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41 Cards in this Set

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Nosocomial
acquired in the hospital
Empiric
Therapy based on best (educated) guess as to likely pathogens
Synergy
A combined effect of two antibiotics that is greater than the sum of their individual
activities
Concentration-dependent killing
Maximal antibiotic effect at concentrations significantly
higher than the minimal inhibitory concentration (MIC).
Time-dependent killing
Equivalent antibiotic effect occurs at any concentration above the
MIC
Post-antibiotic effect
Bacterial inhibition persisting for a significant amount of time after
the antibiotic levels decrease below the MIC. This may allow less frequent dosing than
would be predicted based purely on pharmacokinetics.
Strept group
Streptococci
Strept group
Neisseria meningitidis
H. influenzae group
Neisseria
gonorrhea
H. influenzae group
Moraxella catarrhalis,
H. influenzae group
Moraxella catarrhalis,
H. influenzae group
Haemophilus influenzae,
Staph group
Specifically methicillin-sensitive isolates.
Staph group
Methicillin resistant S. aureus (MRSA)
Staph group
coagulase negative
staphylococci
coagulase negative
staphylococci
sensitive only to vancomycin
Anaerobic group:
includes obligate anaerobes
Anaerobic group
Bacteroides
Anaerobic group
Peptostreptococcus
Anaerobic group
Prevotella
Anaerobic group
Lactobacillus
Enteric group
Members of the family Enterobacteriaceae
Enteric group
gram-negative aerobic bacilli which normally inhabit the
human GI tract.
Enteric group (5)
E. coli
Enterobacter
Klebsiella
Serratia
Proteus
Pseudomonas aeruginosa
An important nosocomial gram negative
pathogen with distinct susceptibility pattern from enteric bacteria.
Enterococcus
Includes both E. faecalis and E. faecium
Vancomycin-resistant
strains (VRE) are now important nosocomial pathogens
Atypical group (5)
Intracellular pathogens including:
Mycoplasma, Chlamydia,
Legionella, Rickettsia, Ehrlichia
Aminoglycosides
gentamicin
Aminoglycosides
amikacin
Aminoglycosides
streptomycin
Aminoglycosides
Mechanism of Action
Target-30s and 50s ribosomal subunits
Aminoglycosides
Indications (5)
neutropenic fever
nosocomial infections
bacterial endocarditis (synergistic against GPC)
intra-abdominal infections
pyelonephritis
Aminoglycosides
Toxicity
Acute tubular necrosis(proximal tubule)
Cochlear and vestibular damage
Neuromuscular blockade (rare)
Beta-lactam antibiotics
Penicillins
b-lactam/b-lactamase inhibitors
cephalosporins
monolactams
carbapenems
Beta-lactam antibiotics
Mechanism of Action
Target
Penicillin binding proteins (PBPs)
Beta-lactam antibiotics
Mechanism of Action (3)
Action
a) Bacteriocidal
b) inhibits final step in cell wall synthesis (transpeptidation)
c) require actively dividing bacteria for maximal activity
Extended Spectrum Penicillins
(Examples)
mezlocillin
piperacillin
Extended Spectrum Penicillins
Indications
neutropenic fever

nosocomial pneumonias/infections

intra-abdominal infections
b-lactam/b-lactamase inhibitors
Examples
a) non-pseudomonal agents: ampicillin-sulbactam,
amoxicillin-clavulanate
b) anti-pseudomonal agents: piperacillin-tazobactam,
ticarcillin-clavulanate
b-lactam/b-lactamase inhibitors
Mechanism of Action
acts as a “suicide
substrate” forming stable bond with b-lactamase
b-lactam/b-lactamase inhibitors
Indications
a) Non-pseudomonals: URTI,
bronchitis, bite wounds, diabetic foot infection
b) Anti-pseudomonals: intraabdominal & gyn infections, diabetic foot, nosocomial pneumonia