarithromycin, Metronidazole, Ciprofloxacin
- Enzyme Inducers: Rifampin
- Absorption: Tetracyclines, Quinolones (reduced by Antacids, Calcium)
- Entero-Hepatic Cycling: Broad Spectrum Antibiotics, Oral Contraceptives
- Vitamin K Synthesis: Broad Spectrum Antibiotics, Warfarin
- Metronidazole: Disulfiram-like interaction with alcohol
Renal Adjustment
- Antibiotics that do not require renal adjustment:
- Nafcillin
- Oxacillin
- Ceftriaxone
- Clindamycin
- Azithromycin
- Erythromycin
- Moxifloxacin
- Doxycycline
- Tigecycline
- Rifampin
Beta-Lactam Antibiotics
- Time Dependent Antibiotics: Beta lactam ring, MOA of Penicillin and Cephalosporin
- Resistance Mechanism: B-Lactamase, PBPs structural changes, Porin structural changes
Penicillins
- Traditional: Narrow Spectrum (Penicillin G, V), Extended Spectrum (Amoxicillin, Ampicillin), Broad Spectrum (Amoxicillin/Clavulanate)
- Coverage: Gram+, Primarily Strep Infections Only! (Staph now resistant)
- Examples: Penicillin G, Penicillin V, Amoxicillin, Ampicillin
Tetracyclines
- Examples: Doxycycline, Tetracycline, Minocycline
- Coverage: Gram+, Gram-, Antiprotozoal properties, and Atypicals
- Concentration Dependent Antibiotic
- Considerations: Doxycycline use more often, Acne, STDs, Pelvic Inflammatory Disease, Rickettsia Disease
Aminoglycosides
- Examples: Gentamicin, Tobramycin, Amikacin
- Coverage: Wide range of bacteria, Most effective = Gram Negative and Pseudomonas
- Concentration Dependent Antibiotic
- Considerations: Not used alone, Typically used with Ampicillin (synergistic), Ototoxicity, Renal Toxicity, Avoid in Pregnancy
Nitrofurantoin
- Example: Nitrofurantoin
- Coverage: Gram+ and Gram-
- Considerations: MOA: Inhibits DNA, RNA, protein, cell wall synthesis, Bacteriostatic/Bactericidal, Urinary Tract Infection Uncomplicated, Urinary Tract Infection Prophylaxis
- Adverse Side Effects: Increased risk for Serotonin Syndrome
This quiz covers the main classes of bacterial organisms, including Gram Positive and Gram Negative bacteria, and considerations for antibiotic treatment of infections.
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