Lecture 4 antibiotics II, mostly just random notes from a guest lectururer

Question 1

What are the 3 major types of pharmacodynamic regimes?

ie different optomized concentrations for an antibiotic to have its best effect.

Answer 1

1) Highest Cmax:MIC ratio.
Achieving the maximal dose posible, even for a short time is most important for the effect. Maximizes the exposure at a single time.
-Aminoglycosides, Fluorquinolones

2) Area under the curve:MIC,
Achieving the highest integral of time spent above the MIC, and for how long. Both dose and time spent above the MIC by how muhc matter. Maximizes the exposure over time.
- Azithromycin, Fluoroquinolones, Ketolides

3)Time>MIC
Maximizing the amount of time spent above the MIC is most important, no matter how much above the MIC it is.
- Carbapenems, Cephalosporin, Macrolides.

Question 2

How should an severe infection be treated?

Answer 2

With the most effective therapy first, the followed by de-escalation once the patient is recovering or the specific pathogen source and antibiotic sensitivity are known.

Question 3

What are the most common pathogens of Community Acquired Pneumonia?

Answer 3

Streptococcus pnemoniae 20-50%

Mycoplasma pneumoniae 10-30%

Chlamydia pneumoniae 5-10%

Haemophilus influenzae 5-10%

Viruses 10-30%

CAP is the most common cause of infectious disease in the world.