IMM&ANTIMICRO AGNTS MEDCH 401
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This 4 page Class Notes was uploaded by Madelyn Rodriguez on Wednesday September 9, 2015. The Class Notes belongs to MEDCH 401 at University of Washington taught by Staff in Fall. Since its upload, it has received 14 views. For similar materials see /class/192632/medch-401-university-of-washington in Medicinal Chemistry at University of Washington.
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Date Created: 09/09/15
Big Bugs Review 1 Beta Lactam Antimicrobials B Characteristics Common Infections Common Treatment with Elactam Resistance and Treatment Strep pyogenes Gram cocci Strep throat Pen G IV Not yet in chains Cellulitis Procaine Pen G IM Erysiphelis Benzathaine Pen G IM Scarlet fever Pen V PO Necrotizing faciitis Strep pneumo Gram cocci CAP Pen G IV PRSP use vancomycin in chains or as Otitis media Pen V PO IV or other appropriate diplococci Meningitis Amoxicillin non beta lactam Sinusitis Bronchitis Staph aureus coag Gram cocci Skin Nafcillin IV If MRSA use vancomycin Staph epi coag in clusters Pneumonia Dicloxacillin PO IV or other appropriate Bone non beta lactam Sepsis etc E faecalis Gram cocci UTI Ampicillin IV Vancomycin is 1st choice if E faecium Sepsis Pen G IV resistant to penicillins Catheter infections No other beta lactams useful If vancomycin resistant Endocarditis Note E faecium mostly resistant to then Zyvox or Synercid Nosocomial infections all beta lactams vancomycin and or daptomycin Synercid Enterobacteriaceae Gram rods Amoxicillin PO If resistant do sensitivity E coli UTI traveler s diarrhea etc AmoxClav PO tests to find an appropriate Enterobacter misc nosocomial AmpSulbactam IV drug Klebsiella nosocomial r etc 2 4th generation cephalosporins Serratia misc nosocomial carbapenems proteus UTI Aztreonam Morganella UTI Providencia UTI Citrobacter UTI Salmonella gut Shigella gut Pseudomonas Gram rods Burns Piperacillin wwo tazobactam May combine with Skin Ceftazidime 3rd gen cef aminoglycosides Bronchitis Cefepime 4th gen cef Resistance is common due Sepsis a carbapenem except ertapenem to beta lactamases and UTI restricted porin N gonorrhoeae Gram cocci Gonorrhoea 3rd gen PO cef Produce S lactamases Vantin PO stat dose ceftriaxone IMIV stat dose N meningitidis Gram cocci Meningitis Pen G Not common Cefuroxime or some 3rd gen cef must cross into CNS in Pen allergies Bacteriodes fragilis Gram rods Sepsis Ampsulbactam IV Produce S lactamase Anaerobe Abscess Moraxella cat Gram cocci Otitis media Augmentin or 2nd3rd gen cephs All produce S lactamases Sinusitis Bronchitis H in uenza Pleomorphic Otitis media Augmentin or 2nd3rd gen cephs Many produce S lactamases Gram Sinusitis Bronchitis Big Drugs Pen V Dicloxacillin 1V Amoxicillin PO 1V inhibitors neisseria Grarn not Weak Grarn not S lactamases Many Broad Pseudornonas in mixed infection Excellent Grarn Grarn Grarn Grarn Pseud Grarn including Pseudornonas except ertapenern If PRSP use use penicillinases and S lactarnases to Ampsulbactam same and also anaerobes Once Crosses into CNS Crosses CNS Crosses CNS can meningitis ertapenem not for Monobactams Aztreonam Gram only Can use in penicillin allergy anaphylactic Special Note Pregnancies All lactams are okay In penicillin allergy rash give cephs Anaphylactic reaction PO no suitable Slactams IV aztreonam with caution if infection is Gram 4808