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52 Cards in this Set
- Front
- Back
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Penicillin G kills:
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Group A, B streps, enterococci
Mouth anaerobes Neiserria meningitidis |
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What dose for neonatal meningitis?
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HIGH dose penicillin B for GBS
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What does Penicillin G NOT kill?
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Most Staph aureus
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What is Penicillin V for?
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Oral use
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What is penicillin G for?
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IV use
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What do you do when giving Penicillin G to salt-sensitive patients?
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Potassium salts - but may be more painful
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Why isn't Penicillin G oral?
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Not broken down by gastric acids
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What is Ampicillin good for?
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Everything Penicillin kills, plus E. Coli and H. flu
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What does Ampicillin NOT kill?
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Staph aureus
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What does Ticarcillin kill?
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Everything ampicillin does plus Pseudomonas aeruginosa
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What is Ticarcillin NOT good for?
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Enterococci and staph aureus
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What is Piperacillin good for?
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Those of Ticarcillin BUT NOT
-E. coli (if amp resistent) -Klebsiella, Enterobacter, Serratia, and Proteus (KESP) Still not staph aureus |
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What do you give with abx to target bata lactamase producers?
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BL inhibitors
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Augmentin
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amoxicillin-clavulanate
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unasyn
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ampicillin-sulbactam
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ticarcillin-clavulanate
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timentin
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4 Bacteria for which beta lactamase inhibitor combination drugs are necessary include:
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-S. aureus (methicillin susceptible only)
-Anaerobes from below the diaphragm -H. influenzae -Moraxella catarrhalis |
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****These 2 bacteria are resistant to bl inhibitors:***
(on the test) |
MRSA
Penicillin resistant staph pneumoniae |
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What is best for PCN resistant Strep pneumo?
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hi-dose amoxicillin will be better
hi-dose augmentin is the same |
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2 drugs to kill anaerobes above/below the diaphragm:
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-Clinda
-Metronidazole -PCN/ampicillin if from the mouth |
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How to kill MSSA:
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Methicillin, nafcillin, oxacillin (IV)
Dicloxacillin (PO) 1st gen ceph's - cefazolin, cephalexin -Erythro/clarithromcin |
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What are 2 drugs kill MSSA OR MRSA?
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Clindamycin
Vancomycin |
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***When is Rifampin useful for killing staph aureus?****
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Only as a part of combination therapy! Never Alone!
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What is usually to be blamed in recurrent S. aureus skin abscesses?
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Usually the SKIN - not the host immune system
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What is the goal in treating recurrent s. aureus skin abscesses?
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Decolonization - not eradication
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What is a good abx for s.aureus decolonization?
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-Mupirocin intranasal BID x5d
-shower daily with soap |
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****What drug does NOT kill enterococci?****
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Cephalosporins!!!!
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**Cephalosporins do not kill:
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-Enterococci
-Listeria -MRSA -Most don't kill anaerobes |
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**What are first and second gen cephalosporins NOT able to do?
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Penetrate CSF - so don't give for meningitis!
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What cephalosporins CAN be used for meningitis?
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3rd-gen cephalosporins
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What are 1st gen cephalosporins good for?
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Staph aureus (MSSA only)
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What are 3rd gen cephs good for?
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GNB (rods) - less good for GPB.
-some only kill enterics, some also kill pseudomonas |
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3rd gen cephs are LESS potent for:
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GRAM POS
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Nafcillin kills:
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s. aureus (mssa)
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1st gen cephs kill:
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mssa, e. coli, klebsiella
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***3rd gen Cefotaxime/ceftriaxone kill:
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-Many GNR
-but NO pseudomonas! -Better for pneumococcus -Worse for staph |
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**Ceftriaxone side effect
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biliary tree stuff - gallstones - do not operate, just stop the drug
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Cefipime kills what in addition to those Cefotax/ceftriaxone kill:
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Pseudomonas
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********What is the 3rd generation drug of choice for penicillin resistant pneumococcus (strep pneumo)?***
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Cefotaxime and Ceftriaxone - this is ON the test
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What is the best drug to kill intermediate penicillin-resistant strep pneumo?
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High-dose penicillins, amoxacillin
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What will NEVER work to kill enterococcus or penicillin-resistant cocci?
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Cephalosporins (1st or 2nd gen)
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Is there an oral equivalent to ceftriaxone/cefotaxime?
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no
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2 tpes of quinolones:
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UTI - cipro
Resp - levofloxacin |
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***I will never use CIPRO to kill a gram positive organism****
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Not for resp infections
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Drugs NOT recommended for PCN-resistant Strep pneumo:
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-First gen cephs
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Gentamicin is good for:
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Anaerobic GNB - pseudomonas; synergistic with ampicillin for enterococcus
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Side effects of aminoglycosides:
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-ototoxicity
-nephrotoxicity |
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Always check what before starting aminoglycosides:
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creatinine
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levo/moxi/gemi-floxacins
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Quinolones for resp infections
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Which is least potent
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levofloxacin
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What quinolones are great for UTIs
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-Ciprofloxacin
-Ofloxacin |
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What are Carbepenams for?
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Broad gram pos and gram neg coverage - esp good for pseudomonas meningitis
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