What is the D.O.C for Neisseria?
Ceftriaxone
What gram - cocci causes acute otitis media and sinusitis
Moraxella catarrhalis
What gram - bacilli causes wound infections and pneumonia?
Klebsiella pneumoniae
3 DOC for KPC producers?
Vabomere
Avycaz
Recarbrio
What gram - bacilli causes complicated UTI's?
Citrobacter and enterobacter cloacae
What is the DOC for Citrobacter and enterobacter cloacae?
Cefepime
What gram - bacilli causes skin and soft tissue infections?
Proteus
What is the DOC for shigella/salmonella?
Fluroquinolones
Which organisms cause complicated UTIs?
Citrobacter and enterobacter cloacae
and Pseudomonas
What is the DOC for acinetobacter baumanni?
Unasyn and carbapenems
Which non-enterobacteriaceae causes BSI in the immunocompromised?
Stenotrophomonas
What is the DOC for Stenotrophomonas?
Bactrim
Which two organisms can cause community acquired pneumonia?
Moraxella catarrhalis
and Haemophilus
What is the DOC for Haemophilus
Augmentin and amoxicillin
What is the DOC for pasteurella?
Augmentin
Which three organisms can cause diabetic foot infections?
B. fragilis, prevotella, and pseudomonas
What anaerobic gram - bacilli causes gynecologic infections and abscesses?
B. fragilis
DOC for B. fragilis?
1. Flagyl
2. Penicillin/B-Lactamase inhibitors
3. Carbapenems
What anaerobic gram - bacilli causes periodontal infections?
Prevotella
HECK YES is an acronym to represent organisms that produce what resistance?
Amp C
HECK YES!
Hafnia alvei
Enterobacter cloacae
Citrobacter Freundin/youngae
Klebsiella aerogenes
Yersinia enterocolitica
What are the 2 DOC for AmpC organisms?
Cefepime
Carbapenems
Which three organisms cause ESBL resistance?
K.E.P
Klebsiella pneumoniae and oxytoca
E. coli
Proteus
What are the 2 DOC for ESBL organisms?
Carbapenems
Cephalosporins: Cefoxitin and cefotetan
What is the only DOC for NDM?
Cefidericol
Which three drugs cover CRE and not KPC?
Tigecycline
Aminoglycosides
Eravacycline
Penicillin-B-lactamase inhibitor combination cover anaerobes? T/F
True
What BLI has activity against Acinetobacter baumannii?
Sulbactam
What Gram - do Zosyn cover?
SPACE/SPICE
Serratia
Pseudomonas/ Providencia
Acinetobacter/ Indole-positive proteus
Citrobacter
Enterobacter
Coverage of 2nd Gen Cephalosporins?
Gram +
Gram -
2nd Gen Cephalosporins
Cefuroxime- Ceftin (IM,IV,PO)
Cephamycins- anaerobes
Cetriaxone
CI in neonates- kernicterus
Excellent BBB penetration
Gram +
Gram -
What is the DOC for penicillinase resistant strept pneumonia?
Ceftriaxone
What 3rd generation cephalosporin has anti pseudomonal coverage?
Ceftazidime
What agent may cause encephalopathy and seizures?
Cefepime
What two agents are DOC for MDR pseudomonas?
Ceftolozane/tazobactam- Zerbaxa
Ceftazidime/avibactam- Avycaz
DOC for MDR pseudomonas and KPC?
Avycaz
What is indication for Cefidericol?
Complicated UTI
Which class of agents have renal dose adjustments?
Carbapenems
Carbapenems have anaerobic coverage? T/F
True
Which carbapenem has the highest seizure risk?
Imipenem-cilastatin- Primaxin
Which carbapenem is the most narrow spectrum and is dosed only once daily?
ErtAPEnem- Invanv
Ertapenem has poor activity against which organisms?
Acinetobacter
Enterococcus
Pseudomonas
Carbapenems/BLI exhibit what coverage?
KPC
Recarbrio has MDR pseudomonas coverage? T/F
True
What drug should be used in the case of a documented type-1 hypersensitivity to a beta-lactam?
Aztreonam- IV
Azetronam has Gram + coverage? T/F
False- Gram - only!!
Enterobacter
Pseudomonas
Aminoglycosides bind to which ribosome?
30S
Which class of AB have mycobacterium?
Aminoglycosides
What is the Peak to MIC ratio should be targeted with ahminoglycosides?
8-10
2 main ADE associated with Aminoglycosides?
Ototoxicity- may be irreversible
Nephrotoxicity- Reversible
What type of amino glycoside dosing does NOT require peak and trough monitoring?
Extended interval dosing- once daily or less
Which class of AB's has atypical coverage against legionella pneumophila, mycoplasma pneumonia, chlamydophila pneumonia, MDR m. tuberculosis, non-tuberculous mycobacteria?
Fluroquinolones
Fluroquinolones increase what?
PT/INR: Warfarin
QTc-prolonging drugs
Why should fluroquinolones be avoided in children <12, pregnancy, and breast feeding?
May impair cartilage development
What are the 8 ADEs associated with fluroquinolones?
1. GI distress
2. Tendonitis
3. QTc prolongation
4. C. diff
5. Dysglycemia
6. Neurotoxicity
7. Mental health side effects
8. Photosensitivity
What are the three indications where risks >> benefits with Fluroquinolones?
1. Acute sinusitis
2. Bronchitis
3. Uncomplicated UTI
All Fluroquinolones are IV AND PO??
TRUE
Which Fluroquinolone has the most pseudomonas coverage?
Cipro
Which Fluroquinolone has the most pneumonia coverage?
Moxifloxacin
Which Fluroquinolone has poor concentration in the urine and has anaerobic coverage?
Moxifloxacin
Which Fluroquinolone has MRSA coverage?
Delafloxacin
Weight based dosing of Bactrim is based on which component?
Trimethoprim (5:1)
DDI with Bactrim?
Warfarin
Bactrim should be avoided in the 1st and 3rd trimester of pregnancy?
True
What is DOC for stenotrophomonas?
Bactrim
What is DOC for
Toxoplasmosis gondii
Nocardia spp
Pneumocystis jirovecii
Bactrim
Which AB has a very LARGE Vd?
Tigecycline
Which AB does not cover the three P's?
Tigecycline
A 5 day course of Azithromycin is as efficacious as a 10-14 day treatment course?
True
Which class of AB is a major INHIBITOR of CYP3A4?
Macrolides
Which AB is the drug of choice for Legionella?
Macrolides
ADE's of Flagyl?
Metallic taste
Nausea
Disulfiram-like reaction with EtOH
Peripheral neuropathy with long term use
When should Flagyl be avoided
1st trimester
Flagyl DDI?
Cyclosporine
Tacrolimus
What is the DOC for bactericides fragilis?
Flagyl
What is DOC for trichomonad, giardiasis, and entamoeba?
Flagyl
Which ABs is used for cystitis only?
Nitrofurantoin
Fosfomycin (Monurol)
Which AB should be used with caution in 38-42 weeks gestation if G6PD deficiency due to concern for hemolytic anemia and neonatal jaundice?
Nitrofurantoin
What organisms due Nitrofurantoin cover?
SEECK
S. sapro
E. faecalis
E. coli
Citrobacter
Klebsiella