Approach to an antibiotic regimen Flashcards
What are the goals of recommending antibiotic regimens
Cure the infection, prevent/minimize complications
What is the primary goal of antimicrobial stewardship
optimize clinical outcomes while minimizing unintended consequences of antimicrobial use
What are the 5D’s of antimicrobial stewardship
Diagnosis, Drug, Dose, De-escalation, and Duration
T/F: Switching from Broad Spectrum to narrow spectrum antibiotics leads to less drug resistance
True
T/F: The is lower mortality with an adequate initial regimen
True
What are the risk factors for infection with antibiotic resistant pathogens
Recent hospitalization, nursing home resident, recent antibiotic use
What is an antibiogram
Guide that helps to select an empiric antibiotic while awaiting culture results
What is a limitation of antibiograms
Susceptibility between institutions may vary
T/F: When a patient has higher creatinine clearance they need lower daily doses of drug
False: A patient with higher creatinine clearance needs higher daily doses due to faster elimination of the drug
What are the three main routes of antibiotics
IV, IM, Oral
What are two antibiotic classes work best when dosed multiple times during the day
Beta-lactams, vancomycin
What antibiotic class works best with a large loading dose given daily
Aminoglycosides
What de-escalation of the route is mostly preffered
IV to oral
When should oral antibiotics be considered
The patient has improvement, afebrile for 24-48 hours, decreased WBC count, functioning gastrointestinal tract
What are possible reasons for unstatisfactory responses
Subopitmal antibiotic choice, subopitmal regimen, is the patient recieving the antibiotic correctly, surgical intervention required
