CICM SAQ 2010.1 Q13
Questions
13.1. Apart from vancomycin, list three antibiotics that have activity against hospital acquired methicillin resistant staphylococcus aureus (MRSA).
13.2 List an example of each of the three main classes of systemic antifungal agents.
13.3. Briefly outline the dosing adjustment and the monitoring necessary in patients with septic shock for each of the following drug groups in patients with moderate to severe renal dysfunction (without dialysis)
- a) Aminoglycosides
- b) Fluoroquinolones
- c) Beta Lactams
- d) Carbapenems
- e) Glycopeptides
Answers
Answer and interpretation
13.1. Apart from vancomycin, list three antibiotics that have activity against hospital acquired methicillin resistant staphylococcus aureus (MRSA).
- Linezolid
- Talavancin
- Streptogramins (not currently available in Australia)
- Tigecycline
13.2 List an example of each of the three main classes of systemic antifungal agents.
- Polyenes e.g. Amphotericin B
- Azoles e.g. Fluconazole
- Echinocandins e.g. caspofungin, andulafungin, micafungin
13.3. Briefly outline the dosing adjustment and the monitoring necessary in patients with septic shock for each of the following drug groups in patients with moderate to severe renal dysfunction (without dialysis)
- a) Aminoglycosides
- b) Fluoroquinolones
- c) BetaLactams
- d) Carbapenems
- e) Glycopeptides
a) Aminoglycosides
- High initial dose and monitor trough concentrations. Extend interval. May be necessary to decrease dose and monitor with MIC data
b) Fluoroquinolones
- Reduce frequency but maintain dose.
- Monitor QT interval
c) BetaLactams
- Can reduce dose OR frequency
- Monitoring unnecessary
d) Carbapenems
- As for Beta Lactams
e) Glycopeptides
- High dosing on day one
- dose adjustments according to Cmin and dependent on degree of renal dysfunction
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