Review of Pharmacology - 9E (2015)

Review of Pharmacology
139. Ans. (c) Inhibits DNA gyrase (Ref: KDT 6/e p688)
140. Ans. (a) Sulfacetamide (Ref: KDT 6/e p684)
141. Ans. (d) Pefloxacin (Ref: KDT 6/e p691)
142. Ans (c) Clindamycin (Ref: Harrison 18/e p1013-1014)
Important points regarding pseudomembranous colitis:
• Most common organism implicated: Clostridium difficile
• Most common antimicrobial implicated: Cephalosporins > Clindamycin
• Drug of choice for treatment of mild to moderate PMC: Metronidazole
• Drug of choice for treatment of severe PMC: Vancomycin
143. (d) Cefotaxime + vancomycin (Ref: Harrison 18/e p3414)
Antibiotics Used in Empirical Therapy of Bacterial Meningitis and Focal CNS Infections
Chemotherapy A: General Considerations and Non-specific...
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Indication
Preterm infants to infants 3 months and adults 55 years and adults of any age with alcoholism or
other debilitating illnesses
Hospital-acquired meningitis, post-traumatic or postneurosurgery
meningitis, neutropenic patients, or patients with
impaired cell-mediated immunity
Antibiotic
Ampicillin + cefotaxime
Ampicillin + cefotaxime or ceftriaxone
Cefotaxime, ceftriaxone or cefepime + vancomycin
Ampicillin + cefotaxime, ceftriaxone or cefepime + vancomycin
Ampicillin + ceftazidime or meropenem + vancomycin
144. Ans. (b) Cefaclor (Ref: KK Sharma 2/e p727)
Cefaclor is a second generation cephalosporin and is not active against MRSA. Resistance in MRSA occurs due to
altered PBPs (transpeptidase). As the binding site is altered, therefore, no beta lactam can bind and thus all beta-lactams
(penicillins, cephalosporins, carbapenems and monobactams) are ineffective against MRSA. However, recently fifth
generation cephalosporins like ceftaroline and ceftobiprol have been formed, which are effective against MRSA.
145. Ans (a) Pencillin (Ref: CMDT 2012/1433)
The only acceptable treatment for syphilis in pregnancy is penicillin in dosage schedules appropriate for the stage of the
disease.
Penicillin remains the preferred treatment for syphilis, since there have been no documented cases of penicillin resistant T
pallidum. Although doxycycline is an alternative for some patients, pregnant women must be treated with penicillin (see
below).
Recommended treatment of Syphilis
Stage of symphilis Treatment Alternative Comment
Primary, secondary, or
early latent
Late
Late latent or uncertain
duration
Tertiary without
neurosyphilis
Benzathine penicillin G 2.4 million
units IM once
Benzathine penicillin G 2.4 million
units IM weekly for 3 weeks
Benzathine penicillin G 2.4 million
units IM weekly for 3 weeks
Neurosyphilis Aqueous penicillin G 18-24
million units IV daily, given every
3-4 hours or as continuous
infusion for 10-14 days
Doxycycline 100 mg orally twice daily
for 14 days or tetracycline 500 mg
orally four times daily for 28 days or
ceftriaxone 1g IM daily for 8–10 days
Doxycycline 100 mg orally twice daily
for 28 days or tetracycline 500 mg orally
four times a day for 28 days
Doxycycline 100 mg orally twice daily
for 28 days or tetracycline 500 mg orally
four times a day for 28 days
Procaine penicillin, 2.4 million units IM
daily with probenecid 500 mg orally
four times a day for 10–14 days or
ceftriaxone 2 g IM daily for 10–14 days
Cerebrospinal fluid
evaluation recommended
in all patients
Follow treatment with
benzathine penicillin G, 2.4
million units IM weekly for
up to 3 weeks
contd...
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