Mucormycosis and Fungus

Common cause- Rhizopus(in moldy bread), spores are deposited at nasal, lung, GI, skin Presentation- Severe facial sinuses infection→  may extend to brain Iron study- High ferritin, low TIBC Treatment- Liposomal form of amphotericin B(nephrotoxicity), Isavuconazole( QTc shortening), Posaconazole 1.Rhinocerebral disease Risk factor- DKA, neutropenia Presentation- Retro-orbital headache, invasion of the CN V and VII , […]

B-lactam antibiotics

1.Penicillin *Cr=50 ml/min(50~75%), 10 ml/min(25~33%) *Carboxy-PCN- Fluid overload, Platelet↓ *B-lactamase- MSSA → Oxacillin *PBP change- MRSA, PRSP → vancomycin 2. Cephalosporins *AmpC B-lactamases- E.coli, K.p → Cefepime, Cefpirome, Imipenam, meropenam *ESBL B-lactamases- E.coli, K.p → Imipenam, Meropenam, Cephamycin *Serine/Metallo-B-lactamse- MDRAB → Tigecycline *Cefoperazone and ceftriaxone– Liver metabolism 3.Carbapenams *Imipenam → seziure 4.Monobactam