Lecture 7

Question 1

characterized by GI upset, nausea, vomiting, rash, and depend on dose/duration/type of antibiotic

Answer 1

intolerance/toxicity

Question 2

probably rare, and is true allergy

Answer 2

anaphylaxis

Question 3

disruption of normal flora cuz of antibiotics can cause:

Answer 3

superinfections

Question 4

antibiotic-associated colitis caused by:

Answer 4

C. difficile (diarrhea, inflammation)

Question 5

is bactericidal or static best for immunocompromised?

Answer 5

bactericidal

Question 6

factors which influence choice of antibiotic use

Answer 6

patient specific, pharmacological, microbiological

Question 7

why tetracycline need take on empy stomach?

Answer 7

cuz strongly bind calcium which is poorly absorbed

Question 8

antibiotics poorly lipid-soluble don’t enter into:

Answer 8

cerebrospinal fluid

Question 9

what are microbio factors?

Answer 9

bacterial or not? Species? Susceptibility?

Question 10

how suspect bacteria resistant?

Answer 10

1) patient infection not responding to antibiotic therapy 2) tested by antimicrobial susceptibility testing

Question 11

why use AST?

Answer 11

quantitative measure of resistance, allow correct antibiotic used at right dose

Question 12

what is disk diffusion method?

Answer 12

spread bacteria onto solid media, add filter disk containing known [] of antibiotic, allow bacteria grow, measure area of growth inhibition

Question 13

what is tube dilution method?

Answer 13

dilute antibiotic in liquid, add bacteria to media containing dilutions, monitor for presence of growth

Question 14

tube dilution method determines ___ of antibiotic

Answer 14

minimum inhibitory concentration (MIC)

Question 15

what is MIC?

Answer 15

lowest [] of antibiotic that will prevent bacterial growth

Question 16

pros of tube dilution over diffusion?

Answer 16

more quantitative, useful for proper dosing, indicates if antibiotic is cidal or static

Question 17

faster method than tube dilution, mixing both methods

Answer 17

E-test (filter strip containing range of antibiotic concentration)

Question 18

what do you consult if you need to initiate therapy before MIC info is available?

Answer 18

consult local antibiogram

Question 19

what is antibiogram?

Answer 19

periodic summary of all bacterial species isolated from patients in area and antibiotic susceptibility patterns

Question 20

bio mechanisms of antibiotic resistance?

Answer 20

1) direct breakdown of antibiotic by bacterial enzymes
2) promote excretion/prevent uptake of antibiotic
3) alter or bypass target of antibiotic

Question 21

this resistance mechanism is used a lot in bacteria:

Answer 21

drug inactivating enzyme (enzyme modifies drug, inactivating it)

Question 22

what is vertical evolution

Answer 22

one cell develop mutation, divides, and creates population of cells that are resistant

Question 23

what is horizontal evolution

Answer 23

plasmid in one strain passes on to number of isolates

Question 24

__% staph is now MR

Answer 24

20

Question 25

biggest cause of death every year

Answer 25

AMR

Question 26

where does selective pressure for resistance occur?

Answer 26

50% antibiotics used for vet/agriculture (feed); overuse in humans (over the counter, prophylactic use) ; patient non-compliance

Question 27

how to combat antibiotic resistance?

Answer 27

find/develop new antibiotics (temporary); stewardship

Question 28

institutional strategies intended to guide optimal antibiotic usage, centered on large acute-care hospital settings

Answer 28

Antibiotic Stewardship Programs