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53 Cards in this Set

  • Front
  • Back
Define selective toxicity.
Kills the invading organism and spares the host
What is a bactericidal?
the organisms are killed
What is a bacteriostatic?
the organisms are prevented from growing
Why can some agents be bacteriostatic and bactericidal?
depends on the concentration of drug achieved at the site of infection and the target bacteria
What type of agents must be used i immunocompetent patients without complement or proper immunity/antibody function?
bactericidal (kills organisms directly)
What is the post antibiotic effect (PAE)?
persistent suppression of organism growth after concentrations fall beneath the MIC
What is MIC (Minimum Inhibitory Concentration)?
lowest concentration of an antimicrobial agent that prevents visible growth after an 18-24 hour incubation period
What is MBC (Minimum Bactericidal Concentration)?
minimal concentration that kills 99.9% of bacterial cells
What conditions require that you know the MBC?
endocarditis, osteomyelitis, and meningitis
What factors can be used to confirm the presence of an infection?
fever, leukocytosis, tachycardia, local signs, mental status changes like confusion and lethargy, chills/rigors
What is the fastest, simplest, and most inexpensive method used to identify types of organisms?
gram stain
This identification method provides conclusion identification and precise targeting of therapy, but it takes more time to get than a Gram stain.
Culture and Sensitivity
How do you empirically select an antimicrobial agent?
based on the most likely factor, host factors, and drug factors
What are the methods for monitoring therapeutic response?
improvement in symptoms (local and systemic), lab tests (WBC, culture negative),
What is considered therapeutic failure?
no improvement or worsening of symptoms
3 considerations in antibiotic use
host, drug, and bug
How long might it take to determine susceptibility of a bug to antibiotics?
18 to 48 hours
What is the Disk Diffusion method?
most common means to determine antibiotic susceptibility
Length of time it takes to get result with Disk Diffusion Method
18-24 hours
Which test is a quantitative test that determines the MBC and MIC?
Dilution Test
What is important to differentiate when someone has a allergy history to a antimicrobial agent?
anaphylaxis versus rash
What two classes of antibiotics are best known for allergic reactions?
penicillins and cephalosporins
What side effect do Tetracyclines have in kids?
yellow teeth
What side effect do FQ have in kid?
joint and cartilage infections
What population is it important to assess renal function in when using antimicrobial?
elderly because they have fewer functioning nephrons
In diabetic foot infections, what is the concern when selecting antibiotics?
antibiotics will be appropriate for bacteria present, however the drug cannot reach the site due to poor perfusion secondary to swelling and co morbid disease state
This method id antimicrobial administration is the most reliable but the least convenient
IV route
Why does inflammation facilitate antibiotic distribution?
it increases blood flow to the area
What is the most pertinent distribution issue in antibiotic use ?
adequate antibiotics must reach the infection site
What drugs in particular must you monitor CNS toxicity with?
penicillins, cephalosporins, quinolones, and imipenem
What drug is known for causing neutropenia?
nafcillin
What drug is known for causing platelet dysfunction?
piperacillin
What drug is known for causing hypoprothombinemia?
cefotetan
What drug is known for causing bone marrow suppression?
chloramphenicol
What drug is known for causing megaloblastic anemia?
Trimethoprim (Bactrin)
What drugs are known for nephrotoxicity?
aminoglycosides and vancomycin (reversible upon discontinuation)
What drugs are known for causing photosensitivity?
quinolones, tetracylcines, sulfonamides
What drugs are known for causing diarrhea/colitis?
clindamycin because it wipes out normal flora of GI tract
These drugs are effective against a single or limited group of microorganisms
narrow spectrum
These drugs are effective against a large number of gram positive and some gram negative bacteria
extended spectrum
These drugs are effective against a wide variety of microbial species (gram positive, gram negative, and anaerobic bacteria)
broad spectrum
Example of broad spectrum antibiotic
Fluoroquinolones (Moxifloxacin)
Why should you use single agents to treat infections whenever possible?
reduces likelihood of resistance; also using multiple agents can disrupt the action of a single agent and increase toxicity risk
What situations require combinations of drugs?
life threatening infections in immunocompromised/chronically ill, empirically when no one agent is known to be effective, to decrease emergence of resistant strains, to decrease toxicity by lower dose, and when synergism is needed
What is synergism?
inhibitory or killing ability of 2 antimicrobials is greater than the expected ability based on their individual effects
How often do you reevaluate response to antibiotics?
every 2-3 days
Failures caused by the drug itself can be due to what?
inappropriate drug selection, inappropriate dosage, inappropriate route of administration (poor penetration to site of infection)
Failures due to bug factors can be due to what?
bacterial resistance, infections that are non bacterial in origin, or undetected microorganism in polymicrobial infection’
What is bacterial resistance?
growth is not halted by maximal level of antibiotic tolerated by the host
What is innate resistance?
resistance as a result of the natural design of bacteria and the design of the drug's MOA
What is acquired resistance?
resistance adapted through spontaneous mutation or DNA transfer of drug resistance
When should antimicrobial prophylaxis be used?
when efficacy has been proven and the benefits of prophylactic treatment outweigh the risk of resistance
Two types of antibiotic prophylaxis
surgical (upper GI, colon, prosthetics, C section, and dirty surgery) and non surgical (prevent UTIs, bacterial endocarditis)