wsmithv's version from 2015-08-01 01:34

Section 1

Question Answer
Beta-Lactam ABX arePenicillins, Cephalosporins, Carbapenams, and Monbactam (Aztreonam)
Penicillin FormulationsG - IV, VK - oral, Benzathine - IM (long-acting, for syphillis)
Penicillin CoversViridans Step, Strep Pyogenes, Oral Anaerobes, Syphilis, Leptospira
Viridans Group StrepFound in Mouth; cause ONLY ENDOCARDITIS
Strep Pyogenes(aka Group A Beta Hemolytic strep) cause of Erisypelas, glomerolonephritis, strep pharyngitis, Scarlet Fever
LeptospirosisInfection of Zoonosis, causes kidney disease, serology for DX, tx with penicillin
Ampicillin/AmoxicillinAmox = oral; Amp = IV; Cover penicillin-covered organisms (Viridans Step, Strep Pyogenes, Oral Anaerobes, Syphilis, Leptospira) and Enteroccocus Lyme and HELPS
Amoxicillin gram negsHELPS (H influenzae, E coli, Listeria, Proteus, Salmonella)
Ampicillin/Amoxicillin is Best Initial Therapy forOtitis media, dental infection and endocarditis prophylaxis, lyme limited to rash, joint, or facial nerve, UTI in pregnant women, Listeria monocytogenes (occurs in immunocompromised person with meningitis), enterococccal infections
Lyme with CNS or Cardiac involvement, best initial therapy =ceftriaxone
Penicillinase Resistant Penicillins (PRPs)oxacillin, cloxacillin, dicloxacillin, nafcillin
Oxacillin, Cloxacillin, Dicloxacillin, Nafacillin TXskin infections (cellulitis, impetigo, erysipelas, NOT MRSA), endocarditis, meningitis, and bacteremia from staph; osteomyelitis and septic arthritis (but only when organism is proven sensitive for osteo and septic arthritis; if proven sensitive, then better than Vanc). DO NOT COVER MRSA OR ENTEROCOCCUS
PRPs are not active againstMRSA and Enterococcus
MethicillinMethicillin causes renal failure from allergic interstitial nephritis. Methicillin is NEVER THE RIGHT ANSWER
Methicillin resistancePRP resistant
Other PenicillinsPiperacillin, ticarcillin, Azlocillin, Mezlocillin
Other Penicillins covergram negative bacilli and pseudomonas
Gram Negative Bacilli areNon-Curved: E. Coli, Klebsiella, Proteus, Morganella, Serratia, Enterobacter, Citrobacter, Salmonella, Shigella, Pseudomonas --> these cause infections of bowel (peritonitis, diverticulitis), urinary tract (including pyelonephritis) and liver (cholecystitis, cholangitis)

Curved: include Vibrio, Camyplobacter, H Pylori
Piperacillin, Ticarcillin, Azlocillin, Mezlocillin TXCholecystitis and ascending cholangitis, pyelonephritis, bacteremia (severe or life-threatening bacteremia), hospital-acquired or vent-associated pneumonia, neutropenia and fever
Other Penicillins are NOT ANSWER WHENexclusive infection from streptococci and anaerobes --> use narrower agent
Other Penicillins used withbeta-lactamase inhibitor such as tazobactam or clavulanic acid (to add staph coverage)

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