Which of the following drug is effective in pseudomonas infection?
A. PiperacillinB. Amoxicillin
C. Oxacillin
D. Vancomycin
Ans. A. (Piperacillin)
Explanation:
Antipseudomonal antibiotics
A. Carbenicillin:
The special feature of this penicillin congener is its activity against Pseudomonas aeruginosa and indole-positive proteus which are not inhibited by penicillin G or aminopenicillins. It is less active against Salmonella, E. coli, and Enterobacter, while Klebsiella and Gram-positive cocci are unaffected by it. Pseudomonas strains are less sensitive to carbenicillin in some areas, especially when inadequate doses have been used.
• Carbenicillin is neither penicillinase-resistant nor acid resistant, it is inactive orally and is excreted rapidly in urine (Ph 1 hour). It is used as sodium salt in a dose of l—2 g IM or l—5 g IV every 4—6 hours. At the higher doses, enough sodium may be administered to cause fluid retention and CHF in patients with borderline renal or cardiac function.
High doses have also caused bleeding by interfering with platelet function. This appears to result from perturbation of agonist receptors on platelet surface.
• The indications for carbenicillin are serious infections caused by pseudomonas or proteus, e.g., burns, urinary tract infection, and septicemia; but piperacillin is now preferred. It may be used together with gentamicin, but the two should not be mixed in the same syringe.
B. Ticarcillin
• It is more potent than carbenicillin against pseudomonas, but other properties are similar to it.
C. Piperacillin
• This antipseudomonal penicillin is about 8 times more active than carbenicillin. It has good activity against Kiebsiella and is used mainly in neutropenic immunocompromised patients having serious Gram-negative infections, and in burns. Elimination half life is 1 hour. Concurrent use of gentamycin or tobramycin is advised.
Antimicrobial agents active against Pseudomonas aeruginosa
• Antipseudomonal penicillins
Explanation:
Antipseudomonal antibiotics
A. Carbenicillin:
The special feature of this penicillin congener is its activity against Pseudomonas aeruginosa and indole-positive proteus which are not inhibited by penicillin G or aminopenicillins. It is less active against Salmonella, E. coli, and Enterobacter, while Klebsiella and Gram-positive cocci are unaffected by it. Pseudomonas strains are less sensitive to carbenicillin in some areas, especially when inadequate doses have been used.
• Carbenicillin is neither penicillinase-resistant nor acid resistant, it is inactive orally and is excreted rapidly in urine (Ph 1 hour). It is used as sodium salt in a dose of l—2 g IM or l—5 g IV every 4—6 hours. At the higher doses, enough sodium may be administered to cause fluid retention and CHF in patients with borderline renal or cardiac function.
High doses have also caused bleeding by interfering with platelet function. This appears to result from perturbation of agonist receptors on platelet surface.
• The indications for carbenicillin are serious infections caused by pseudomonas or proteus, e.g., burns, urinary tract infection, and septicemia; but piperacillin is now preferred. It may be used together with gentamicin, but the two should not be mixed in the same syringe.
B. Ticarcillin
• It is more potent than carbenicillin against pseudomonas, but other properties are similar to it.
C. Piperacillin
• This antipseudomonal penicillin is about 8 times more active than carbenicillin. It has good activity against Kiebsiella and is used mainly in neutropenic immunocompromised patients having serious Gram-negative infections, and in burns. Elimination half life is 1 hour. Concurrent use of gentamycin or tobramycin is advised.
Antimicrobial agents active against Pseudomonas aeruginosa
• Antipseudomonal penicillins
o Piperacillin
o Piperacillin/tazobactam
o Meziocillin
o Ticarcillin
o Ticarcillin/clavulanatc
o Piperacillin/tazobactam
o Meziocillin
o Ticarcillin
o Ticarcillin/clavulanatc
• Antipseudomonal
cephalosporins
o Ceftazidime
o Cefoperazone
o Cefepime
o Cefoperazone
o Cefepime
•
Carbapenems
o Imipenem/cilastatin
o Meropenem
• Monobactams
• Monobactams
o Aztreonam
• Aminoglvcosides
• Aminoglvcosides
o Tobramycin
o Gentamicin
o Amikacin
• Fluoroquinolones
• Fluoroquinolones
o Ciprofloxacin
o Levofloxacin
• Other Agents
• Other Agents
oPolymyxin B
o
Colistin 