Antibiotics Flashcards
How has the use of antibiotics increased antibiotic resistance?
By providing a selection pressure
What are worst offender agents?
The antibiotics which are most likely ti cause problems later on
What is antibiotic stewardship?
The reduction of antibiotic consumption by promoting logical antibiotic choices to limit collateral damage and avoid the use of worst offender agents.
What is guided therapy?
This is when the cause of the infection is identifies and then a treatment plan is devised.
For what kind of infections is guided therapy used for?
Mild infections (cystitis, mild wound infections) that can wait a few days to be treated
What is empirical therapy?
Therapy where treatment is given based on what is deemed most appropriate from an educated guess as to what is causing the infection.
When is empirical therapy used?
When a patient needs immediate treatment and cannot wait for test results to come back before treatment is started. (For example patients with sepsis or meningitis)
Empirical therapy can be rationalised. What dies this mean?
Empirical therapy can be started in the mean time whilst awaiting test results but this treatment can be modified accordingly when the test results come back.
What is prophylactic therapy?
This is when antibiotics are given in advance to prevent infection before it begins.
Where is prophylactic therapy commonly used?
Healthy people who have undergone surgery, had an injury or been exposed to infected material
In immunocompromised individuals (such as those with HIV)
Individuals who have undergone transplantation.
What are the qualities of an ideal antibiotic?
Be highly toxic to bacteria causing infection
Penetrate the body area which is infected
Limit toxin release from bacteria
Be non-toxic to the patient
Have a limiting effect on colonising bacteria (reducing incidence if c.difficile and selection of resistant bacteria)
Have a low potential for bacteria to escape treatment by developing resistance
In what kind of therapy are antibiotics which are mostly non-toxic to a patient, little impact on colonisation and low chance if resistance but limited action on bacteria be used?
Guided therapy
What kind of therapy uses ‘broad spectrum’ antibiotics?
Empirical therapy
What is the difference between bactericidal and bacteriostatic antibiotics?
Bactericidal - kill off the bacteria completely and remove the infection so that it does not return but can cause the release of toxins during bacterial lysis and therefore an inflammatory response
Bacteriostatic - prevent bacteria from growing /carrying out certain metabolic functions therefore once they are removed the bacteria are still present and able to grow so requires immune-mediated killing of bacteria to stop the infection
What are the most common sites within a bacterium that an antibiotic will target?
Cell wall peptidoglycan
DNA
Ribosome
Certain metabolic pathways
