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15 Cards in this Set

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Decisions in Antibacterial Therapy
1) Determine the need for antibacterial therapy
2) Maximize the efficacy of the antibacterial therapy
3) Use an appropriate dosage regimen
4) consider the patient and client
5) monitor results of treatment
MIC
minimum inhibitory concentration = lowest concentration of antibac agent at which there is no viible growth of bacteria in broth
MBC
Minimum Bactericidal Concentration = lowest concentration of an antibacterial agent that actually kills all of the bac growth in broth when checked by plating out on agar (not routinely done)
Kirby Bauer method of susceptibility testing
1) antibacterials diffuse into agar at a known rate, decreasing in concentration w/ the distance from the disk
2) microbial growth inhibited by drug produces a zone of no growth that correlates inversely w/ an MIC of the drug
3) Each drug has its own size standard for the zone of no growth for calling a bacterium sensitive, intermediate and resistant
Flexible
Category for select antibacterials (fluoroquinolones) in which appropriate dosing modifications are allowed; designed to reach higher tissue concentrations at which the bacterium is susceptible
Breakpoint MIC
the approximate drug concentration that can reasonably be achieved safely in the plasma using the clinically accepted dose and route
Things to consider when choosing an antibiotic
1) susceptibility
2) Rte. of administration
3) timing of admin
4) toxicity
5) cost
6) immune status of patient
7) Rte of elimination
8) avoid contributing to resistant bacterial populations
Properties of bactericidal agents
1) kill susceptible organisms
2) do not rely on host defenses
3) MBC/MIC ratio is low
4) MBC safely attainable in host
Properties of bacteriostatic agents
1) inhibit growth of susceptible organisms
2) Rely on host defenses
3) MBC/MIC ratio is high
4) MBC not safely attainable
Combo therapy: synergism
combination therapy enhances performance of both drugs
E.g. B-lactams + aminoglycosides, amoxi + clav, sulfonamides + trimethoprim
Combo therapy: Additive
E.g. Chloramphenicol + tetracyclines; clindamycin + aminoglycosides; imipenem + vanco
Combo therapy: Antagonistic
e.g. bactericidal + bacteriostatic; chloramphenicol + clindamycin; B-lactam + B-lactam
Depot Form
long-acting
Aqueous Form
short-acting
TI: Therapeutic Index
Cmax - MIC = TI
TI can be lower in time-dependent drugs; need to be higher in concentration-dependent drugs