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15 Cards in this Set
- Front
- Back
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How does Vancomycin work?
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Binds to -D-ala-D-ala and prevents the cross-linking of the cell wall where it binds
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What is the mechanism for intermediate level resistance of S. aureus to vancomycin?
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Overproduction of PBP2 and PBP2a
Overproduction of peptidoglycan precursors These lead to a thicker cell wall, which increases the amount of vancomycin necessary to kill |
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How did VRSA (high level vancomycin resistant S. aureus) acquire resistance to vancomycin?
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Got it from a plasmid from Enterococcus faecium that had developed resistance
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How does VRSA resistance work?
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5 proteins that change -D-ala-D-ala to -D-ala-D-lac
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How is vancomycin administered?
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IV for systemic disease - not absorbed from the GI tract
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How is vancomycin excreted?
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Renally, unchanged (so is bactericidal in urine)
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What are the clinical uses of vancomycin?
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Serious infections not susceptible to other agents
- hospital-acquired MRSA - C. difficile |
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How is vancomycin administered to treat C. diff?
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Orally, because it does not need to be absorbed to be effective
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What are the adverse effects of vancomycin?
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Ototoxicity, nephrotoxicity (rare at normal dose), and "Red man" syndrome from rapid infusion of vancomycin
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How does daptomycin work?
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Binds to bacterial membrane in a calcium-dependent manner and then depolarizes the cell
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What is the mechanism of bacterial resistance to daptomycin?
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Alteration in bacterial phospholid membrane resulting in a change in surface charge
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How is daptomycin administered?
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IV
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What are the clinical uses of daptomycin?
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Complicated skin and soft tissue infections
VISA, VRSA infections |
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What are the adverse effects of daptomycin?
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GI irritation
Elevation in creatine phosphokinase Chance of muscle injury if administered with statins |
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What is the best predictor of daptomycin administration that leads to elevated CPK levels?
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Increased dosing interval
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