General Principles of Antimicrobials

Question 1

Guiding Principles of Antibiotic Therapy

Answer 1

• Make correct diagnosis (pathogen and location)
• Source control
  -Antimicrobial selection
  (Initially empiric followed by definitive therapy, right drug, dose, duration)
• Monitor outcome

Question 2

Considerations in microbial use

Host, Bug, Drug

Answer 2

Host- Type, signs and symptoms, health status, comorbidities), immune status
Bug- Likely/confirmed pathogen, susceptibility data, local antibiogram, risk of resistance
- Drug- efficacy, PK/PD, Drug penetration, combo therapy

Question 3

Colonization vs. Infection

Answer 3

Sterile sites: CSF, blood, urine
Normal flora: colonize non-sterile sites
Colonization: presence of bacteria not causing disease
Infection: Presence of bacteria causing disease

Endogenous- Normal floral can become pathogenic, host defense is impaired, via translocate to other body sites
Exogenous: Acquired from external source