More gram positive than gram negative
Levofloxacin
3rd generation Fluoroquinolone Moxifloxacin
Gemifloxacin
-moxi and gemi are respiratory Fluoroquinolones
Inhibits DNA synthesis
Bactericidal
Fluoroquinolones MOA
Concentration dependent killing
Resistance- target sites altered by mutation & change in sensitivity of target enzymes
GI upset, rash, abnormal LFTs
Fluoroquinolone ADE Prolonged QTc
Tendinitis and tendon rupture (caution in pregnancy)
Norfloxacin & Ofloxacin Mainly used for UTI
Ciprofloxacin GI, GU, and some respiratory infections
respiratory fluoroquinolones
Levofloxacin & Moxifloxacin
Good against gram + cocci & atypical like chlamydia and mycoplasma
Antifolate drugs
Antimetabolites
Sulfonamides
Sulfonamides Bacteriostatic inhibitors of folic acid synthesis
Synergistic (Bactericidal)
Trimethoprim-Sulfamethoxazole Sulfonamides- inhibit microbial enzymes involved in folic acid synthesis
Trimethoprim- selective inhibitor of dihydrofolate reductase
Plasmid mediated
TMP-SMX Mechanism of Resistance Reduced cell permeability so the drug can't penetrate
Reduced drug binding
Rash
Steven Johnson syndrome
Photosensitivity
TMP-SMX ADE
NVD
Fever, bone marrow suppression, hyperkalemia
Crystalluria & hematuria
2/5
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