Intro to Antimicrobials (Exam 1a.)

Question 1

Antimicrobials

Answer 1

Medications that slow or inhibit the growth of bacteria, or kill bacteria

Naturally occuring in nature (Antibiotics)

Synthetic

Semi-synthetic

Question 2

Bacteriostatic

Answer 2

Medications that slow or inhibit bacterial growth

Question 3

Bactericidal

Answer 3

Medications that kill bacteria

Question 4

Broad spectrum

Answer 4

-Effective against numerous organisms

-Shotgun approach

-Don’t know specific organisms

Question 5

Narrow spectrum

Answer 5

-Effective against a fe wspecies or organisms

-Using a BB gun

-Know the organism and what drug it is sensitive to

Question 6

Resistance

Answer 6

-Ability of an organism to survive against an antimicrobial or to render the antimicrobial ineffective

-Innate (always been like that) or acquired (pathogen has mutated)

Question 7

Super infections

Answer 7

An infection that occurs because of during treatment for a primary infection

Question 8

Prophylactic antibiotic use

Answer 8

-Antibiotics that are used to prevent infections

-Some procedures have a higher risk of infections

Surgical procedures - Dental procedures in patients at risk for endocarditis - Immunocompromised patients

Question 9

Antimicrobials are separated based on

Answer 9

MOA’s

Question 10

How to choose an antibiotic: Community vs Hospital acquired

Answer 10

-Different susceptibility patterns

-Different organisms

Question 11

How to choose an antibiotic: Site of infection

Answer 11

-Antimicrobials that can penetrate areas of infections (can it get to bone?)

-Antimicrobials that work in specific areas (lung liver kidneys?

Question 12

How to choose an antibiotic: Suspected organism

Answer 12

-Choose an antimicrobial that is effective against the suspected organism

Question 13

Choosing an antimicrobial: Goal

Answer 13

-Try and get cultures before starting antimicrobials

-If patient is critically ill and cultures might be delayed, there may be a need to begin antimicrobials prior to cultures

-Meningitis

-Sepsis

-Giving antimicrobials might prevent organism from growing in culture

Question 14

Different places to get cultures

Answer 14

Sputum

Urine

Blood

Question 15

Sputum Cultures

Answer 15

Gram stain

C&S

Question 16

Urine cultures

Answer 16

-Urinalysis

-C&S

Question 17

Blood Cultures

Answer 17

-Aerobic and anaerobic bottles

-2 sets

-One should always be peripheral

-Skin organisms can contaminate

Question 18

Minimum Inhibitory Concentrations (MIC)

Answer 18

-Grow organisms in tubes that have different concentrations of an antimicrobial

-Minimum inhibitory concentration (Lowest amount of drug that inhibits bacterial growth) (Does not kill organism)

-Lowest concentrations that decreases size of bacterial colonies by 99.9%

Question 19

Patient Characteristics: Allergies

Answer 19

-Antimicrobial will not work

-What is the allergy? N/V is not an allergy; it is an adverse effect

-Rash, welts, and anaphylaxis is signs of an allergy

Question 20

Penicillin allergy

Answer 20

-May also be allergic to cephalosporins

-Cross sensitivity

Question 21

When do allergy typically develop?

Answer 21

Age extremes: Young or old age. But can develop at any stage

Question 22

Dose and Length of treatment depends on

Answer 22

-Patient host defense?

-Site of infections?

-Organism causing infection?

-How sick is the patient?

-Time versus concentration

Question 23

Nosocomial Infections

Answer 23

-Infections that occur within a healthcare facility.

-More drug resistant

Question 24

Infections can be resistance to a specific drug

Answer 24

MRSA

-Methicillin resistant Staph areus

Question 25

Infections can be resistant to an anitmicrobial class

Answer 25

-CRE

-Carbapenem resistant eneterobacteriacease

Question 26

Infections can be resistance to multiple drugs/classes

Answer 26

-MDRO

Question 27

Post-Operative Infections: Respirartory

Answer 27

Increase risk of atelectasis

Increased risk of pneumonia

Question 28

Post operative infections: Surgical wound infections

Answer 28

-What would you expect a fresh incision to look like?

-Wound dehiscence (opening of the wound - portal for bacterial contamination)

Question 29

Post-operative infections: UTI

Answer 29

-Cath increase risk

Question 30

Antimicrobial resistance

Answer 30

Organisms are able to live and grow in an environment where antimicrobials are present

Innate resistance (born that way)

Sharing of genetic material between organisms (a learned response)

Question 31

Antimicrobial Resistance: Mutations

Answer 31

-exposure to an antimicrobial agent. Not given. taken, long enough to kill all the organsims. (survival of the fittestI

Question 32

Antibiotic Prescribing

Answer 32

-Patents demand them (want pill)

Upper Respiratory Infection (mostly viruses) (1 in 4000 chanc eAbx will help acute URI) (1 in 1000 chance Abx will send you to the ED) (rahs, allergic reactions, Diarrhea)

Question 33

Environment

Answer 33

C.Diff spores can survive 5 or more months (Even reports of years)

Question 34

Clothing

Answer 34

-37% of HCW gowns contaminated after care of patient with VRA

65% HCW gows contaminated after morning care in patients with MRSA in wound or urine

40% contamination after care of patient colonized with MRSA or VRE

Question 35

Treatment Failures

Answer 35

-wrong drug used

-started too late

-Too low dose

-Not taken long enough