Microbiology

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Rapid IV infusion is associated with diffuse flushing ("red man" syndrome)

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VANCOMYCIN
Used for MRSA and Pseudomembranous Colitis (C.Difficile). Limit side effects with slow infusion and antihistimines.

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These 2 drugs create a block in successive reactions for folate synthesis; also often used to treat UTI.

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TMP-SMX
TMP = DHFR inhibitor = megaloblastic anemia
SMX = hypersensitivity Rxns and hemolysis in pts with G6PDH.

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Contraindicated in pregnant women and children, because it causes bone dysplasia and defects in dental enamal.

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TETRACYCLINE
Broad spectrum bacteriostatic drug that inhibits 30S protein synthesis; provides good coverage against Mycoplasma, Chlamydia, Rickettsia, Vibrio.

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This class of antibiotics that inhibits protein synthesis and is effective in the treatment of MRSA and VRE.

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STREPTOGRAMINS
Synercid is a mixture of quniupristin and dalfopristin; use has been associated with arthralgias and myalgias as well as inhibition of P450 enzymes.

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Rarely used alone, except for the treatment of the meningococcal carrier state, this drug imparts a red-orange color.

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RIFAMPIN
Inhibits DNA dependent RNA polymerase; often used in a combined drug regimen for M. TB because of rapid resistance if used alone.

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Administered as an aerosol, this drug is used for the tx of RSV.

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RIBAVIRIN
Guanosine analog that inhibits formation, the capping of viral mRNA, and viral RNA dependant RNA polymerase activity; also used for the management of viral hemorrhagic fevers and hepatitis C infection.

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This antibiotic disrupts bacterial membranes and is often too toxic to be administered systemically, although it is safe topically.

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POLYMYXIN B
This agent acts as a cationic detergent that disrupts the membrane; systemic use causes neurotoxicity and acute tubular necrosis.

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This group of bactericidal antibiotics inhibits the transpeptidation step during cell wall synthesis, resulting in the activation of autolytic enzymes, which destroy the bacteria.

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PENICILLINS
The mechanism of cephalosporins is nearly identical; major side effects include hypersensitivity with uticaria and rarely, anaphylaxis leading to life-threatening asphyxiation.

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Aminoglycoside given orally for prophylaxis in bowel surgery, and also used to treat hepatic encephalopathy.

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NEOMYCIN
This drug prevents the growth of GI flora and the accumulation of nitrogenous microbial metabolites, which contribute to the development of hepatic enchephalopathy; too toxic to be administered IV, but often used topically in OTC antibiotic ointments.

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Antiprotozoal agent used in the tx of amebiasis, thrichomoniasis, and giardiasis, as well as for pseudomembranous colits.

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METRONIDAZOLE
undergoes activation by anaerobes and parasites, to create products that interfere with nucleic acid synthesis, resulting in cytotoxicity.

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Narrow spectrum, penicillinase-resistant Beta lactam antibiotics, used to tx penicillin-resistant S. Aureus.

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IV
METHICILLIN
NAFCILLIN
OXACILLIN

Oral
DICLOXACILLIN
CLOXACILLIN

Bulkier R-groups on the penicillin backbone prevent degradation by penicillinases

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This agent is recommended for prophylaxis of TB in skin test converters and in people who have close contact iwth patients with active disease. It is also the primary drug in omst multidrug regimens for the tx of TB.

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ISONIAZID (INH)- give with B6
Inhibits synthesis of mycolic acid in the mycobacterial cell wall; because it is acetylated by the liver, side effects include peripheral neuritis in slow acetylators and hepatitis in fast acetylators. Due to the multidrug-resistant strains of M.TB, multidrug regimens also include ETHAMBUTOL, PYRAZINAMIDE, RIFAMPIN, STREPTOMYCIN.

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Broad-spectrum penicillinase resistant carbapenem, administered in conjunction with CILISTATIN

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IMAPENUM
used against gram + cocci, gram - rods, and anaerobes. It is metabolized by renal dihydropeptidase, which is blocked by the coadministraion of cilastatin.

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Can cause tendon damage in adults, and is contraindicated in children and pregnant women bc of damage to developing cartilage.

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FLUOROQUINOLONES -floxacin
Bactericidal inhibitor of DNA Gyrase, used for gram - Rods, Neisseria spp. and some gram + orgnaisms.

Penetrating:
Enterics
Bone
Tissue (Intracellular orgainsms)

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Side effects of this widely used antibiotic include GI irritation and a hypersensitivity based acuet cholestatic hepatitis.

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ERYTHROMYCIN
Bacteriostatic inhibitor of protein sysnthesis, functioning to the 50S. Good coverage of Mycoplasma, Corynebacterium, Chlamydia, Legionella and Bordatella supp.

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Antibiotic associated with the development of pseudomembranous colitis, due to overgrowth of Clostridium difficile.

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CLINDAMYCIN
50S inhibitor (methylation), bacteriostatic.used in the tx of serious anaerobic infections due to Bacteroides spp.

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Administered with penicillins to enhance their antimicrobial effects.

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CLAVULANIC ACID
SULBACTAM
TAZOBACTAM

Inhibit penicillinase, resulting in increased microbial coverage.

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Associated with myelosupression and rarely, an idiosyncratic, irreversible aplastic anemia.

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CHLORAMPHENICOL
Bc of its inhibition of RBC maturation, it is rarely used systemically; it is available as a topical preparation

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Causes cyanosis and cardiovascular collapse in premature neonates deficient in hepatic gluconosyltransferase (Gray baby syndrome)

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CHLORAMPHENICOL
Bacteriostatic inhibitor of protein synthesis, blocking peptidyl transferase activity at the 50S.

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Used for the tx of septic meingitis, bc this cephalosporin has good penetration into the CNS.

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CEFTRIAXONE
It demonstrates coverage against the leading causes of bacterial meningitis; S. Pneumoniae, N. Meningitidis, H. Influenzae; other 3rd generation cephalosporins, such as CEFIXIME, are the drug of choice for tx of N. Gonorrhoeae infection.

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These extended-spectrum penicillins are particularly useful against infection with Pseudomonas and Enterobacter spp.

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CARBENICILLIN
PIPERACILLIN
TICARCILLIN
these agents can be used with penicillinase inhibitors and work synergistically with aminoglycosides.

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Inhibitor of bacterial cell wall synthesis, this agent is available as the topical preparation on many OTC antibacterial ointments.

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BACITRACIN
This peptide antibiotic inhibits cell was synthesis in Gram + organisms; causes sever nephrotoxicity if used systemically.

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Although it works similarly to penicillins and cephalosporins, this monobactam is resistant to penicillinases, and displays no cross allergenicity with penicillins

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AZTREONAM
Although it is ineffective against Gram + or Anaerobic bacteria, it works synergistically with Aminoglycosides against Gram - Rods.

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This extended-spectrum penicillin is used to tx infections with Gram - organisms such as Haemophilus spp., E.Coli, Listeria, Proteus spp, and Salmonella spp

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AMPICILLIN
Often admistered with penicillinase inhibitors; a similar drug, AMOXICILLIN, often is preferred bc of its greater oral bioavailability and decreased GI irritability

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Ineffective against anaerobes, due to the requirement for oxygen to be taken up by the organism.

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AMINOGLYCOSIDES
Gentamicin, Streptomycin,Tobramycin,Neomycin, Amikacin

Bactericidal inhibitors of mRNA translation at the 30S, these agents are associated with significant nephrotoxicity and ototoxicity.

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Urinary antiseptic that requires acidification and, therefore, is ineffective systemically, although toxic levels can accumulate in pts with renal failure.

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NITROFURANTOIN
Can cause GI side effects, rash, and hemolysis in G6PDH deficient pts.