Other beta lactams 2
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- Other beta lactams are?
-
Monobactam - Aztreonam
Carbapenems - Impinem, Meropenem - Aztreonam MOA
- Aztreonam interferes with biosynthesis of bacterial cell walls by binding to PBPs
- Aztreonam activity
-
only against gram - bacteria
UTI, urosepsis, often hospital acquired.
Moster enterobaceteriaceaa (e. coli, klebsiella)
Modest activity against P.aeruginosa
Poor oral abs. given IM or IV
Poor CSF levels, good tissue and urine.
Combination good for anaerobic and gram +. Metronidazole or clindamycin - Aztreonam general
-
Exreted via kidneys, reduce dose in renal failure.
No nephrotoxicity and no ototoxicity. - Imipenem MOA
-
binds with PBP's to lyse cell walls
IV or IM usually IV
NO Nephro or ototoxicity. - Imipenam is combined with?
- Cilastatin a potent enzyme inhibitor. Prevents inactivation by the kidney brush border cells.
- Impenam activity
-
Gram + for MSSR, GAS, most pneumococci, many enterococci, strep B.
Gram - for community acquired gram - and most hospital acquired gram -. Most P.aeruginosa.
Anaerobes
NOT GOOD FOR
MRSA, VRE, and some hostpial acquired gram -, meningitis
VERY BROAD ABX BUT DON'T WANT TO SELECT OUT FOR RESISTANCE. BIG GUN. SEIZURES IN HIGH DOSES. - Impenam cannot be used if allergic to what?
- Penicillin and/or cephalosporins
- Impenam is DOC for?
-
for certain hospital acquired gram -'s
Enterobacter
Acinetobacter
Citrobacter - Metropenam
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just like impenam but side effects are lessened and can be used for CNS infections..
IV use only