Anti-infective therapy Flashcards
1
Q
What is empiric antimicrobial therapy?
A
adm before C&S results are available = choice based on experience
adm within 1 hrs sepsis - decrease complications - multiple agents at broad spec
2
Q
What is definitive antimicrobial therapy?
A
adm after C&S are available
3
Q
Factors determine selection of antimicrobial
A
- site/source infec
- causative pathogens
- community / nosocomial - hopsital acquired infection
- immune status of patient
- antibiotic susceptibility + resistance profile
- patient history
- adverse reactions
- costs
4
Q
Strategy to antimicrobial treatment
A
- adm within 1st hr sepsis
- collect appropriate cultures
- adm antimicrobials that concentrate at site of infec
- monitor patient parameters to ensure adequate dosing
- abnormal renal + hepatic function = increase drug concentrations = avoid toxicity
- once renal funtion norma - change antibiotic dosing
- initial large vol resuscitation + cause increase Vd
- re-evaulate intiial dosing regime on daily basis
- step down therapy - IV–> oral
- monotherapy
5
Q
Duration of anti-infective therapy
A
- 7-10 days
- vary depends site of infect + response
6
Q
when is step down therapy recommended
A
- haemodynamically stable
- afebrible 48-72hrs
- normalize WBC
- organism susceptibel to oral therapies
- able to take oral med
7
Q
Types of source control measures
A
- drainage + debridement
- device removal - gastrostomy tube
- prevention - hand hygien
8
Q
complications of source control measures
A
- bleeding
- fistulas
- organ injury