NURS 5334 Antimicrobial Review
Gram positive organisms - *answers *Staph, Strep, Enterococcus
1st line Treatment of Gram positive - *answers *Penicillins
2nd line treatment of Gram positive with Penicillin Allergy - *answers *Cephalosporins:
3rd generation (cefdinir, cefuroxime) Macrolides: if anaphylactic (azithromycin,
clarithromycin)
AOM and sinusitis organisms - *answers *Haemophilus influenzas, Moraxella
catarrhalis, Streptococcus pheumoniae
1st line tx for AOM - *answers *high dose amoxicillin 5-10 days
AOM pain - *answers *Ibuprofen, acetaminophen
for Antibiotic resistant AOM - *answers *amoxicillin- clavulanate or ceftriaxone
AE with clavulante - *answers *diarrhea
Renders PCNs G and V inactive - *answers *beta-lactamases
to Tx Step and AOM - *answers *Ampicillin, amoxicillin
DOC for PCN allergies - *answers *Macrolides
Narrow spectrum PCNs resistant to penicillinase enzymes - *answers *Oxacillin,
Nafcillin, dicloxacillin,
extended spectrum antipseudomonal PCN - *answers *Piperacillin/tazobactam
Not affected by beta lactamase bacteria - *answers *oxacillin, nafcillin, dicloxacillin
Piperacillin (given with tazobactam)=Zosyn - *answers *effective against pseudomonas,
Enterobacter, Bacteroides fragilis and klebsiella. is not given alone.
Beta lactamase inhibitors - *answers *never given alone: clavulanic acid, tazobactam,
sulbactam no MRSA coverage
piperacillin/tazobactam - *answers *effective against pseudomonas
amoxicillin/clavulanic acid - *answers *ears, lungs, sinus, skin, and urinary tract. used
to treat infections caused by beta-lactamase producing organisms.
Beta lactamase inhibitors combined drugs - *answers *ampicillin/sulbactam;
amoxicillin/clavulanic acid; Piperacillin/tazobactam NO:MRSA coverage
, NURS 5334 Antimicrobial Review
Cephalosporins - *answers *most widely used, has a beta lactam ring
1st generation Cephalosporins - *answers *presurgical prophylaxis, gram-positive,
2nd generation cephalosporins - *answers *mostly gram-positive. cefoxitin-(anaerobic
Bacteroides fragilis),cefuroxime (URI, pneumonia from h flu, pneumococci and staph)
some beta-lactamase cover
3rd generation cephalosporins - *answers *meningitis=penetrates the CSF. good Gram
negative aerobe coverage. no pseudomonas or enterococcus activity.
4th generation cephalosporins - *answers *pseudomonas and hospital acquired
infections; Ceftaolozane/tazobactam; cefepime
5th generation cephalosporins - *answers *Ceftaroline: MRSA, VRSA, community-
acquired pneumonia, broad-spectrum with gram- and + cover, pseudomonas and some
Enterobacteriaceae
3rd generation cephalosporin names - *answers *cefotaxime, cefdinir, cefditoren,
cefixime, cefpodoxime, ceftazidime, ceftibuten, ceftriaxone, cefoperazone, ceftibuten,
ceftizoxime
cephalosporins Side effects - *answers *Cross allergy with PCN; NO: Alcohol increased
bleeding=decreased prothrombin via interference with Vitamin K
cephalosporins that cause bleeding and are contraindicated with Alcohol - *answers
*Cefotetan, cefmetazole, cefoperazone
Carbapenems - *answers *weakens the cell wall, big Guns, Broad spectrum, given in
hospital and not given alone. end with -enem, except for avibactam. covers gram -,
gram + and anaerobes, renal excretion
Carbapenems contraindicated with - *answers *reduces levels of Valproate
Imipenem - *answers *not given alone: broadest spectrum given with vancomycin
Meropenem - *answers *meningitis
ertapenem - *answers *complicated GI, GU, soft tissue infection, CAP
Doripenem - *answers *complicated intra-abdominal infections/complicated UTIs
Avibactam - *answers *combined with ceftazidime for intra-abdominal and UTIs
Vancomycin - *answers *glycopeptide; inhibits cell wall synthesis;
narrow-spectrum used only for MRSA and C.Diff, only oral is for C. Diff.
Gram positive organisms - *answers *Staph, Strep, Enterococcus
1st line Treatment of Gram positive - *answers *Penicillins
2nd line treatment of Gram positive with Penicillin Allergy - *answers *Cephalosporins:
3rd generation (cefdinir, cefuroxime) Macrolides: if anaphylactic (azithromycin,
clarithromycin)
AOM and sinusitis organisms - *answers *Haemophilus influenzas, Moraxella
catarrhalis, Streptococcus pheumoniae
1st line tx for AOM - *answers *high dose amoxicillin 5-10 days
AOM pain - *answers *Ibuprofen, acetaminophen
for Antibiotic resistant AOM - *answers *amoxicillin- clavulanate or ceftriaxone
AE with clavulante - *answers *diarrhea
Renders PCNs G and V inactive - *answers *beta-lactamases
to Tx Step and AOM - *answers *Ampicillin, amoxicillin
DOC for PCN allergies - *answers *Macrolides
Narrow spectrum PCNs resistant to penicillinase enzymes - *answers *Oxacillin,
Nafcillin, dicloxacillin,
extended spectrum antipseudomonal PCN - *answers *Piperacillin/tazobactam
Not affected by beta lactamase bacteria - *answers *oxacillin, nafcillin, dicloxacillin
Piperacillin (given with tazobactam)=Zosyn - *answers *effective against pseudomonas,
Enterobacter, Bacteroides fragilis and klebsiella. is not given alone.
Beta lactamase inhibitors - *answers *never given alone: clavulanic acid, tazobactam,
sulbactam no MRSA coverage
piperacillin/tazobactam - *answers *effective against pseudomonas
amoxicillin/clavulanic acid - *answers *ears, lungs, sinus, skin, and urinary tract. used
to treat infections caused by beta-lactamase producing organisms.
Beta lactamase inhibitors combined drugs - *answers *ampicillin/sulbactam;
amoxicillin/clavulanic acid; Piperacillin/tazobactam NO:MRSA coverage
, NURS 5334 Antimicrobial Review
Cephalosporins - *answers *most widely used, has a beta lactam ring
1st generation Cephalosporins - *answers *presurgical prophylaxis, gram-positive,
2nd generation cephalosporins - *answers *mostly gram-positive. cefoxitin-(anaerobic
Bacteroides fragilis),cefuroxime (URI, pneumonia from h flu, pneumococci and staph)
some beta-lactamase cover
3rd generation cephalosporins - *answers *meningitis=penetrates the CSF. good Gram
negative aerobe coverage. no pseudomonas or enterococcus activity.
4th generation cephalosporins - *answers *pseudomonas and hospital acquired
infections; Ceftaolozane/tazobactam; cefepime
5th generation cephalosporins - *answers *Ceftaroline: MRSA, VRSA, community-
acquired pneumonia, broad-spectrum with gram- and + cover, pseudomonas and some
Enterobacteriaceae
3rd generation cephalosporin names - *answers *cefotaxime, cefdinir, cefditoren,
cefixime, cefpodoxime, ceftazidime, ceftibuten, ceftriaxone, cefoperazone, ceftibuten,
ceftizoxime
cephalosporins Side effects - *answers *Cross allergy with PCN; NO: Alcohol increased
bleeding=decreased prothrombin via interference with Vitamin K
cephalosporins that cause bleeding and are contraindicated with Alcohol - *answers
*Cefotetan, cefmetazole, cefoperazone
Carbapenems - *answers *weakens the cell wall, big Guns, Broad spectrum, given in
hospital and not given alone. end with -enem, except for avibactam. covers gram -,
gram + and anaerobes, renal excretion
Carbapenems contraindicated with - *answers *reduces levels of Valproate
Imipenem - *answers *not given alone: broadest spectrum given with vancomycin
Meropenem - *answers *meningitis
ertapenem - *answers *complicated GI, GU, soft tissue infection, CAP
Doripenem - *answers *complicated intra-abdominal infections/complicated UTIs
Avibactam - *answers *combined with ceftazidime for intra-abdominal and UTIs
Vancomycin - *answers *glycopeptide; inhibits cell wall synthesis;
narrow-spectrum used only for MRSA and C.Diff, only oral is for C. Diff.
