Antibiotic Selection Flashcards
Intro?
What the MAIN species of Gram-Positive/Negative Bacteria?
- Cocci & Bacilli
What are some of the Aerobic Gram-Positive Cocci Cluster?
- Coagulase Positive: S. Aurues
- Coagulase Negative: S. Epidermis, S lugdunesis, S. Hominis, S. Capitis, S. Sarprophyticus, S. Haemolyticus
What are some of the Aerobic Gram-Positive Cocci Pairs?
- Strepococcus Pneumoniae
What are some of the Aerobic Gram-Positive Cocci Chains?
- S. Pyogenes & S. agalactiae [b-Hemolytic]
- Virdians: S. Milleri, S. Mutans, S. Salivarius, S. Anginous, S. Sanguis [a-Hemolytic]
What is important to know about the Hemolysis Pattern within Antibiotics?
- a = Partial Hemolysis
- b = Complete Hemolysis
- y = No Hemolysis
What are the Aerobic Gram-Positive Cocci Pairs & Chains?
- Enterococcus Faecalis [suseptalbe to Ampilcillijn]
- Entercoccus Faecium [Vancomycin resistance]
What are the subclasses of Bacilli in Gram-Positive Bacteria?
- Non Spore
- Spore
- Branching
What are the Aerobic Gram-Positive Non-Spore Bacilli?
- Listeria Monocytogenes
- Corynebacterium [Diphtheriae, Jeikium, Striatum]
- Lactobacillus
What are the Aerobic Gram-Positive Spore Bacilli?
- Bacillus [Cereus, Anthraics (basically Anthrax)]
What are the Aerobic Gram-Positive Branching Bacilli?
- Nocardia [Asteroides, Brasiliensis]
What are some of the Aerobic Gram-Negative Cocci?
- Neisseria [Gonorrhoeae, Meningitidis]
- Moraxella Catarrhalis
What are some of the Aerobic Gram-Negative Coccobacilli?
- Haemophilus [Fluenzae, Parainfluenzae, Ducreyi]
What are the Entrobacterales [Enterobacteriaceae] in Bacteria?
- Citrobacter [Freundii, Koseri]
- Enterobacter [Cloacae]
- E. Coli
- Klebsiella [Pneumoniae, Oxytoca, Aerogenes]
- Morganella Morganii
- Proteus [Mirabilis, vulgaris]
- Providencia [Rettgeri, Stuartii]
- Salmonella [Enteritidis, Typhi]
- Seratia Marcescens
Shigella Dysenteriae
What are the Aerobic Gram-Negative Lactose forming Bacilli?
- CEEK
- Citrobacter [Freundi, Koseri], Enterobacter [Cloacae], E. Coli, Klebsellia [Pneumoniae, Oxytoca, Aerogenes]
What are the Aerobic Gram-Negative Non-Lactose forming Bacilli?
- Pseudomonas Aerogenosa
- Acinetobacter Baumannii
- Burkholderia Cepacia
- Strenotrophomoas Maltophilia
What is the bacteria is that assciated with straches or bites from a cat?
- Pasteurella Multocida
What are Anaerobic Gram-Positive Cocci Chains?
- Peptostreptococcus [Anaerobius, Intermedius]
- Finegoldia Magna
What is the subclasses for the Anaerobic Gram-Negative Bacilli?
- Same as Aerobic
- Spore, Non-Spore, Branching
What are some Anaerobic Gram-Positive Non-Spore Bacilli>
- Cutibacterium Ances
What are some Anaerobic Gram-Positive Spore Bacilli?
- Clostirdium [Perfringes, Tetani, Botulinum]
- Clotridioides Difficile
What are the Anaerobic Gram-Postive Branching Bacilli?
- Actinomyces [Isrealii]
What are the Anaerobic Gram-Negative Cocci?
- Veillonella [Parvula]
What are Anaerobic Gram-Negative Baciili/
- Bacteroides [Fragilis, Ovatus, Vulgatus, Distasonis, Thetaiotaomicron]
- Prevotella [Melaninogenica, Denticola, Bccae, Oralis, Bivia]
What are the organisms found on the Normal Flora of Skin?
- Diphteroids [Corynebacterium]
- Staphylocci [epidermidis]
- Streptococci
- Cutibaterium
What are the organisms found on the Normal Flora of the GI Tract?
- Bacteroides
- Enterobacterales
- Enterococci
- Fuseobacterium
- Peptostreptococcous
- Clostridium
What are the organisms found on the Normal Flora of the Oropharynx?
- Haemophilus
- Streptococci [Viridans]
- Diphteroids
- Neisseria
- Oral Anaerobes
What are the organisms found on the Normal Flora of the Genitals Tract?
- Corynebacterium
- Enterobacterales
- Lactobacillus
- Myocoplasma
- Staphylococci
- Streplococci
- Anerobes
- Candida
When trying to comfirm an infection, what is the big thing that we are looking for?
- FEVER: >38 C or 100.4 F [Rectal = +1 degree & Armpit = -1 degree]
What are some of the Non-infectious causes of a fever [False Positives]?
- Autoimmue disorders
- DRUG FEVER: basically giving a drug that causes a fever
- Blood Transfusions
What are some fo the False Negatives that can happen with fevers?
- Antipyretics: masks fever
- Cortiosteriods
- Not finishing drug therapy
- Super Infection
What are some of Systemic sign and symptoms of infections?
- FEVER *
- Increased WBC Count
- Chills
- Tachycardia *
- Tachypnea *
- Hypotension
- Malise
- Mental Status
What is important to know about the WBC count within an infection?
- Normal: 4500-10000
- Mature Neutrophils = “Polys” & Immature Neutrophils = “Bands”
- BANDS: increased bone marrow response
What is importance of Leukocytosis in the signs and symptoms of infection?
- Bacterial infections with increased Neutrophils +/- Bands [left shift]
- Increased due too non-infectious causes or drugs
What is the importance of Lymphocytosis. in the signs and symptoms of infection?
- Associated with Viral, TB, Fungal
- B-lymph: Humoral Immunity
- T-lymph: Cell-Mediated [
What is the importance of Monocytosis & Ensinophilia in the signs and symptoms of infection?
- Monocytosis: Associated with TB or Lymphoma
- Eosinophilia: Associated with allergies or Protozoal/Parasitic Infections
What are the Localized signs and symptoms of Infections?
- Pain and Inflammation [swelling, redness, tenderness, purulent drainage]
- Deep-seated: needs imaging [Pneumonia, meningitis, UTI]
- Specific Organs [Flank Pain = Pyelonephritis (E. COLI)]
What are the Additional Acute Phase Reactant Lab Tests?
- Erythrocyte Sedimentation Rate [ESR] & C-Reactive Protien [CRP]: increased with inflammation BUT doesnt equal infection
- Procalcitonin [PCT]: specific toward bacterial infections
What are the Radiographic Test that are used in infections?
- X-Rays
- Computed Tomography [CT or CAT scan]
- Magnetic Resonance Imaging [MRI]
- Nuclear Imaging
- Echocardiography
When identifying a pathogen, what are some things that we need to do?
- Collect infected material BEFORE any therapy [drug might still be in it]
- MUST avoid contamination
- Direct Exams [Gram Stains, Ziehl-Nielsen, India Ink]
What is the main differences between Colonization and Infection?
- Colonization: A potentially pathogenic organism but is not invading host tissues or causing a response
- Infection: A Pathogenic organism that is damaging the host
What is the main differences between Sensitivity and Specificity in Infections?
- Sensitivity: Positive in the presence of disease [EVERYONE has the disease]
- Specificity: Negative in the absence of disease [NOBODY has the disease]
What are some of the host factors that relate toward infections?
- Allergies, Age, Sex, Weight, Pregnancy, Genetics, Renal/Hepatic [FIND ClCr], Interactions
What is the differences in Empiric and Directed Therapies in Infections?
- Empiric: Therapy BEFORE identification [multiple antibiotics]
- Directed: AFTER identification [Narrow effective spectum drug]
What are some of the things that we should base our empiric therapy on?
- Knowledge [whats the pathogen, where…]
- Antibiograms: shows a summary of what drugs are susceptibility
What is the difference between Bactericidal & Bacteriostatic Therapy?
- Bactericidal: KILLS the organism
- Bacterostatic: stops replication WITHOUT KILLING the organism`\
What are the 3 primary reasons that someone may need to use combination therapy for an infection?
- Broaden Spectrum Coverage
- Synergistric Bactericidal Activity [KILLING POWER]
- Preventing Emergence of resistance
What are some of the disadvantages of Combination therapy?
- Increased Cost
- Increased Toxicity
- Superinfection
- Antagonism
What is the criteria for selecting antimicrobial therapy?
- Efficacy
- In Vitro Activity
- Pharmacokinetics
- Pharmacodynamics
- Drug Interactions
- Cost
What is important to know about Efficacy in selecting antimicrobial therapy?
- Basically looking at clinical trials to see how “effective” it is
What is important to know about In Vitro Microbiological Activity?
- Spectrum of activity = MUST KNOW
What is the important to know about Pharmacokinetics in selecting antimicrobial therpay?
- ADME
- Tissue Distribution: Intra v Extracellular [mircodialysis - “typical” = Intra; “atypical” = Extra]
What is the important things to know about pharmacodynamics in selecting antimicrobial therapy?
- Understanding the effects of drugs & their mechanisms of action
Within monitoring clincial responses, what are some of the Oral Agents that have good bioavailavilty?
- Augmentin
- Cephalexin
- Fluoroquinolones
- Linezoild
- Bactrim
- Metronidazole
- Doxycycline
- Clindamycin
- Etc
