NAPLEX (North American Pharmacist Licensure Examination) Practice Exam

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Which antibiotics' effectiveness is based on maintaining high peak levels compared to MIC?

  1. aminoglycosides, quinolones, daptomycin

  2. vancomycin, macrocodes, tetracyclines, polymyxins

  3. B-lactams

  4. cephalosporins

The correct answer is: aminoglycosides, quinolones, daptomycin

Aminoglycosides, quinolones, and daptomycin are the three classes of antibiotics that are effective when maintained at high peak levels compared to MIC. This means that these antibiotics work best when they are administered at a high dosage, as their effectiveness depends on reaching a certain concentration in the body to effectively kill bacteria. The other options, vancomycin, macrocodes, tetracyclines, polymyxins, B-lactams, and cephalosporins, do not depend on maintaining high peak levels and may have different mechanisms of action or dosage requirements. For example, B-lactams and cephalosporins are known to work by disrupting the bacterial cell wall and do not rely on high peak levels for their effectiveness. Similarly, vancomycin and macrocodes work by inhibiting bacterial protein synthesis, while tetracyclines and polymyxins work by disrupting bacterial membrane function. Therefore, these antibiotics have different means of achieving their antimicrobial effects and do not rely on maintaining high peak levels compared to MIC like aminoglycosides, quinolones, and daptomycin do.