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Antimicrobial General Priniciples
Terms in this set (47)
do you treat viral infections?? why??
no!!!! it encourages resistance
what is colonization?
when the presence of a microbe in a host does not cause a specific immune reaction or infection
do you treat colonization with antibiotics?
what is a pathogen?
any microbe that has the potential to cause disease, tissue damage, invoke immune response
what is an infection?
successful multiplication of organisms in a host
what is a nosocomial infection?
from healthcare associated pathogens (hospital, nursing homes)
what is empiric therapy?
antibiotic choice based on clinically most likely pathogen
what is definitive therapy?
antibiotic choice based on identified pathogen and susceptibility patterns
what is de-escalation?
adjustment of an antibiotic regimen from broad (empiric) coverage to narrow (definitive) therapy
what is prophylaxis?
antibiotic intended to prevent an infection
what is collateral damage?
unwanted negative effect of an antibiotic on the normal bacterial flora of a patient
-killing normal flora
what is minimum inhibitory concentration?
minimum concentration of a drug that will inhibit growth of an organism
what is resistance?
bacteria not killed/inhibited by the antibiotic
what is antibiogram?
compilation of susceptibility data for bacteria vs. various antibiotics
what is bacteriacidal?
drug that actually kills the bacteria
what is bacteriastatic?
drug inhibits the growth of the bacteria
what are the 3 biggest microbe classes?
gram + cocci
gram - rods
broad spectrum treats these
what are some gram + cocci? (8)
-s. epidermidis (other coagulase - staph)
-streptococcus pyogenes (group A)
-streptococcus agalactiae (group B)
-streptococcus pneumoniae (pneumococcus)
-enterococci (strep bovis)
-viridans streptococci (groups C/G strep)
-streptococcus intermedius group
what are some gram + bacilli? (4)
-Bacillus antracis (anthrax)
what are some gram - cocci? (3)
what are some gram - rods/bacilli? (9)
-Enterobacteriaceae (E. coli, Citrobacter, Klebsiella)
what are some anaerobes? (8)
what are some antibiotics? (4)
what are mechanisms of actions for antibiotics? (3)
-interferes with cell wall synthesis
-interferes with DNA replication, transcription
-binds to 30s/50s ribosomal subunit
what are broad spectrum antibiotics?
effective against a wide variety of organisms
what are narrow spectrum antibiotics?
more targeted activity
what are pharmacokinetics?
what the body does to the drug
-absorption, distribution, metabolism, elimination
what are pharmacodynamics?
relationship between drug concentration the bug
what is bioavailability?
% of oral dose available compared to when given via IV
what is clearance?
determines steady state of drug
-determined by blood flow to the organ that metabolizes the rate of extraction of the drug from blood
what is volume of distribution?
proportionality factor that related the amount of drug in the body to the concentration of drug measured in a biological fluid
what is half life?
time required for serum concentrations to decrease by 1/2
what are factors to be considered with antibiotics?
-severity of infection
-spectrum of activity and local susceptibility patterns
what is susceptibility testing?
help guide clinician to choose the most appropriate antibiotic for the infection
-disc diffusion assay, etest, automated systems
what is postantibiotic effect?
phenomenon where there is a delay before organisms recover and begin growing despite decreased concentration of drug
-duration of PAE is species + drug dependence
what are breakpoints?
clinical efficacy of the drug and PK properties of the drug in humans
-sensitive, immediate, resistant
how do you pick an antibiotic?
you want the most potent antibiotic
DO NOT just compare the MICs
what are the limitations of MIC?
-not an all or nothing phenomenon
-subpopulations of bacteria within inoculum-> selecting out resistant strains
-not always an accurate predictor of success or failure
-must consider site of infection and PK/PD
what does sensitive mean?
infection caused by the tested organism may be adequately treated with the usual recommended dose
what does intermediate mean?
isolate may be inhibited if higher doses can be safely used or if infection in body site where drug concentrate well
what does resistant mean?
organism not inhibited by the concentration normally achievable with the recommended dose
what are the 4 primary mechanisms of resistance?
1. alterations in outer membrane permeability
2. alteration in drug bindings sites
3. production of molecules capable of inactivating drug molecules
4. active efflux of antibiotic from the bacteria
how do you control resistance?
-proper dosages and durations
-education on the problem
-increased infection control practice
-decrease inappropriate use of antibiotics
-development of new antimicrobials
what should be used in patients with reduced immunity?
what can accumulation of a drug lead to?
what does drug in the urine mean?
concentrations exceed serum concentration
what tissues are difficult to penetrate?
bone, synovial fluid, prostate, abscesses, peritoneal fluid
Sets with similar terms
Pharm Chapter 38/39 Antibiotics
Basic Principles of Antimicrobial activity
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