Surgical Abx

Front 1

Common nose bugs?

Back 1

S. aureus, pneumococcus, meningococcus

Front 2

Common skin bugs?

Back 2

S. aureus, S. epidermidis

Front 3

Common mouth bugs?

Back 3

streptococci, pneumococcus, e.coli, bacteroides, fusobacterium, peptostreptococcus

Front 4

Common UTI bugs?

Back 4

E.coli, proteus, klebsiella, enterobacter

Front 5

Common Colonic bugs?

Back 5

E. coli, klebsiella, enterobacter, bacteroides spp, peptostreptococci, clostridia

Front 6

Common biliary tract bugs?

Back 6

E. coli, klebsiella, proteus, clostridia

Front 7

Common vaginal bugs?

Back 7

Streptococci, staphylococci, E. coli, peptostreptococci, bacteroides spp.

Front 8

Common URI bugs?

Back 8

Pneumococcus, H. influenzae

Front 9

#1 choice for clean/clean-contaminated skin infections?

Back 9

Ancef (cefazolin - 1st gen cephalosporin)

Front 10

1st gen Cephalosporin activities?

Back 10

+Gram-pos: +penicillinase-producing, MSSA and strep. NO MRSA or enterococci.
-Gram-negative: PEcK only: Proteus, some Escherichia coli, and Klebsiella pneumoniae ("PEcK"), but NO B fragilis, Pseudomonas, Acinetobacter, Enterobacter, indole-positive Proteus, or Serratia.

Front 11

2nd gen Cephalosporin activities?

Back 11

-Gram-positive: Less than first-generation.
+Gram-negative: Greater than first-generation: HEN & PEcK (Haemophilus influenzae, Enterobacter aerogenes and some Neisseria

Front 12

3rd gen Cephalosporin activities?

Back 12

-Gram-positive: Decreased activity against Gram-positive organisms.
Gram-positive: Broad activity. Particularly useful in treating hospital-acquired infections, althoable increasing resistance. Able to penetrate CNS => useful against meningitis caused by pneumococci, meningococci, H. influenzae, and susceptible E. coli, Klebsiella, and penicillin-resistant N. gonorrhoeae. #1 tx for gonorrhea.

Front 13

What are the general rules for cephalsporin bacterial activity?

Back 13

1st generation are similar to broad spectrum penicillins, but have slightly improved gram positive and gram negative anaerobic spectrum. As they go up in in generation they have decreasing positive activity and increasing negative activity. Fourth generation are effective against pos and best against gram neg

Front 14

4th generation cephalosporin activity?

Back 14

+Gram-positive: Extended-spectrum against Gram-pos ~1st gen.
+Grcan eg: can penetrate outer membrane of Gram-negative bacteria. Greater resistance to beta-lactamases than the third-gen. can cross the BBB => effective in meningitis. Used against Pseudomonas aeruginosa.

Front 15

Backup for Ancef in MRSA/MRSE hospital or serious penicillin allergy?

Back 15

Vanco

Front 16

ABX selection for Surgical procedures which enter the gastrointestinal, oropharyngeal, genitourinary, biliary, or tracheobronchial tracts and result in spillage of bacteria?

Back 16

Cefoxitin or cefotetan alone
– Clindamycin with amino glycoside
– Metronidazole with cefazolin

– Broad spectrum agents are frequently utilized for prophylaxis as monotherapy
- Unasyn, Timentin, Zosyn, Primaxin, Merrem

Front 17

ABX selection for Dirty procedures? E.g ruptured appendix.

– Patient already has an established infection and requires a surgical procedure that is often times emergent.

– Therapeutic course of antibiotics is required and is no longer considered prophylaxis

Back 17

- Surgery required to remove remains of appendix

– Requires broad spectrum activity

- Unasyn, Timentin, Zosyn, Merrem, Primaxin

Front 18

Summary of surgical wound prophylaxis?

Back 18

Identify wound infection risk based on patient's surgical procedure

– Clean
- Cefazolin

– Clean/contaminated
- Cefazolin vs broad spectrum (cefoxitin or cefotetan)

– Contaminated
- Broad spectrum (cefoxitin or cefotetan)

– Dirty
- Therapeutic antibiotics

Front 19

Cefoxitin or cefotetan generation & activity/use?

Back 19

2nd gen : fox, fur, tea. Gram -ves HEN PEcK. Little gram pos. Use for GI dirty procs with Gram Neg & Anaerobes.

Front 20

Clindamycin activity?

Back 20

Linezolid: Anerobes, gram-negs, MRSA, Staph epi, VRE.
Enterococcus, nocardia, Strep pneumoniae & viridians.
Clostridium but NOT difficile

Front 21

aminoglycoside activity & examples?

Back 21

Streptomycin, gentamycin, amikacin
Protien synthesis inhibitor => good to stop toxin synthesis & release.
Main action = aerobic, gram-negative bacteria, such as Pseudomonas, Acinetobacter, and Enterobacter. In addition, some Mycobacteria, including TB. Serious infections such as septicemia, complicated intraabdominal, complicated UTI & nosocomial respiratory tract.

Front 22

Metronidazole activity?

Back 22

Anaerobes & gram negs.
C DIFFICILE. B fragilis, peptostrep.
BAC Vaginosis gardnerella. H pylori. Amoebiasis, trichomonas, Giardiasis.

Front 23

cefazolin activity?

Back 23

1st gen. Gram positive : Staph, Strep.

Front 24

Unasyn activity?

Back 24

Ampicillin/sulbactam is also used when the cause of an infection is not known (empiric therapy). Intra-abdominal infections, skin infections, pneumonia, and gynecologic infections. It is active against a wide range of bacterial groups, including Staphylococcus aureus, Enterobacteriaceae, and anaerobic bacteria. Importantly, it is not active against Pseudomonas aeruginosa and should not be used alone when infection with this organism is suspected or known.

Front 25

Zosyn activity?

Back 25

piperacillin/tazobactam combination has activity against many Gram-positive and Gram-negative pathogens and anaerobes, including Pseudomonas aeruginosa.

Front 26

Erythromycin activity?

Back 26

Erythromycin is a macrolide antibiotic that has an antimicrobial spectrum similar to or slightly wider than that of penicillin, and is often used for people who have an allergy to penicillins. For respiratory tract infections, it has better coverage of atypical organisms, including mycoplasma and Legionellosis