Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
39 Cards in this Set
- Front
- Back
What is the definition of antibiotic prophylaxis?
|
Giving antibiotics before contamination or infection
|
|
Antibiotic prophylaxis is an empirical choice of _________.
|
Agent- don't want to pick one that will cause resistance
|
|
What is the goal of antibacterial prophylaxis?
|
Maintain inhibitory antimicrobial concentrations at incision site for duration of surgery
|
|
*What is an acceptable postoperative infection rate for small animal clean wounds?
|
5% infection rate
|
|
*What is an acceptable postoperative infection rate for small animal clean-contaminated wounds?
|
12%
|
|
*What is an acceptable postoperative infection rate for a small animal contaminated/ dirty wound?
|
10%
|
|
How can antimicrobial associated complications be minimized?
|
-With little change in patient microbial flora
-Reduction in development of resistant microbial flora in hospital / staff |
|
When do you want to administer prophylatic antibiotics for a surgery?
|
at least 30 minutes prior to surgical incision
-No greater than 60 minutes prior to surgical incision |
|
Should you administer antibiotics if its been 3 hours post-op? Why or why not?
|
No, if its been 3-6 hours post-op it doesn't help so don't give
|
|
Why is it so important for surgeons to wear facemasks?
|
Because MRSA can reside in our noses
|
|
Why is the timing of prophylactic antibiotics so important?
|
Must maintain adequate concentrations throughout the surgery (>MIC for expected pathogen)
|
|
When should prophylactic antiobitics be re-administered?
|
At 1-2 times the elimination half-life of the drug
|
|
Is it really necessary to administer prophylctic antibiotics?
|
Yes, appropriately administered antibiotic prophylaxis reduces chance of surgical site infection 6-7 fold
-Humans: regardless of type of surgery, ALL have reduced infections w/ prophylaxis |
|
What bacteria are targeted by cefazolin when you give 2 mg/kg every 3 hours?
|
Suppresses 90% of Staphylococcus and E. coli throughout the contamination period
|
|
How often is cefazolin given for an orthopedic surgery? Soft tissue surgery?
|
-Ortho is every 90 min
-Soft is every 120 min -We want to do better than 90% reduction |
|
What is the half life of cefazolin?
|
48 minutes
|
|
You forget to re-administer an antibiotic and it's been 3 hours since the initial dose. Should you still give the antibiotic?
|
Yes, if given 3 hours after initial dose it still has an impact so give it
|
|
How long can you administer antibiotics following surgery?
|
Can continue up to 24 hours following surgery but NOT longer or may increase chance of infection
|
|
True or false. Cefazolin can cause hypotension in healthy dogs when under anesthesia.
|
False, Cefazolin has no effect on BP of dogs while under anesthesia as long as HEALTHY!
|
|
What is the mechanism of action of cefazolin?
|
Alters bacterial cell wall formation= gram positive organisms i.e. staph
|
|
_________ (antimicrobial) rapidly reaches therapeutic concentrations following IV administration.
|
Ampicillin
|
|
What are the side effects of ampicillin? (2)
|
1) trend for this drug to cause decreases in systolic, mean and diastolic blood pressure **why Baltzer prefers cefazolin
2) Hypersensitivity reactions can occur: ranges from anaphylaxis to cutaneous reactions |
|
True or false. Ampicillin has some anaerobic activity so is a better choice for regions with poor circulation.
|
True
|
|
What type of antibiotic is cefoxitin?
|
3rd generation (some say second) cephalosporin
|
|
What is the spectrum of activity of cefoxitin?
|
Gram negative, some gram + spectrum
-if think gram negative or anaerobe think this* |
|
What prophylactic antibiotic should you use when you're trying to target E. coli?
|
Cefoxitin
|
|
What are 4 surgeries where cefoxitin is the prophylactic antimicrobial of choice?
|
1) Cardiopulmonary surgery
2) Small intestinal surgery 3) Colorectal and liver/ biliary surgery 4) Urogenital surgery |
|
What are 6 patient-associated determinants of an animal's predisposition to surgical site infections?
|
1) Extremes of age
-often drop body temp and get infection 2) Morbid obesity (dogs NOT cats) 3) American society of anesthesiologists score -increasing score= more compromised patient= greater risk 4) Prolonged preoperative hospitalization -more likely to be colonized by resistant bacteria the longer in hospital 5) Removal of hair the day before surgery -If bathed or clipped more than 24 h prior to surgery then definitely increases risk because changes normal flora of skin 6) Preoperative antibiotics (+/-) -If give antibiotics greater than 1 hours prior to surgery= increased risk of resistance |
|
How does the duration of a surgery affect the rate of infection?
|
Double the risk of infection ~ every 70 minutes of surgery time
|
|
How does the duration of anesthesia affect the rate of infection? Why?
|
30% increase in risk of infection for every additional hour of anesthesia
-hypothermia, hypotension, hypoxia in tissues |
|
Why is it important to minimize the number of people in the surgery room?
|
Risk of infection for each additional person in surgery suite, risk of infection is 1.3x higher
|
|
How is surgical infection minimized in the surgery room at OSU?
|
Shut doors when operating, every hour there are 10 pull air exchanges
|
|
What are 2 types of surgery that should definitely have a limited number of people in the surgery suite?
|
-Cardiovascular
-Joint replacement |
|
What should you do whenever performing a dirty surgery?
|
Culture and sensitivity- ALWAYS DO SENSITIVITY
|
|
How much more likely is an infection at the surgery site when working with a dirty wound?
|
5.5x increased risk of infection at surgery site
|
|
To move a patient to an ICU or not is a difficult decision to make. What are 3 reasons doctors are hesitant to put patients in the ICU?
|
1) 20% nosocomial infections occur in ICU
2) Surgical ICU patients at greatest risk of developing a nosocomial infection 3) Multiresistant organisms through invasive devices -e.g. can't leave any catheter in for longer than 3 days |
|
How common is infection in animals with a drain?
|
Very common, drains reduce # of organisms needed to establish infection by 10,000x - why she sends them home w/ penrose to prevent resistant infection or use a jackson pratt in ICU that is closed off
|
|
Why does Dr. Baltzer refuse to use cold sterile?
|
There are fungal organisms in the cold sterile
|
|
Once an implant is infected, can you treat with antibiotics?
|
No, have to remove implant because cannot penetrate the biofilm with antibiotics
|