C.1. General considerations of antimicrobial therapy. Disinfectants and antiseptics Flashcards
what does antimicrobial therapy do?
kills or inhibits the growth of microorganisms (bacteria, viruses, fungi, protozoans)
what are the characteristics of antibiotic therapy?
- directed against the cause of the disease
- antimicrobial activity + sufficiently high concentration at the site of infection
- microbes respond to the Ab
- permanent interference with the environment
- the most effective and least toxic drug has to be used
give 5 consideration in antibiotic choice and therapy
- spectrum of action
- site of infection (degree of penetration)
- pharmacodynamics and pharmacokinetic properties
- dosage
- adverse effects
- presence of renal or hepatic failure
- drug interactions
- cost
what are the types of antimicrobial therapy?
- empiric therapy
- definitive therapy
- prophylactic therapy
what is empiric therapy?
treatment is given based on clinical presentation and experience. broad-spectrum antimicrobial agents
what is definitive therapy?
based on microbiological results and/or sensitivity tests. narrow antibiotic spectrum.
what is prophylactic therapy?
administration of antimicrobial agent for preventing infection prior to clinical presentation.
classified as either pre-exposure prophylaxis or post-exposure prophylaxis
what do bacteriostatic agents do?
inhibit the growth of microorganisms
what do bacteriocidal agents do?
kill microorganisms within a short period of time.
what is the minimum inhibitory concentration (MIC)?
the lowest concentration that inhibits the growth of the organism.
what is the minimum bactericide concentration (MBC)?
the lowest concentration that kills 99.9% of the organisms
why are immunocompromised patients given bactericidal agents rather than bacteriostatic?
cause their host immunity cannot achieve the final elimination of the weakened organisms.
what is a concentration-dependent antibacterial activity?
killing action increases proportionally above the MIC. Requires high-dose administration, once daily.
ex. Aminoglycosides
what is a time-dependent antibacterial activity?
killing action continues as long as the drug serum concentration is maintained 40-60% above the MIC.
Requires continuous administration or multiple doses daily.
example for Ab with synergistic effect?
aminoglycosides +cell wall active agent
sulfonamide +trimethoprim
beta lactam+ beta-lactamse
when do we use an extended antimicrobial spectrum Ab?
polymicrobial infections
when is Ab given in combination to prevent the development of resistance?
Tuberculosis
what is disinfection?
removal of actively dividing microorganisms. only reduce the number of potential pathogens