Antibiotics Overview - the barest facts

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My final revision slides for microbiology in 2nd clinical year pathology finals at the University of Cambridge.

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Antibiotics Overview - the barest facts

  1. 1. Antibiotics – The barest facts Penicillins – gram +ve bacilli/cocci and gram –ve cocci (proliferating bacteria) - Flucloxacillin – b-lactamase resistant - Amoxicillin – H. influenzae - Augmentin (Co-amoxiclav = Amoxicillin and Clavulanate) – b-lactamase resistant, gram –ve bacilli - Tazocin (Piperacillin and Tazobactam) – b-lactamase resistant, Pseudomonas Cephalosporins – broad spectrum - Ceftazidime – Pseudomonas Carbapenems – exceptionally broad spectrum - Meropenem – EXCEPT MRSA, VRE, Mycob.. Mycopl., Chlam., Ricketts., Klebs. Macrolides – gram +ve bacilli/cocci and gram –ve cocci (similar to penicillins) - Clarithromycin – + Myocbacteria (not TB), Mycoplasma, Chlamydia, some gram -ve Lincosamines – narrow spectrum, gram +ve cocci incl. MRSA (?) and anaerobes - Clindamycin Sulfonamides – broad spectrum - Trimethoprim – H. influenza, E. coli, Klebsiella Tetracyclines – broad spectrum - Doxycycline – Chlamydia, Rickettsia, Brucella, Borrelia Glycopeptides – narrow spectrum, gram +ve cocci - Vancomycin – MRSA Aminoglycosides – gram –ves unless synergism with other antibiotic - Gentamycin Imidazoles – as a class of compounds they are antifungals - Metronidazole – anaerobes, C. diff! Quinolones – broad spectrum - Ciprofloxacin – only oral AB against Pseudomonas, Chlamydia, E.coli, Klebsiella ATYPICALS GRAM –ve BACILLI AND BACTERIA OF THE GUT
  2. 2. Treating Infectious Diseases – The barest facts UTI – E. coli, Klebsiella, Enterococci = Gram –ve bacilli - Trimethoprim (better if resistance likely) - Co-Amoxiclav - Ciprofloxacin possible but likelihood of C. diff - If ESBL (Extended spectrum b-lactamase) o Meropenem – hospital o Nitrophenytoin – community Pneumonia – COMMUNITY: 90% Strep. pneumoniae, Haemophilus influenzae, atypical – HOSPITAL: MRSA, gram –ve - COMMUNITY o Severity determined by CURB65 o Low: Amoxicillin OR Doxycycline (if allergic) Strep. pneumoniae + H. influenzae o Moderate: Amoxicillin + Clarithromycin OR Doxycycline Strep. pneumoniae + H. influenzae + atypicals o High: Co-amoxiclav + Clarithromycin Strep. + H. influenzae + gram -ve cocci + atypicals - HOSPITAL o Early onset: Co-amoxiclav Gram +ve + H. influenzae + gram-ve cocci o Late onset: Tazocin/Ceftazidime/Ciprofloxacin Pseudomonas Skin and Tissue Infections – gram +ve, mainly Staph - Flucloxacillin OR Clarythromycin (if allergic) b-lactamase resistant Staph (doxycycline if allergic also possible as Staph less sensitive to Clarythromycin than Strep) - Vancomycin MRSA Meningitis - Penicillin Empirical - Benzylpenicillin/Cefotaxime OR Chloramphenicol (if allergic) Neisseria meningitides - Cefotaxime OR Chloramphenicol Strep. pneumoniae, H. influenzae - Amoxicillin AND Gentamycin Listeria - Think cef for cephalic? Diarrhoea - Ciprofloxacin (can cause C. diff) gram –ve cocci - Metronidazole C. diff

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