ID intro objective Flashcards
spirochetes
treponema pallidum
borrelia burgdorferi
leptospira interrogans
atypical bacteria
chlamydophilia pneumoniae
chlamydia trachomatis
legionella pneophilia
mycoplasma pneumoniae
acid- fast bacilli
mycobacterium tuberculosis
Mycobacterium intracellulare complex
mycobacterium kansasii
mycobacterium leprae
mycobacterium marinum
nocardia spp.
gram negative ONLY
aztreonam
aerobic ONLY
aminogycosides
polymyxins
sulfonamides (bactrim)
aztreonam (Azactam)
colonization
Presence of organism at the site that does not cause disease
indications of infections
-increased wbc with or without left shift
-increase in WBC at site of infection
-presence of pathogens on gram strain+/- culture
- positive antigen, antibody or PCR testing
-localized s/sx: cough, erythema, inflammation, increased sputum
- pain, purulent discharge , swelling, tenderness
-systemic s/sx; chills/rigors, hypothermia or hyperthermia, hypotension, mints status changes, tachycardia. tacgypnea
-radiographiic; computed tomography (CT), MRL, ultrasound, xray
catalase positive
staphylococci
catalase negative
streptococcus and enterococci
coagulase
significant for staphylococcus aureus
lactose positive
citrobacter spp.
enterbacter spp
eschericha spp.
klebsiella spp.
pasteurella multocida
alpha partia hemolysis
viridian’s group strep
beta total/complete hemolysis
Group A.B,C,F,G street
gamma no hemolysis
enterococcus spp.
host factors
age
allergies
pk/pd
site of infection
history of recent antimicrobial use
travel history
pets or animal exposure
drug factors
allergies
adverse effects/ CI/ safety concerns
antibiogram
MOA
pk/pd (ADME, DDI)
spectrum of activity
rout of administration
cost
site of infection
minimum inhibitory concentration and breakpoints
organism factors
identification of organism
antimicrobial susceptibility
multidrug resistant risk factors
minimun inhibitory concentration (MIC)
lowest antimicrobial concentration thats prevents visible growth of an organism within 24hrs of incubation
susceptible
likely to eradicate organisms using the standard antimicrobial doses
intermediate
likely to eradicate organisms using maximum antimicrobial doses or if the antimicrobial concentrates at the site
resistant
the organism is not inhibited by standard antimicrobial doses likely leading to therapeutic failure and/or mechanisms of resistance may be present , and clinical efficacy has not been demonstrated
Pharmacokinetics (ADME)
what the body does to the drug
max concentration in the plasma (cmax)
area under the curve for 24hrs (AUC)
time that the drug concentration exceeds a certain value (T>con)
minimum conc during a dosing interval
pharmacodynamic
what the drug does to the bug
free time above MIC (ft> MIC)
max conc to MIC ratio (cmax/mic)
24hr under the curve to MIC ratio (AUC/MIC)
time dependent (fT>MIC)
b-lacatams (PCNs, carbapenems, cephalosporins)
licosamide
monobactams
oxazolidinone
concentration dependent
(larger doses and decreased frequency of time)
AmG
daptomycin
fluroquinolones
metronidazole
lipopeptide
AUC dependent (time + conc)
AMGs,
lipopetetracyclines,
vancomycin,
glycylcycline ptide,
fluoroquinolones,
macrolides,
oxazolidinone
polymyxins,
Post antibiotic effect (PAE)
persistant suppression of bacerial growth after antibiotic exposure despite concentration <MIc
b lactams against GP staph
carbapenems with p. aeruginosa
empiric
initiation of drugs prior to identification of causitive organism
directed
drugs targeting causative organism upon results
prophylaxis
administration of drugs to prevent or reduce risk of infection
de-escalation
process of streaming antimicrobial therapy from broad spectrum to narrow spectrum
antimicrobial stewardship
effort to measure and improve how antibiotics are prescribed by clinicians and used by patients
Bactericidal
aminoglycosides
carbapenems
ceholorsporins
monobactams
penicillins
daptomycin
floroquinolones
metronidazole
polymyxin
vancomycin
Oritavancin
bacteriostatic
chloramphenicol
clindamycin
glycyclines
linezolid
macrolide
nitrofurantoin
sulfonamides
tetracycline
