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

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2
Q

What is definitive antimicrobial therapy?

A

adm after C&S are available

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3
Q

Factors determine selection of antimicrobial

A
  1. site/source infec
  2. causative pathogens
  3. community / nosocomial - hopsital acquired infection
  4. immune status of patient
  5. antibiotic susceptibility + resistance profile
  6. patient history
  7. adverse reactions
  8. costs
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4
Q

Strategy to antimicrobial treatment

A
  1. adm within 1st hr sepsis
  2. collect appropriate cultures
  3. adm antimicrobials that concentrate at site of infec
  4. monitor patient parameters to ensure adequate dosing
  5. abnormal renal + hepatic function = increase drug concentrations = avoid toxicity
  6. once renal funtion norma - change antibiotic dosing
  7. initial large vol resuscitation + cause increase Vd
  8. re-evaulate intiial dosing regime on daily basis
  9. step down therapy - IV–> oral
  10. monotherapy
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5
Q

Duration of anti-infective therapy

A
  • 7-10 days

- vary depends site of infect + response

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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
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7
Q

Types of source control measures

A
  1. drainage + debridement
  2. device removal - gastrostomy tube
  3. prevention - hand hygien
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8
Q

complications of source control measures

A
  1. bleeding
  2. fistulas
  3. organ injury
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