Bugs and drugs

by Lorien E. Menhennett

Talking to yourself is a sure-fire way to look crazy. I’ve discovered it’s also a sure-fire memory enhancer. When I was first learning Spanish, I would have conversations with myself, voicing my thoughts in Spanish rather than English. These days, I find myself muttering antibiotic treatment algorithms aloud. I (mostly) do this alone in my apartment, for everyone’s sake.

Identifying the bacteria causing an infection is sometimes trickier than it sounds.

Identifying the bacteria causing an infection is sometimes trickier than it sounds.

Tomorrow is our first infectious disease exam, and there is so much to memorize. Every little bump helps. I can sum up this exam in two words:

  1. bacteria
  2. antibiotics

That might not sound like such a big deal. Trust me. It’s a big deal. I can prove it. I’ve included a photo of my dry erase board, which currently sports an identification tree for both the common gram positive and gram negative bacteria. (There are other bugs to know, but these are the main ones.)

The list of antibiotics to learn is also long. The list here is a screenshot from an e-mail sent by our course director, telling us what we drugs to focus on. Antibiotics are tricky though. Each one covers a slightly different spread of bacteria. I also need to know the mechanism for each drug, possible side effects, and how various bacteria can become resistant to the drug. That’s a lot of information.

Learning all these drugs -- what they treat, how they work, side effects, and resistance mechanisms -- is a feat.

Learning all these drugs — what they treat, how they work, side effects, and resistance mechanisms — is a feat.

Thankfully, my motivation for learning these bugs and drugs is high. Antibiotic therapy is something I will definitely use on a regular basis. Seeing that clinical application helps me slog through. Silly mnemonics are also a boost. Some are my own, like this one:

  • Ceftaroline, a fifth generation cephalosporin, is one of a few drugs with activity against MRSA. Here’s how I remember that: Ceftaroline‘s got a line on MRSA.

Here are a couple from the book I’ve been using to study, Microbiology Made Ridiculously Simple:

  • Carbapenems like Imipenem and Meropenem are broad spectrum antibiotics that cover all kinds of things — gram positives, gram negatives including Pseudomonas, and anaerobes.  To remember the coverage of Imipenem, think of this: I’m a pen, crossing out all bacteria.
  • Bactrim is another antibiotic that covers all sorts of bugs. This drug’s generic name is trimethoprim/sulfamethoxazole, or TMP/SMX. You can use four of those letters, TMP/S, to remember some of Bactrim’s capabilities:
    • T (Tree): respiratory tree. The drug covers all kinds of respiratory infections.
    • M (Mouth): gastrointestinal tract. The drug covers many gram negative bugs that cause diarrhea.
    • P (Pee): genitourinary tract. Bactrim covers UTIs and other nearby infections.
    • S (Syndrome): The drug covers a devastating disease called Pneumocystis carinii pneumonia (PCP), which affects people with AIDS who have low T-cell counts.

These are stupid, but they stick. And that’s what matters. It matters for my test tomorrow, but more importantly when it comes to treating a patient who presents with one of these infections. If it takes me mumbling these mnemonics to myself and looking like an idiot to get there, I’m ok with that.

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