Antibiotic classes mapped to gram-positive, gram-negative and anaerobic coverage, mechanisms and adverse effects.
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- What is the mechanism of action of penicillins?
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They inhibit bacterial cell wall synthesis by binding penicillin-binding proteins (PBPs).- What organisms does penicillin G (a natural penicillin) primarily cover?
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Streptococcus species and Treponema pallidum (syphilis).- What do antistaphylococcal penicillins like oxacillin and nafcillin cover?
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Methicillin-susceptible Staphylococcus aureus (MSSA), not MRSA.- What extra coverage do aminopenicillins like amoxicillin add over natural penicillins?
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Some gram-negative coverage (H. influenzae, E. coli) and Listeria.- Why does piperacillin-tazobactam have broad coverage including Pseudomonas and anaerobes?
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The antipseudomonal penicillin component plus the beta-lactamase inhibitor extend its spectrum.- What is a major hypersensitivity risk with penicillins?
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Anaphylaxis (immediate allergic reaction).- What is the mechanism of action of cephalosporins?
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They inhibit bacterial cell wall synthesis by binding penicillin-binding proteins, like other beta-lactams.- What is the main coverage strength of first-generation cephalosporins like cefazolin?
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Good gram-positive coverage (e.g., used for surgical prophylaxis), minimal gram-negative activity.- Which cephalosporins reliably cover Pseudomonas aeruginosa?
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Ceftazidime and cefepime.- What allergy risk do cephalosporins carry in penicillin-allergic patients?
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A small risk of cross-reactivity due to the shared beta-lactam ring.- What is the mechanism of action of carbapenems?
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They are beta-lactams that inhibit cell wall synthesis by binding penicillin-binding proteins.- What makes carbapenem spectrum unique among beta-lactams?
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They cover gram-positive, gram-negative, and anaerobic organisms, the broadest beta-lactam spectrum.- What is the coverage profile of monobactams (aztreonam)?
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Gram-negative only, with no gram-positive or anaerobic activity.- Why can aztreonam be used safely in patients with severe penicillin allergy?
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It has minimal cross-reactivity with other beta-lactams.- What is the mechanism of action of vancomycin?
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It binds the D-Ala-D-Ala precursor to block bacterial cell wall synthesis, a different site than beta-lactams.
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