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41 Cards in this Set
- Front
- Back
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Nosocomial
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acquired in the hospital
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Empiric
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Therapy based on best (educated) guess as to likely pathogens
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Synergy
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A combined effect of two antibiotics that is greater than the sum of their individual
activities |
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Concentration-dependent killing
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Maximal antibiotic effect at concentrations significantly
higher than the minimal inhibitory concentration (MIC). |
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Time-dependent killing
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Equivalent antibiotic effect occurs at any concentration above the
MIC |
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Post-antibiotic effect
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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. |
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Strept group
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Streptococci
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Strept group
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Neisseria meningitidis
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H. influenzae group
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Neisseria
gonorrhea |
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H. influenzae group
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Moraxella catarrhalis,
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H. influenzae group
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Moraxella catarrhalis,
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H. influenzae group
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Haemophilus influenzae,
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Staph group
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Specifically methicillin-sensitive isolates.
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Staph group
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Methicillin resistant S. aureus (MRSA)
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Staph group
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coagulase negative
staphylococci |
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coagulase negative
staphylococci |
sensitive only to vancomycin
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Anaerobic group:
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includes obligate anaerobes
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Anaerobic group
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Bacteroides
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Anaerobic group
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Peptostreptococcus
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Anaerobic group
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Prevotella
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Anaerobic group
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Lactobacillus
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Enteric group
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Members of the family Enterobacteriaceae
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Enteric group
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gram-negative aerobic bacilli which normally inhabit the
human GI tract. |
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Enteric group (5)
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E. coli
Enterobacter Klebsiella Serratia Proteus |
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Pseudomonas aeruginosa
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An important nosocomial gram negative
pathogen with distinct susceptibility pattern from enteric bacteria. |
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Enterococcus
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Includes both E. faecalis and E. faecium
Vancomycin-resistant strains (VRE) are now important nosocomial pathogens |
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Atypical group (5)
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Intracellular pathogens including:
Mycoplasma, Chlamydia, Legionella, Rickettsia, Ehrlichia |
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Aminoglycosides
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gentamicin
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Aminoglycosides
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amikacin
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Aminoglycosides
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streptomycin
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Aminoglycosides
Mechanism of Action |
Target-30s and 50s ribosomal subunits
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Aminoglycosides
Indications (5) |
neutropenic fever
nosocomial infections bacterial endocarditis (synergistic against GPC) intra-abdominal infections pyelonephritis |
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Aminoglycosides
Toxicity |
Acute tubular necrosis(proximal tubule)
Cochlear and vestibular damage Neuromuscular blockade (rare) |
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Beta-lactam antibiotics
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Penicillins
b-lactam/b-lactamase inhibitors cephalosporins monolactams carbapenems |
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Beta-lactam antibiotics
Mechanism of Action |
Target
Penicillin binding proteins (PBPs) |
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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 |
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Extended Spectrum Penicillins
(Examples) |
mezlocillin
piperacillin |
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Extended Spectrum Penicillins
Indications |
neutropenic fever
nosocomial pneumonias/infections intra-abdominal infections |
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b-lactam/b-lactamase inhibitors
Examples |
a) non-pseudomonal agents: ampicillin-sulbactam,
amoxicillin-clavulanate b) anti-pseudomonal agents: piperacillin-tazobactam, ticarcillin-clavulanate |
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b-lactam/b-lactamase inhibitors
Mechanism of Action |
acts as a “suicide
substrate” forming stable bond with b-lactamase |
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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 |
