Name that Bug, Name that Drug
This Gram-positive coccus is the most common cause of strep throat.
What is Streptococcus pyogenes?
Mayo Clinic. Strep throat. Mayo Clinic. Published 2022. https://www.mayoclinic.org/diseases-conditions/strep-throat/symptoms-causes/syc-20350338
A 26 year old woman presents with dysuria, frequency, and suprapubic pain. UA is positive for nitrites and leukocyte esterase. She has no comorbidities and normal renal function. What is the first-line outpatient antibiotic?
What is nitrofurantoin?
These antibiotics inhibit bacterial cell wall synthesis by binding to penicillin-binding proteins (PBPs), preventing peptidoglycan cross-linking.
What are beta-lactams?
These two concentration parameters should be closely monitored while taking Amikacin.
What is peak and trough?
This global organization tracks antimicrobial resistance trends and provides guidelines for surveillance.
What is the World Health Organization (WHO)?
This Gram-negative diplococcus is responsible for gonorrhea infections.
What is Neisseria gonorrhoeae?
A 68-year-old hospitalized patient is being treated for a severe Gram-negative infection. After several days of IV antibiotics, his serum creatinine rises from 1.0 to 2.2 mg/dL, and he reports decreased urine output. Which class of antibiotics is most likely responsible for this kidney injury?
What are aminoglycosides?
These antibiotics bind to the 30S ribosomal subunit and cause misreading of mRNA, leading to defective proteins.
What are aminoglycosides?
Practitioners must inform patients to seek medical attention immediately if they experience sweating, hunger, dizziness, or pallor while taking this class of medication.
What are fluoroquinolones?
This U.S. agency runs the Antibiotic Resistance Solutions Initiative and the National Healthcare Safety Network (NHSN)
What is the CDC (Centers for Disease Control and Prevention)?
These Gram-positive cocci grow in pairs and chains, and are the most common cause of community-acquired pneumonia.
What is Streptococcus pneumoniae?
A 52-year-old man on mechanical ventilation for 5 days develops fever, purulent tracheal secretions, and a new right lower lobe infiltrate on chest X-ray. He is diagnosed with ventilator associated pneumonia (VAP). What empiric antibiotic class should be started?
This antibiotic inhibits the RNA polymerase enzyme, blocking bacterial RNA synthesis.
What is rifampin?
This aminoglycoside is offered in ophthalmic and inhaled formulations.
What is Tobramycin?
Overuse of this class of broad-spectrum antibiotics, often ending in “-floxacin,” can drive resistance and increase risk of C. difficile infections.
What are fluoroquinolones?
These Gram-positive cocci form chains and are known for causing neonatal sepsis and meningitis.
What is Streptococcus agalactiae?
A 45-year-old male with a history of IV drug use presents with fever and a new systolic murmur. Blood cultures grow Staphylococcus aureus. The microbiology report shows the following susceptibility profile:
Antibiotic
Result
Oxacillin: R
Vancomycin: S
Daptomycin: S
Linezolid: S
Cefazolin: R
Based on these results, which IV antibiotic is the most appropriate first-line treatment?
What is Vancomycin?
This antibiotic inhibits bacterial enolpyruvyl transferase (MurA), thereby blocking the formation of N-acetylmuramic acid (NAM), an essential precursor in peptidoglycan cell wall synthesis.
What is fosfomycin?
Women of childbearing age must test negative for human chorionic gonadotropin (hCG) before starting this Pregnancy Category C, short-acting lipoglycopeptide
What is Televancin?
Taking antibiotics for viral infections, like the common cold, is considered this.
What is inappropriate antibiotic use?
This antibiotic is often used for MRSA infections and requires monitoring of trough levels due to nephrotoxicity risk.
What is Vancomycin?
A 74-year-old woman is admitted with urosepsis (fever, hypotension, positive blood cultures for E. coli). Based on this antibiogram, which empiric IV antibiotic is most appropriate? The following susceptibilities are reported:
cefepime (95%)
piperacillin/tazobactam (89%)
ceftriaxone (72%)
ciprofloxacin (58%)
TMP-SMX (65%)
What is cefepime?
This antibiotic disrupts mycolic acid synthesis, which is required for the integrity of the mycobacterial cell wall.
What is isoniazid?
This uricosuric agent will increase the concentration and duration of action of beta-lactam antibiotics by inhibiting their renal excretion.
What is Probenecid?
This surveillance system collects global data on antimicrobial resistance, helping countries monitor and respond to emerging threats.
What is GLASS (Global Antimicrobial Resistance Surveillance System)?