Antimicrobial selection Flashcards
What parts of human body are sterile
CSF, blood, urine
usually lower respiratory tract
colonization vs infection
colonization= bacteria NOT causing disease
infection= bacteria causing disease
labs for infection
WBC w/ diff
CRP
ESR
procalcitonin
what’s a left shift
elevated neutrophils
released to fight infection. AKA bandemia
WBC can be normal w/ left shift
what lab tests are markers of clinical response
*Not for abx initiation/dx
ESR and CRP
procalcitonin can tell when abx can be safely d/c’d
procalicitonin is produced in response to …
bacterial infection
dosing strategy ex for maximizing efficacy of time-dependent abx like beta lactams
extending infusion time
fluoroquinolones for acute infection guideline
avoid use in uncomplicated infection d/t increased risk of adverse effects
STEP when choosing abx meaning
safety, tolerability, efficacy, price/preference
why IV abx if hypotensive
decreased blood flow to GI tract can impact absorption
antimicrobial associated with red man syndrome and not a risk of C diff
glycopeptides
vancomycin, teicoplanin, and ramoplanin; second-generation semi-synthetic glycopeptide antibiotics include oritavancin, dalbavancin, and telavancin.
penicillins main SE
hypersensitivity, GI, interstitial nephritis, leukopenia/thrombocytopenia, Coomb’s anemia, C diff, electrolyte imbalance, seizure
cephalosporins exs and main SE
cefazolin, cephalexin, cefuroxime, cefoxitin, ceftriaxone, ceftazidime, cefepime, ceftaroline
similar to PCN w/o seizure and WITH hepatic risk
hypersensitivity, GI, interstitial nephritis, leukopenia/thrombocytopenia, Coomb’s anemia, C diff, hepatitis
what class is vancomycin & SE
glycopeptides
red man syndrome, renal dysfunction, WBC/platelet
tetracycline ex and SE
lymecycline, methacycline, minocycline, rolitetracycline, doxycycline, tigecycline, ervacycline, sarecycline, and omadacycline
*GI, hepatic, photosensitivity, visual disturb, vertigo, C diff
**doxy for renal pts.
macrolides ex and SE
zithromycin, clarithromycin, and erythromycin
GI, prolonged QT, hepatitis, ototoxicity, torsade de pointes, rash, myasthenia gravis
clindamycin (a macrolide) SE
*GI, C diff, rash
fluoroquinolones ex and SE
levofloxacin (Levaquin), ciprofloxacin (Cipro), ciprofloxacin extended-release tablets, moxifloxacin (Avelox), ofloxacin, gemifloxacin (Factive) and delafloxacin (Baxdela)
** GI, HA, photosensitivity, QT prolong, tendon rupture, neuropathy, seizure, stevens-johnson, C diff
sulfonamides & trimethoprim SE
GI, hyperkalemia, bone marrow suppression, serum sickness, hepatitis, photosensitvity, stevens-johnson, pancreatitis, neuro/nephro tox
metronidazole SE
GI, HA, metallic taste, dark urine, neuropathy, disulfiram rxn w/ ETOH, insomnia,
most common agent for surgical prophylaxis
cephalosporin
beta lactams ex
penicillins, cephalosporins and related compounds
if allergy to penicillin should pt receive beta lactams
for IgE mediated rxn YES can be safely administered but NOT if non-IgE rxn like Stevens-johnson, toxic epidermal necrolysis, interstitial nephritis
cross-reactivity cephalosporins/PCN
less than 1%
if PCN allergy, cephalosporins with dissimilar side chains, carbapenems, monobactams can be safely administered
