Antimicrobials

Question 1

Minimum inhibitory concentration

Answer 1

lowest concentration of antibiotic required to prevent growth - cannot compare across classes

Question 2

Minimum bacterial concentration

Answer 2

lowest concentration required to kill bacteria

Question 3

Bactericidal

Answer 3

will kill - no better than - static, just coverage dependent
penicllins
cephalosporins
aminoglycosides
vanco
quinolones
imipenem
bacitracin
polymixins

Question 4

Bacteristatic

Answer 4

stop growth
tetracyclines
chloramphenicol
erythromycin
clindmycin
sulfonamides
trimethoprim

Question 5

Narrow Spectrum

Answer 5

penicillin
erythromycin
clindamycin

Question 6

Broad Spectrum

Answer 6

amipicillin
cephalosporins
aminoglycosides
tetracyclines
quinolones

Question 7

Concentration dependent killing

Answer 7

aminoglycosides and flouroquinolones

start at 4x MIC and then taper down slow to reduce toicity

Question 8

Time - Dependent Killing

Answer 8

-want to be above MIC for as long as possible
-vanco, checking troughs
beta lactams
- cont not better than boluses

Question 9

Post Antibiotic Effect

Answer 9

-Some continue to suppress growth even when not there
altered processes within cells
PAE leukocyte effect

Question 10

Resistance

Answer 10

intrinsic - vanco will never treat gram neg
all gram neg are naturally resistant

acquired - from cont exposure
reduced permeability
efflux mechanisms

Question 11

Nosocomial Infection

Answer 11

majority: urinary, respiratory, blood

* from hospital. -use of vent, etc

Question 12

Central Line Infection rates

Answer 12

Femoral > IJ > subclavian

Question 13

Non-tunneled caths

Answer 13

usually colonized by normal flora: candida, enterococcus, s. aureas, s. epidermis

Question 14

C. Diff treatement

Answer 14

oral vanco
dificid (fidoxamicin)
fecal transplants
may add flagyl IV for recurrent infections
cut out PPI's (increases risk)

Question 15

Surgical Prophylaxis

Answer 15

depends on pt factors
usually not used past day one post op
usually 1st generation cephalosporin
low cost, broad spectrum , low incidence of allergic rxn

Question 16

Wound classes

Answer 16

1 - clean (staph) - may not need abx
*anything below get abx regularly
2- clean-contaminated
3- contaminated
4- dirty/infected

Question 17

Surgical Prophylaxis timing

Answer 17

must admin within 120 mins of incision
ancef = 60 mins
vanco = 120 mins

Question 18

Cephazolin (Ancef) Dosing

Answer 18

dose = 2g
>120 kg = 3 g
peds 30 mg/kg
T1/2 = 2 hrs, so redose 4 hr procedure

Question 19

Vanco Dosing

Answer 19

15 mg/kg

T1/2 = 8 hrs

Question 20

Clinda Dosing

Answer 20

900 mg adult
10 mg/kg
T1/2 = 3 hrs

Question 21

Cleocin

Answer 21

worst for c. diff development