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Antimicrobials (Drug Special (Indications, Side Effects, Mechanism of…
Antimicrobials
Drug
Special
Indications
Side Effects
Mechanism of Action
Protein Synthesis
50s Subunit
Chloramphenicol
Clindamycin
Linezolid
Macrolides
Streptogramins
Chloramphenicol
Clindamycin
Linezolid
Macrolide
Azithromycin
Clarithromycin
Erythromycin
Azithromycin
Clarithromycin
Erythromycin
Streptogramins
Quinupristin
Dalfopristin
Quinupristin
Dalfopristin
30s Subunit
Aminoglycosides
Glycylcycline
Tetracycline
Aminoglycosides
Gentamicin
Neomycin
Amikacin
Tobramycin
Streptomycin
Gentamicin
Neomycin
Diseases Treated
Hepatic encephalopathy
Diarrhea due to E. coli
Amikacin
Tobramycin
Streptomycin
Glycylcycline
Tigecycline
Tigecycline
Tetracyclines
Tetracycline
Doxycycline
Minocycline
Tetracycline
Doxycycline
Diseases Treated
Clostridial skin infections
Minocycline
RNA Polymerase
σ-Subunit of RNA Polymerase
Macrocyclic
Fidaxomicin
Leads to protein synthesis impairment and cell death
Good Rx for C. Difficile
DNA-dependent RNA Polymerase
Rifaximin
alters GI flora to decrease intestinal production and absorption of ammonia
Diseases Treated
Hepatic encephalopathy
Traveler's diarrhea
Inhibit Cell Wall Synthesis
Most effective against Gram (+) because Gram Negatives don't rely on a cell wall for structural integrity
Inhibit Peptidoglycan Cross-linking
β-lactams
Stop peptidoglycan synthesis - at D-ALA-D-ALA groups
Monobactams
Aztreonam
Carbapenems
Imipenem
Meropenem
Ertapenem
Doripenem
Imipenem
Meropenem
Ertapeneum
Doripenem
Penicillins
Good activity against Gram (+) organisms which rely on their thick cell walls for survival. Bind to Penicillin-Binding Proteins which form peptidoglycan cross-links. They are bacteriocidal
No Resistance to Beta-Lactamases
Penicillin G, V
Ampicillin
Amoxicillin
Give With β-Lactamse Inhibitors
Tradintional Penicillins
Gram (+) Organisms
S pneumoniae
S. pyogenes
Actinomyces
N. meningitidis
T. apllidum
Acid Labile Penicillin
Penicillin V
Penicillin V
Administered via IV
Indications
Group A (S. Pyogenes) Streptococcal Pharyngitis
Rheumatic Fever
Acid Stable Penicillin
Penicillin G
Penicillin G
Oral administration
Special
Intrapartum Group B Strept Prophylaxis
Treats Pasturella
Actinomyces Isrealii (G(+) Rod growing in chains
Single dose needed to treat Syphilis
N. meningitis
Indications
Rheumatic Fever
Left-sided Endocarditis caused by S. viridans and S. bovis
Intrapartum for Group B strept prophylaxis
Clostridium perfringens
Pasteurella multocida infected bites
Single dose treated Treponema pallidum
Neisseria meningitidis (Gram (-))
inflammation in the meninges makes Penicillin G more able to cross the BBB
2 more items...
Beta-Lactamase Inhibitors
Taxobactam
Sulbactam
Clavulonate
AminoPenicillins
Mechanism of Action
Better ability to penetrate gram negative membranes
make these broad-spectrum antibiotics.
They are "amped-up" penicillins but should be given with beta-lactamase inhibitors
Amoxicillin (oral)
Special
Amoxicillin + Clavulonate (beta-lactamase inhibitor) (Augmentum)
S. pneumonia
H. influenzae
S. pyogenes
Borrelia burgdoerfi (Lymes)
Indications
Sinus Infections
Respiratory Tract Infections
Acute Otitis Media (S. Pneumo and H. Influ)
Prophylaxis to Asplenic patients (S. Pneumo, H. Influ, and Moraxella)
Pneumonia due to H. influ and S. Pneumo
Triple Therapy for H. Pylori
Lyme's Disease (Early stage / Young Children to avoid staining of teeth caused by doxycycline)
Prophylaxis prior to dental procedures for high risk endocarditis
Resistance
Give with beta-lactamase inhibitor to avoid beta-lactamase resistance
Clavulonate
Solbactam
Tazobactam
Side Effects
Rash
Steven Johnson Syndrome
Drug-induced liver injury
Rare skin rash if given in setting of viral infection like EBV
Ampicillin (IV)
Special
Ampicilln + Solbactam (Uniten)
Anaerobic Infections
Meningitis due to Listeria
Indications
Serious Anaerobe infections
Aspiration pneumonia
Enterococcus
Listeria
Coverage against Gram Negative Rods
Resistance
Beta-lactamase producing enterococcus
Give with beta-lactamase inhibitors to avoid beta-lactamase resistance
Clavulanate
Solbactam
Tazobactam
Anti-Pseudomonal Penicillins
Piperacillin and Ticarcillin
Special
Pseudomonas coverage
Indications
Pseudomonas
Hospital Acquired Pneumonia
Empiric Treatment for Pneumonia
Patients at risk for hospital acquired infections
Anaerobic infections
Resistance to Beta-lactamases
Have bulky R groups that prevent beta-lactamase binding
Oxacillin
Nafcillin
Dicloxacillin
Nafcillin
Oxacillin
Dicloxacillin
Special
Naf for Methicillin Sensitive Staph aureus
Indications
MSSA
Narrow spectrum Gram Positive Staphylococci
Oral for minor, IV for serious staphylococcal infections
Staph Osteomyelitis
Staph endocarditis
Mechanism of Action
Have large R groups that prevent Beta-lactamases from inactivating them
Resistance
MRSA has altered penicillin binding proteins that make it resistant to even Nafcillin
Cephalosporins
1st- Cefazolin
2nd - Cefoxitin
3rd - Ceftriaxone
4th - Cefepime
5th - Ceftaroline
1st Gen
Cefazolin
2nd Gen
Cefoxitin
3rd Gen
Ceftriaxone
4th Gen
Cefepime
5th Gen
Ceftaroline
Inhibit Peptidoglycan Synthesis
Glycopeptides
Vancomycin
Bacitracin
Vancomycin
Bacitracin
Folic Acid Synthesis and Reduction
DNA Methylation
Sulfonamides
Sulfamethoxazole
Sulfisoxazole
Sulfadiazine
Sulfamethoxazole
Sulfisoxazole
Sulfadiazine
Trimthoprim
Gyrase
Fluoroquinolones
Ciprofloxacin
Levofloxacin
Ciprofloxacin
Levofloxacin
Quinolone
Nalidixic Acid
Nalidixic Acid
Membrane Integrity
Daptomycin
Daptomycin
DNA Integrity
(Free Radical Generation)
Metronidazole
Metronadazole
mRNA Synthesis
(RNA polymerase)
Rifampin
Rifampin
