Antimicrobial Chemotherapy Flashcards
What factors are important when deciding whether to use IV or Oral antimicrobials?
Oral bio-availability - Ratio of the drug level when given orally compared to level if given IV
Oral route:
- Not vomitting
- Normal GI function
- No shock
- No organ dysfunction
IV route:
- For severe or deep-seated infection
- When oral route is not reliable
What is the spectrum of actions of different antimicrobial groups?
Inhibition of cell wall synthesis
Inhibition of Protein synthesis
Inhibition of Nucleic acid Synthesis
What is the advantage of using single therapy?
- Simpler
- Fewer side effects
- Fewer drug interactions
What are the advantages of using combination antimicrobial therapy?
- Good for HIV and TB therapy
- Good for sepsis
- Good for mixed organisms
Why is it important to monitor the number of antibiotics being prescribed?
- Overuse of broadspectrum antibiotics can lead to infection outbreaks (e.g. Vale of Leven)
- Reduce the 4 C’s (Ciprofloxacin, Co-Amoxiclav, Clindamycin, Ceftriaxone)
What are the commonly encountered adverse effects of antimicrobials?
1) Allergic reactions (immediate and delayed hypersensitivity reactions)
2) GI - Nausea, vomiting, diarrhoea
3) Candida (Thrush)
4) Liver problems
5) Renal problems
6) Neurological (ototoxicity - gentamicin, vancomycin)
7) Haematological
What are the common diseases treated with antivirals?
Herpes virus
HIV
Hepatitis B & C
Influenza
What antiviral is used to treat herpes?
Herpes - Aciclovir
What antiviral is used to treat HIV?
HIV - Tenofovir
Which antiviral drug is used to treat hepatitis B&C
Tenofovir
Which antiviral is used to treat influenza?
Oseltamivir
What are the most likely organisms causing a soft tissue infection?
Strep pyogenes
Staph aureus
How should soft tissue infections be treated?
Flucoloxacilin
Which group of antibiotic kill bacteria cells?
Beta-lactams
Which group of antibiotics stop bacteria cells from increasing in number?
Macrolides
The list the penicilin based antibiotics
Benzylpenicillin
Pencillin V
Amoxicillin
Flucloxacillin
Co-amoxiclav
What antibiotics are used to treat C diff infection?
Metronidazole
OR
Vancomycin
What are the severity markers used to assess someone with C.diff?
Temperature > 38.5
Suspicion of pseudomembranous colitis or toxic megacolon
Evidence of severe colitis on CT
WBC > 15X10^9
Rising serum creatinine
Which antibiotics are associated with increased risk of C.diff?
Cephalosporins
Co-amoxiclav
Ciprofloxacin
Clindamycin
What medications are used to eradicate H.pylori?
1 - PPI
2 - Amoxicilin
3 - Metronidazole (or clarithromycin)
‘Triple therapy’
How is gastroenteritis treated?
Fluid replacement
No need for antibiotics
How is intra-abdominal sepsis treated?
Amoxiciln
Metranidazole
Gentamicin
How is bacterial vaginosis treated?
Metronidazole
How is chlamydia treated?
Doxycyline
How is pelvic inflammatory disease treated?
Metronidazole
AND
Doxycyline
How is vaginal candidiasis treated?
Fluconazole cream
How is Lyme disease treated?
Doxycyline
How is suspected meningococcal (meningitis) disease treated?
Ceftriaxone
How is osteomyelitis treated?
Flucloxacillin
How is septic arthritis treated?
Flucolaxillin
How is otitis externa treated?
Acetic acid
How is otitis media treated?
Amoxicilin
How is acute rhinosinusitis treated?
Do not treat if uncomplicated
If persistent and purulent nasal discharge consider:
Amoxicillin
How is an acute sore throat treated?
Avoid antibiotic treatment
