Mode of action Type Drug

Pen G,V

-lactams Penams
Ampicilin/amoxacilin

Piperacilin/tazobactam
(ticarecillin)
Nafcilin, oxacillin,
dicloxacillin (oral)
Cephalexin
cefuroxime
Cell wall Antibiotics
Cephalosporins ceftriaxone/ceftazidime

cefepime

meropenem

Carbapenems

imipenem

monobactam azteronam

Vancomycin vancomycin

gentamicin
aminoglycosides (STAG
ag)
tobramycin (CF)
streptomycin
amikacin

erythromycin

clarithromycin
Macrolides
azithromycin

Inhibitors of protein
synthesis AteML
(ribosome attach, A, AP,
MAO) (Buty AT 30 and
 Macrolides

Inhibitors of protein
synthesis AteML clindamycin
(ribosome attach, A, AP,
MAO) (Buty AT 30 and
CCEL (ML) at 50)

tetracyclin

tetracyclines (TeTiDoCo)

tigecycline

doxycycline

coxycycline

oxazolidinoes linezolid

rifampin rifamipin

ciprofloxacin
levofloxacin
Fluroquinolones
Inhibit nucleid acid moxifloxacin
metabolism ready for
metabolism

metronidazole metronidizole

sulfamethoxazole
sulfonamides
Antimetabolites CUPS
(COtrimethoprim treats
UTI and Pnumocystis, dapsone
with Steven Johnson)
trimethoprim
(dihydrofolate reducase trimethoprim
inhibitor)

Misc daptomycin daptomycin

Isoniazid Isoniazid

Anti mycobacterial RIP

TB sucks
 pyrazinamide pyrazinamide
Anti mycobacterial RIP
TB sucks
ethambutol ethambutol

rifampin rifampin

STEMac Sulfonamids Tetracyclines

BARF VIMM

Metronidizole,
Imipenem, I MET the PIPER at the
Anerobic coverage/B Meropenem, TICket office to buy my
fragelis Amoxaciliin/ AMOr some ClauMeroImi
Clauvulanate, Ticarcilin,
and piperacilin

BBB
Anerobes
Aerobes
renal vs hepato
clearance
UTI
 Quick note/remember this by! method of intake

IM, IV only, the OG. V is oral version pretty much IM/IV Oral

Gm - coverage, use with -latamase inhibitor, Oral

Clavulante (CAST for the lactamase inhibitors).

Pseudomonas covage, gm - rodes extended IV only

spctrum
S. Aureus Coverage, Mec A resistnace for IV only
methiciline, penicillinase resistant
prophylaxix, 1st gen, widely used
2nd gen
gonorrhaeae, outpatient, long half life, strep
pneumonia, not good for B. Fragilis, gm - IM/IV
infections resistant to other -lactams
4th gen, more resistance to -lactamase
coverage, better at pseudomonas

resistant to -lactamases, multispectrum, hosptial

induced infections, siezures

OG, need to slow metabolism, fix metabolism

with cilastatin, neurotoxicity, good against not oral
psuedomonas, siezures

not cross allergenic like the others, good CNS

penetration, pseudomona, more like Ag, rash

glycopeptid, MRSA, NOT trouble free (nephro, IV, oral

oto, thrombophelbitis) Red man syndrome

most widely used, narrow spectrum, use for UTIs,

ototoxicity , Gm - aerobic, no anerobes, IV only
nephrotoxcity, 30S, need to monitor drug
accumulation, teratogen

oldest, some negative drug interactions, overall it

is all safe, 50S, ErmB gene, chlaymidia
Oral
another one
most common, penerates phagocytes well
 above the belt, colitis, anaerobic coverage, like Oral
erythromycin, B fragilis, 50S

30S, no for pregnancy, secrete with bile,

phtosensitive, Dont eat with milk, efflux
resistence, change in stool composition, C Diff Oral
overtake, teeth issues, not for children under 8,
DOC for typhus, efflux resistance

MAO inhibitor, Gm +, resistant, better than

vancomycin , peripheral myopathy, for catheter oral
induced bacteremia , bone marrow suppression

See below See below

Photosensitizing, DNA gyrase, topo IV, UTI/URI,

Tendon, GyrA gene., confusion, Gm -, oral
pseuomonas, otitis externa, not for people less
than 18 years old.

Cancer in mice, anerobes, good tissue

penetration, O2 will recycle it back to its state, No Oral
alochol! Only anerobic bacteria can transform
them, metallic taste

benzoid acid analogs, cotmoxazole, same as

methotrexate, old and very little used, rash, oral
Steven Johnson, UTIs, E coli, Proteus, GI
intolerance. Gm + and -

Cell wall, S aureus and Gm +, no for pnumonia, IV

myalgia, myopathy

Only for prophylaxis of latent TB and active TB,

peripheral neuropathy, co administer with
pyridoxine, faster half life, heptatoxicity

oral
 TB, hepatotoxic, fatty acid inhibition

oral

cell wall, static, optic neuritis

Drug interaction, orange, hepatotoxic, also for gm

+ bacteria, cipro is better

Ethambutol Macrolides
 bacteria it treats Activity spectrum

group A strep (pyogenes), viridans strep,

neisseria meningitdis, treponema pallidum

anerobes, Gm - coverage, fragilis

pseudomonas, anerobe coverage, Fragilis,

wide spectrum

S Aureus

better at gm + than gm -
Bactericidal (only towards
HENS PEcK growing)

Strep pneumenia (knight), pseudomonas

(dime)

more gm - coveratge, pseudomonas

widest lactam spetrum, anerobes, fragelis,

gm -

Anerobes, fragilis

Only gm - aerobes (GNA)

Gm + only Bactericidal

enterobacteriaceae, klebsela, proteus, and Bactericidal

serratia, pseudomonas. Gm - aerobes (GNA)

URIs, strep pneumenia, legionella, good for

targetting intercellular bacteria, Static
mycoplamsa, atypical pneumnias
(mycoplasma, chlamydia, legionella)
 anerobic bacteria, not good for gm - or
aerobic, alt to penicilin for staph infections, Static
bacteriodes fragilis

Gm + > Gm -, mycoplasma, rickettsiae,

chlamydia, lyme disease, cholera, Static
brucellosis, chancroid, mycoplama
pneumonia, rocky mountain spotted fever,

VRE, S aures, No good for Gm -, E faecium, E

faecalis, MRSA skin suture infections, Static
enterococci

Gm + bacteria See below

UTIs, URIs, bone/joint/soft tissue infections, Bactericidal

TB, mycobacteria, peudomonas, some gm +

Anerobes, DOC for T vaginalis, amebiasis (E.

histolytica), C diff, bacteriodes, heliobacter Bactericidal
pylorri, Fragelis

Wide spectrum, UTIs first choice,

pneomocystis, nocardia, protosoza, leprosy Static
for dapsone

Gm +, S aureus, right sided endocarditis, NO Bactericidal

for pneumonia

Bactericidal

TB
 Both

TB

Static

Bactericidal
 Mechanism
They act as a false substrate for the D-ala-D-ala
transpeptidases
Binds the penultimate D-ala with high affinity
Inhibits ribosomes at 30S
Prevent A--> P movement in ribosomes, phagocytes will carry
them to the site, 50S subunit
mechanism of resistance
BPBs will not be as easily fooled, only
rapidly growing bacteria can be killed.
Tolerance through autolytic enzyme
deficiency, production of lactamase, an
dfailure to penetrate the outer layer of
gram negative bacteria.
VRE as D-ala changes to D-Lactate, VanA
gene
covalent modfication of the target by
kinases or acetylases
efflux (mefA/E gene), target site
methylation (erm gene)
 inhibitor of protein synthesis, 50s C diff, efflux, target site methylation

Inhibits 30S unit at A site to prevent first tRNA binding Gm -, increased efflux, altered 30S target

Protein synthesis inhbitor, 50S point mutations in the ribosome

See below see below

two targets makes it hard to resist, Gyn

Targets DNA gyrase and Topo IV, gene for resistence, efflux

Rare resistence, could be due to reduced

Prodrug reduced by ferrodoxins to form nitro radical --> compliment of ferroxodins made by the
highly reactive aklyating agent, done only by anerobic bacteria. Can be overcome iwh higher
bacteria dose

Blocks precursor to dihydrofolate (dihydropteroate

synthetase)
horizontal gene transfer of antibiotic
resistance

blocks dihydrofolate

inhibits membrane function recent development

pyridoxine analoge to prevent mycolic acid synthesis

mutation in enzymes that activate it,

MDR --> INH and RIF resistance, XDR -->
resistant to INH + RIF + FQN + other stuff.
Inhibits fatty acid synthesis, prodrug that opens up a
carboxylic acid
mutation in enzymes that activate it,
MDR --> INH and RIF resistance, XDR -->
resistant to INH + RIF + FQN + other stuff.
arabinosyl transferase inhibition, dirsupt cell wall

Inbitor of RNA polymeraase, the beta unit

 adverse events Pharmacodynamics/kinetics

max levels reached in blood by 3-4 hours, wide

distribution except CNS, eye, and prostate, 30-
90 min halflife, not metabolized, acid labile

can penetrate the proins of Gm -

transferred to bile so half life doesnt change

with renal failure, MRSA
Allergy, neurotoxicity, c diff colitis --> diarrhea,
antibodies produced agains penicillinoid acid (due to
the -lactamase activity), thrombocytopnia,
ampiliccin rashes
Long half-life, can cross BBB

70% renal clearance

reman syndrome from rapid infusion --> histamine

release, thromophlebitis, otoxicity, nephrotoxicity, Not well absorbed through oral
eosinophilia

drug toxcitiy, ototoxicity, nephrotoxicity, narrow stuff Very low volume of distribution, unchanged in
Urine, small theraputic window

GI upset, hepatitis, negative drug interactions, long long half life

QT interval, Rash,
antibiotic asscociated colitis, C diff, decreased hepttic Poor penetration into CNS, excretion by liver
function, rashes, thrombophelbitis, fever, diarrhea and renal route

pregnant women may develop fatal fatty necrosis of

liver, retard bone growth in fetus, not for pregnancy,
GI distress, phototoxicity, fanconi syndrome
(nephrotocity), disposition in devleoping bone and
teeth, contraception failure due to disruption to
microbio flora, multiple drug interations
1/4 concentration in plamsa but good
everywhere else. Excrete in primarly kidney.
Doxycycline cleared by liver, all are secreted
with some bile

weak monamine oxidase inhibitor so no tyramine

ingestion, thrombocytopenia and bone marrow well tolerated, no interaction with P450
suppresion, peripheral myopathy

see below see below

Gi disturbances, nausea, vomiting, cramping, CNS

headaches, photosensitizing, tendon rupture, not for good oral absportion, good tissue penetration,
secreted unchaged by kidney, antacids inhibit
<18 or pregnant women,

headach, nasuea, dry mouth, metallic taste, dark

urine. No alcohol since it inhibits metabolism. Good CNS penetration
Siezures, mutagen in other animals

Allergic, and wide spread resistant, exfoliated skin,

Steven Johns , hyperkalemia, creatinine elevation, Wildely distiributed, some liver metabolism, it
bone marrow suppression, hemolysis for G6PD is acetylated and can still be toxic after
defeciency

skeletal muscle activity issues well tolerated

peripheral neruopathy (prevent with pyridoxine), Well abosorbed with good penetration. 80-180
bone marrow suppression, optic neruitis, half life so there needs to be daily dosing.
hepatotoxicity, GI intolerance, inhibits metabolism Aceylated metabolites apear in urine
through phenytoin
 hyperuricemia, non-gouty polyarthralgia,
hepatotocicity, GI intolerance, gout
well abosrbed in GI, widely distributed,
excreted by glomerular filtration
optic neuritis, Gi intolerance, gout, peripheral
neuropathy, confusion and diziness, interstitial
nephritis 8 hour half life

orange coloration of bodily fulids, GI intolerance, well abosrbed, de-acylated by liver, extensive
Hepatotoxicity, flue like, drug interactions (induces enteropathic cycling, only 20% in urine
P450) --> decreased effacacy of other drugs
 Notes

augmentin is the amoxicillin/clavulanic acid

combination, rashes

-lactamase resistant, leukopnia, nephritis MecA gene

with methicilin resistance

In Me is One Dime and it gives me Pain (Pime)

Can be resisted by psudomonas by down Some

regulating the outer membrane oprD carbepenemases
channels. are coming along

neurotoxicity more so. Gina the Aztec god

(acts like the aminoglycosides)

Anerobes don't have energy to transport

them, trobramycin is used for CF patients

Well tolerated
 lyme disease, preferred for patients with
imparied renal function

it gets changed

cotrimoxazole is the combo drug name.

use for right sided endocarditis, some MRSA is

resistant, dont use with statins
Bacteria Notes Gm stain

Staphlococcus aurerus looks like grapes

No catalase, HA capsule, bacitracin Positive

Streptococcus pyogenes (group A) sensitive, ASO titers

capsule, optochin sensitive, most

Streptococcus pneumoniae pathogenesis comes from extracellular
growth
actin-rich attaching lesions that destroy
EPEC microvilli

EHEC food borne. O157H7

ETEC travelers diarrhea

EAEC biofilms

EIEC

MNEC

UPEC sexually active 2omen

can perist on abiotic surfaces, burn Negative

Psudomonas aeruginosa patients

prevents lysosome fusion, obligate

Legionella pneumophila aerobe

resistent to lactams, has catalase to

Bacteroides fragilis live with other bacteria. No type III

escapes lysosome, acid resistant, taken

Shigella Spp. up by M cells in Peyer' patches
Salmonella prevents lysosome fusion
 Shape Feeding Virulence factors

Cell wall, coagulase, protein A (bind Fc), Catalse,

cocci, polyssaccharide Faculatative anaeobes, ETA/ETB, enterrotoxins, TSST -1, hyluronidase,
capsule hemolytic, mannitol yellow lipase, Dnase, Teichoic acid is endotoxic

M-protein mimics mitral valve, streptolysin O,

fatidious, microaerophilic, Dnase,
Cocci, chains, streptokinase to convert plasminogen to
hemolytic plasmin

Cocci, lancet shaped, Pneumolysin, IgA protease to cleave IgA and

hemolytic, bile soluable,
capsule invade mucus

BPB, Type III

Shiga toxin binds Gb3, Type III

CFA fimbriae, LT and ST enterotoxin

ferment lactose (pink on
MacConkey), Green on EMB
capsule, bacilli agar, faculatative anerobe, AAF,
hardy
Shigella like, type III
BBB with OmpA, IbeA-C, As1A, K1 capsule, S
fimbriae

T and P fimbriae, heolysins, pathogenicity ilands,

CNF1/2 to allow immune cells to enter

rod, single flagellum, obligate aerobe cytochrome C pili, LPS, elastase, Exotoxin A (ADP ribosylation of
EF2), type III to Block phagocytosis, pyocyanin,
encapsulated oxidase +, oxidizes sugars alginate, hemolysins, efflux, catalase +

charcoal yeast agar, Fe,

rod, poor gram stain type IV, LPS
cysteine, fastidious

PSA activates CD4 T cells for abceses, fimbriae,

hylauonidase, collagenase, phospholipase, Zn
rods, pleomorphic anerobic metalloprotease, catalase, SOD, lactamase, LPS
but not endotoxic, BFT,

pilli/fimbriae, type III, IcsA recruits actin to shoot

non motile rods no lactose around, Shiga toxin, LPS, TTSS2
 no lactose, black for H2S H antigen for motlitiy, TTSS 1, type III, prevent
motile rods formation lysosome fusion, LPS, pili/fimbriae
 Pathogenesis Acquisition
Pyogenic: abscesses, joint pain, impetido, pyoderma,
pneumonia, bacteremia, osteomyelitis, acute endocarditis of Nose, nosocomial, opportunistic
tricuspid valve. Toxigenic: rapid onset food poisioning, TSS,
Scalded skin syndrome

Inflammatory: impetigo, pharyngitis, erysipelas; SPE: scarlet

fever, TSLS, Nec Fasc (SPEB), pharyngitis, diffuse rash; ARF: 2
week post not skin infection, Joints, heart valve damage, Human only
Nodules, eryhema marginatum, Sydenham's chorea
(neurodamage); PSGN: post skin infection, impetigo, facial
sweling, immune complex disease, glomerular infection

Lobar pneumonia (rust sputum), CMOPS: conjunctivitis, inhalation, bacteremia

menningitis, pneumonia, otitis media, sinuitis, s

watery diarrhea, vomiting

bloody diarrhea, low HCT, HUS

Non-inflammatory watery diarrhea,

Overall it causes UTI, sepsis, neonatal
meningitis if K positive, all are catalse +,
mucus watery diarrhea, growth retardation LPS, and fimbriae, fecal oral or commensal
bloody diarrhea, dysentery

sepsis, acute meningitis, thrombosis

cystitis, peylonephritis

UTI (cipro), CF lungs, nosocomial pneumonia, endocarditis, extracellular surfaces, nosoomial in

ecthyma gangrenosum, otitis externa, inflamation catheters, burn infections, it is everywhere

legionaires diseas with with lobar pattern, atypical nonpurulent

sputum, pontiac disease, heachache, high fever, non-bloody water sources only, intracellar
diarrhea

when mucus is compromised, colon and

polymicrobial infections, abcesses in UTI, bacteremia, sepsis vagina

hemmoragic inflammatory diarrhea, HUS in kids sewage

inflammatory diarrhea, lymph node infiltartion fecal oral, chicken
 Treatment Special concern

Nafcillin if it is meticilin-sensitive,
Vancomycin for MRSA to combate altered
PBP, daptomycin, linezolid

Penicillin, PSGN not protected by

penicillin, daptomycin

Macrolides, ceftriaxone, Pneumovax sickle cell disease people

(adult, IgM) and Prevnar (Children, IgG) suseptible

Do not treat with antibiotics

due to shiga toxin

GI = type 1 pilus, UTI = P pilus

systemic infections can be treated with
gm - aneobe coverage. persisitent diarrhea in AIDS,
another travelers
<5 years old

neonates

Piperacilin, Aminoglycolyses,
FQN,ceftazidime, cefepime, azteronam,
imipenam

macrolides, FQNs, tetracyclines

piperacilin, metroizadole, carbapenems,

ampicillin/amoxacilin with the inhibitors,
clindamycin

self-limiting, cipro and the

sulfmethoazoles in rare cases
 self limiting, resistance is common,
antibiotics in the case of HIV or neonates.