Pharm Lecture 4- Antibiotics

Superinfections can occur when the normal flora, which are the beneficial bacteria that naturally reside in the body, are disrupted or destroyed by broad-spectrum antibiotics or prolonged use of antibiotics. These medications can kill not only the harmful bacteria causing the infection but also the beneficial ones, creating an opportunity for other opportunistic pathogens to grow and cause a secondary infection. This is why it is important to use antibiotics judiciously and only when necessary to minimize the risk of superinfections.

When choosing an antibiotic, several factors should be considered. The drug should be effective against the specific pathogen involved, ensuring that it can effectively treat the infection. Additionally, the antibiotic with the lowest side effect profile should be chosen, prioritizing patient safety and minimizing potential adverse reactions. It is also important to consider the safety of the drug for the individual patient, taking into account any allergies or underlying medical conditions. Lastly, the cost of the antibiotic should be taken into consideration, aiming for the least expensive option that is still effective. Therefore, all of the options listed should be considered when choosing an antibiotic.

The statement is true because natural penicillin (PCN) does indeed include a beta-lactam ring. This ring structure is susceptible to the penicillinase enzyme, which has the ability to split the ring and render the PCN ineffective. As a result, the presence of the beta-lactam ring in natural PCN makes it vulnerable to the action of penicillinase, limiting its effectiveness.

Cephalosporins, a commonly prescribed antibiotic, are categorized into four generations based on their range of effectiveness against bacteria. They are similar to penicillin (PCN) but provide better coverage for bacteria within their spectrum. This statement is true as it accurately describes the classification and effectiveness of cephalosporins.

Pathogens cause disease through various mechanisms. They can increase in number, overwhelming the immune system's ability to control them. Additionally, pathogens can disrupt cellular function by interfering with normal cellular processes. Some pathogens also produce toxins, which can further disrupt cellular function and cause damage to tissues. Therefore, the correct answer is "all of the above" as all these mechanisms contribute to the pathogenicity of diseases.

The correct answer is "bacilli" because bacilli refers to a type of bacteria that are rod-shaped. This term is commonly used in microbiology to describe the morphology or shape of certain bacteria. It is important to note that cocci refers to bacteria that are spherical in shape, and spirilla refers to bacteria that are spiral-shaped. Therefore, the most appropriate answer in this case is bacilli.

Penicillins are a class of antibiotics commonly used to treat Gram-positive bacterial infections. They are effective against a wide range of bacteria, including Streptococcus and Staphylococcus species. However, like any medication, penicillins can cause side effects. Common side effects include nausea, vomiting, diarrhea, and abdominal pain. In rare cases, penicillins can cause severe allergic reactions that may be life-threatening or even fatal. Therefore, the statement that penicillins may have life-threatening or fatal adverse effects is true.

An antibiogram is a laboratory test that determines the susceptibility of bacteria to different antimicrobial agents. It measures the effectiveness of antibiotics by determining the percentage of bacteria that are susceptible to a specific antimicrobial agent. Therefore, the statement is true as an antibiogram does indeed provide information about the percentage of bacteria that can be killed or inhibited by a particular antimicrobial agent.

The term "spirilla" refers to a type of bacteria that has a spiral shape. This distinguishes it from the other options provided, which are "bacilli" (rod-shaped bacteria) and "cocci" (spherical-shaped bacteria). Therefore, the correct answer is "spirilla" because it accurately describes bacteria with a spiral shape.

anaerobic do not need oxygen but facultative can go either way

Bacteria can develop resistance to drugs by producing chemicals that act as antagonists. These chemicals can neutralize the effects of the drug, making it ineffective against the bacteria. This is one of the mechanisms through which bacteria can adapt and become resistant to antibiotics or other drugs. By producing antagonist chemicals, bacteria can protect themselves from the harmful effects of the drugs and continue to survive and multiply.

Aminoglycosides are known to have ototoxicity and nephrotoxicity as their most significant adverse effects. Ototoxicity refers to damage to the inner ear, leading to hearing loss or balance problems, while nephrotoxicity refers to kidney damage. These adverse effects are well-documented and can occur with the use of aminoglycoside antibiotics. Penicillin, cephalosporin, and macrolides do not have these specific adverse effects associated with their use.

Macrolides are a class of antibiotics that are highly protein bound, which means they can interact with other drugs that are also protein bound, leading to potential drug interactions. Additionally, macrolides can exhibit both bactericidal (kill bacteria) or bacteriostatic (inhibit bacterial growth) effects, depending on the dose and the specific target organism. One of the main mechanisms of action of macrolides is the inhibition of protein synthesis in bacteria, which contributes to their antimicrobial activity. Therefore, the statement is true.

Pyridium, also known as phenazopyridine, is often prescribed in combination with a sulfonamide to reduce costs. However, it should only be taken for a maximum of two days. One side effect of Pyridium is that it can stain contact lenses and cause urine to appear bright orange.

Bactericidals directly cause the death of susceptible bacteria, while bacteriostatics inhibit the growth/reproduction of susceptible bacteria and indirectly cause death. This means that both statements A and B are true.

Patient education is a vital component of reducing inappropriate antibiotic use because it helps patients understand when antibiotics are necessary and when they are not. By educating patients about the risks and benefits of antibiotic use, as well as the importance of completing a full course of antibiotics, healthcare providers can empower patients to make informed decisions about their own healthcare. This can help prevent unnecessary antibiotic prescriptions, reduce antibiotic resistance, and improve overall patient outcomes.

Combination antibiotic therapy has several benefits, including increased effectiveness against certain infections caused by multiple pathogens, as well as the potential for synergy between different antibiotics. However, one drawback of combination therapy is that it often requires higher doses of each drug, particularly in serious infections. This is because using multiple antibiotics simultaneously can increase the risk of drug resistance and may necessitate higher drug concentrations to achieve the desired therapeutic effect.

Carbapenems are another type of non-penicillin beta-lactam antibiotics. They are structurally similar to penicillins and monobactams but have a broader spectrum of activity against bacteria. Carbapenems are often used to treat serious infections caused by multidrug-resistant bacteria. They are considered a last resort option due to their potency and potential for developing resistance. Zosyn, Timentin, and Augmentin are not carbapenems, but rather combinations of different antibiotics.

Sulfacetamide Opthalmic is the correct answer because it is a sulfa drug that specifically treats bacterial eye infections. Pink eye infections are usually viral, so using Sulfacetamide Opthalmic for most pink eye infections would not be effective.

4th generation Cephalosporins have better coverage against gram-positive bacteria compared to 3rd generation Cephalosporins. They also have excellent coverage against Pseudomonas, a type of bacteria that can cause infections in humans. Additionally, 4th generation Cephalosporins are effective against bacteria that have developed resistance to older generations of Cephalosporins. However, it is important to note that 4th generation Cephalosporins can have similar effects to Penicillin, so patients with a known allergy to Penicillin should be treated cautiously when using these antibiotics.

Clindamycin (Cleocin) is known to have a high risk of causing pseudomembranous colitis, which is an infection of the colon caused by the bacteria Clostridium difficile (C.Diff). This adverse effect is well-documented and has been reported in patients taking clindamycin. Macrolides and acetaminophen do not have a known association with pseudomembranous colitis.

Silver sulfadiazine (silvadeen) is the correct answer because it is a topical cream commonly used to treat burns and prevent infections that may occur as a result of burns. It contains both silver and sulfadiazine, which have antimicrobial properties and help to prevent the growth of bacteria on the burned skin. This cream is often prescribed by healthcare professionals for burn patients to promote healing and reduce the risk of infection.

Sulfamethoxazole in Bactrim or Septra is combined with trimethoprim to create a synergistic effect. This combination is effective in treating urinary tract infections (UTI), Pneumocystis Jiroveci (a type of pneumonia), Otitis media (middle ear infection), and chronic obstructive pulmonary disease (COPD).

All of the options mentioned in the question - clauvulanic acid, tazobactam, and sulbactam - are penicillinase inhibiting chemicals. Penicillinase, also known as beta-lactamase, is an enzyme produced by certain bacteria that can inactivate penicillin antibiotics. These chemicals are specifically designed to inhibit the action of penicillinase, thereby allowing penicillin antibiotics to remain effective against these bacteria. Therefore, all of the options mentioned are correct as they all possess penicillinase inhibiting properties.

Sensitivity testing is a method used to determine the effectiveness of different drugs against resistant strains of organisms. It involves exposing the organisms to various drugs and observing their response. By comparing the results, the most effective drug can be identified and chosen as the best treatment option. This test helps healthcare professionals make informed decisions about which drug will be most successful in treating the infection caused by the resistant strains.

Antibiotic treatment does not improve resolution of influenza infections or prevent complications. This statement is the most accurate because antibiotics are not effective against viral infections like influenza. Influenza is caused by a virus, not bacteria, so antibiotics have no effect on it. Antiviral medications may be used to treat influenza, but antibiotics are not recommended for this purpose.

Following shorter courses of antibiotic use with duration of therapy based on the time the patient takes to achieve clinical stability can help prevent pathogen resistance. This approach ensures that the antibiotic is used for an appropriate amount of time, enough to treat the infection effectively, but not longer than necessary. Prolonged use of antibiotics can lead to the development of resistance in pathogens, making them less susceptible to the effects of the antibiotic. Therefore, using antibiotics for shorter durations based on clinical stability can help prevent the development of resistance.

Cocci are bacteria that have a spherical shape. Bacilli, on the other hand, are bacteria that have a rod-like shape. Spirilla are bacteria that have a spiral or helical shape. The question is asking for the correct answer regarding the shape of the bacteria, and out of the options given, cocci are the only bacteria that have a spherical shape. Therefore, the correct answer is cocci.

Demeclocycline is indeed used to treat SIADH (syndrome of inappropriate antidiuretic hormone secretion). SIADH is a condition characterized by excessive release of antidiuretic hormone (ADH), leading to water retention and dilutional hyponatremia. Demeclocycline is a tetracycline antibiotic that works by inhibiting the action of ADH, thereby increasing water excretion and correcting the hyponatremia. It is commonly used in the management of SIADH to restore normal fluid and electrolyte balance in the body.

Vancomycin is commonly used as a drug of last resort for serious to life-threatening infections. It is reserved for cases where other antibiotics, such as macrolides, penicillin, and cephalosporins, have failed to effectively treat the infection. Vancomycin is often used to treat infections caused by bacteria that are resistant to other antibiotics, such as methicillin-resistant Staphylococcus aureus (MRSA). Therefore, vancomycin is the correct answer in this case.

The test that identifies the bug and selects the drug is C&S (Culture and Sensitivity). This test involves taking a sample of the bug (such as bacteria) and growing it in a laboratory to identify the specific type of bug causing the infection. Once identified, the bug is then tested against different antibiotics to determine which drug is most effective in treating the infection. This helps healthcare providers choose the appropriate drug for the specific bug, increasing the chances of successful treatment.

Hyposensitivity is not an adverse effect from antibiotics. Adverse effects usually refer to negative or harmful reactions that occur as a result of taking antibiotics. Renal toxicity, GI tract toxicity, neurotoxicity, and superinfections are all possible adverse effects that can occur when taking antibiotics. However, hyposensitivity refers to a decreased sensitivity or response to a substance, which is not typically associated with antibiotic use.

gram negative are red, gram Positive are Purple

Virulence is the correct answer because it refers to the measure of the disease-producing potential of a pathogen. It describes the ability of a microorganism to cause disease and the severity of the resulting illness. Virulence factors such as toxins, adhesion molecules, and evasion mechanisms contribute to the pathogen's ability to invade and damage host tissues. Therefore, virulence is a key characteristic in understanding the impact and severity of a particular disease-causing microorganism.

The statement "all cases should be treated with antibiotics" is inaccurate. Acute respiratory tract infections (ARIs) are most likely viral, and therefore antibiotics are not effective in treating them. In fact, more than half of all antibiotics prescribed for ARIs are unnecessary, as they do not target the viral infection. Treatment for ARIs should focus on symptom relief, rest, and staying hydrated, rather than relying on antibiotics.

Penicillin G is not a penicillinase-resistant penicillin. Penicillinase is an enzyme that breaks down penicillin, making it ineffective. However, penicillin G is susceptible to penicillinase and can be easily degraded by the enzyme. On the other hand, dicloxacillin, methicillin, nafcillin, and oxacillin are all penicillinase-resistant penicillins, meaning they are not easily broken down by the enzyme and remain effective in treating bacterial infections.

Zohan is not a penicillin-beta-lactamase inhibitor combination drug. The other options listed (zosyn, augmentin, timentin, and unasyn) are all combinations of penicillin antibiotics and beta-lactamase inhibitors. However, Zohan does not fall into this category and is therefore not a correct answer option.

The alarming aspect of MSRA that was not true before is that it is now becoming a problem in community acquired infections. This means that the infection is no longer limited to hospitals or healthcare settings, but is spreading among the general population. This is concerning because it increases the risk of transmission and makes it more difficult to control the spread of the infection.

Pathogenicity refers to the ability of a microorganism to cause disease in a host. It encompasses various factors, including the ability to bypass or overcome the host's immune system. Virulence, on the other hand, specifically refers to the severity or harmfulness of a pathogen's effects on the host. Therefore, pathogenicity is the correct answer as it encompasses the ability to bypass or overcome the immune system, while virulence focuses on the severity of the disease caused.

Culture and sensitivity tests are performed to identify the specific bacteria causing an infection and determine which antibiotics are effective against it. However, once antibiotic treatment has been initiated, it can kill or suppress the growth of bacteria, making it difficult to obtain an accurate culture result. Therefore, it is generally recommended to perform these tests before starting antibiotic treatment to ensure the most accurate and effective treatment plan.

The best time to give a patient antibiotic prophylaxis to prevent infection would be before traveling to an area where infectious disease is endemic. This is because traveling to such an area increases the risk of exposure to infectious diseases that may not be prevalent in the patient's home region. Administering antibiotic prophylaxis before travel can help prevent the development of infections and protect the patient's health. The other situations mentioned in the options do not specifically involve a higher risk of exposure to infectious diseases, making them less suitable for antibiotic prophylaxis.

Increased uptake is not a mechanism of antibiotic resistance. Antibiotic resistance occurs when bacteria develop ways to evade the effects of antibiotics. Enzymatic inactivation refers to the production of enzymes that can deactivate antibiotics. Increased removal refers to the ability of bacteria to pump out antibiotics from their cells. Alteration of target sites means that bacteria modify the target sites where antibiotics usually bind, making them ineffective. However, increased uptake does not contribute to antibiotic resistance as it would enhance the effectiveness of antibiotics rather than resist them.

doesn't treat human folic acid and there is a high bacterial resistance rate

Macrolides are a class of antibiotics that include Biaxin (clarithromycin). When combined with Biaxin, macrolides can cause a metallic taste in the mouth. This side effect is commonly reported by patients taking macrolide antibiotics and can be attributed to the drug's interaction with taste receptors in the mouth.

The given options describe the characteristics of Penicillins accurately. Penicillins are bactericidal antibiotics that inhibit cell wall synthesis, hence they are also known as Beta lactams. They have a broad spectrum of activity, meaning they are effective against a wide range of bacteria. Penicillins cause bacteria to die from cell lysis, which is the bursting of the bacterial cell. Therefore, the correct answer is "none of the above" as all the options accurately describe Penicillins.

Sulfatetride is not a sulfa drug because it does not contain the sulfonamide functional group, which is a key component of sulfa drugs. Sulfadiazine, sulfamethoxazole, sulfisoxazoles, and sulfacetamide all contain this functional group and are therefore considered sulfa drugs.

3rd gen are most effective against gram -

most effective against aerobic gram -

Genes that confer antibiotic resistance are least likely to be found in the cell wall. Antibiotic resistance genes are typically found in plasmids, which are small, circular pieces of DNA that can be easily transferred between bacteria. These plasmids can carry multiple resistance genes, allowing bacteria to survive exposure to antibiotics. While DNA is the genetic material that carries the genes, the cell wall itself does not typically contain antibiotic resistance genes. Therefore, the correct answer is cell wall.

Pediazole is the correct answer because it is a combination of sulfisoxazole, a sulfa drug, and erythromycin, a macrolide antibiotic. It is available only as a suspension and is used to treat otitis media (OM) in young children. The other options listed do not contain both sulfisoxazole and erythromycin, and therefore, are not the correct answer.