Antimicrobials Flashcards
CHX
- type
- mode of action
- prescription
- caution
- bisbiguanide
- dicationic -one end attaches to tooth pellicle, the other to the bacterial membrane. Causes increased membrane permeability and so cell death.
- CHX mw 0.2%, send 300ml
rinse mouth for 1 min 10ml 2x daily
-chance of anaphylaxis
Nystatin
- type
- mode of action
- prescription
- caution
- Polyene
- bind to sterols in fungal membrane, leaks metabolites
- Nystatin oral suspension, 100,000 units/ml send: 30ml, 1ml after food 4x daily
- retain the solution near lesion for <5min
Fluconazole
- type
- mode of action
- prescription
- caution
- tri-azole
- interfere with primary sterol component of fungal cell walls
- Fluconazole capsules 50mg
send: 7 capsules, 1 capsule daily - AVOID in WARFARIN/STATINS - Liver metabolism
Miconazole
- type
- mode of action
- prescription
- caution
- imidazole
- interfere with primary sterol component of fungal cell walls
- Miconazole oromucosal gel
send: 80mg tube, apply peasized amount after food <4x daily - AVOID in WARFARIN/STATIN
name a gram positive and a gram negative bacteria
gram positive - actinomyces israelii
gram negative - prevotella intermedia
ideal specimen type for an abscess
eg of specimens found
pus aspirate
Streptococcus anginosus
Prevotella intermedia
most common bacteria found in ludwig’s angina
anaerobic streptococci
streptococcis anginosus
what is sepsis
Sepsis: Life-threatening organ dysfunction caused by dysregulated host response to infection
sepsis and SIRS
what is SIRS and its components
systemic inflammatory response syndrome -temp <36/>38 -HR >90bpm -Resp rate >20bpm -WCC <4x10*9/>12x10*9 need >2
what is septic shock
Septic Shock: Subset of sepsis with circulatory and
cellular/metabolic dysfunction associated with higher risk
of mortality
SEPSIS + unresponsive to fluid resus
what can predispose osteomyelitit
poor vascularity of bone MRONJ foreign bodies compund # impaired host defence (diabetes)
what species are involved in osteomyelitis
Anaerobic Gram negative rods
• Anaerobic streptococci
• Streptococcus anginosus
• Staphylococcus aureus
antimicrobial stewardship - what must be documented
Document your diagnosis
- Document Ab choice, dose, route & duration
- Document a review date
- Document deviation from guidance
how does antibiotic resistance occur
Antimicrobial resistance occurs when microorganisms such as bacteria, viruses, fungi and parasites change in ways that render the medications used to cure the infections they cause ineffective.
how do macrolides work
block protein synthesis in bacteria
