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Chloramphenicol
2%
5/267
Gentamicin
6/267
Ciprofloxacin
5%
14/267
Ceftriaxone
87%
233/267
Trimethoprim
1%
2/267
Select Answer to see Preferred Response
This patient presents with symptoms of disseminated gonococcal infection caused by Neisseria gonorrhoeae, which can be treated with a 3rd generation cephalosporin such as ceftriaxone. Ceftriaxone blocks cell wall synthesis. Ceftriaxone belongs to a larger class of ß-lactam antimicrobials called cephalosporins. Cephalosporins bind to transpeptidases resulting in the inhibition of peptidoglycan cross-linking. They are more resistant to ß-lactamases which would otherwise destroy the active ß-lactam ring responsible for its activity. Penicillins are another class of ß-lactam antimicrobials which also inhibit transpeptidases. Incorrect Answers: Answer 1: Chloramphenicol and macrolides bind the 50S subunit of ribosomes blocking the peptidyl transferase resulting in inhibition of protein synthesis. Answer 2: Aminoglycosides (gentamicin) bind the 30S subunit of ribosomes resulting in misreading of the mRNA, premature termination of translation, and blocking the initiation of translation. Answer 3: Fluoroquinolones (ciprofloxacin) inhibit the bacterial topoisomerases preventing the unwinding of DNA during replication. Answer 5: Trimethoprim inhibits dihydrofolate reductase preventing the recycling of folic acid and inhibition of the synthesis of purine nucleotides.
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