Lecture 9 - Pharmacodynamics of Antibiotics Flashcards
What does it mean to initiate empirical broad-spectrum antibiotic therapy?
Start a patient on a drug that kills a wide range of bugs
What does it mean to narrow empirical therapy from “broad” to “targeted”?
Change medication to more specific once you know specific bug causing infection
What does it mean to de-escalate from “empirical” to “definitive” antibiotics?
Once you learn if the bug is sensitive or resistant, medication can be changed to even more specific
What is needed to take into account when optimizing antibiotic dosing?
Weight
Why is it important to use appropriate duration of antibiotic therapy?
Want to go long enough to kill all bacteria, but don’t want to go too long
Why is it important to step down from IV to oral antibiotics?
So patient can leave hospital
Define cellulitis
Diffuse infection of epidermis/dermis extending to lymphatic system and subcutaneous fat
Who are at increased risk of cellulitis?
Diabetic and obese individuals
What can cellulitis cause?
- Bloodstream infection
- Septic shock
- Endocarditis
- Osteomyelitis (cellulitis of bone)
What is the cell shape, form, and Gram reaction of staphylococcus aureus?
Gram positive cocci in clumps
What is the most common pathogen in skin and soft tissue infections?
Staphylococcus aureus
What cause staphylococcus aureus to become penicillin resistant?
Change in penicillin binding protein in the cell wall, preventing penicillin from altering cell wall
Why is obesity a significant risk factor for antibiotic treatment failure?
The “one size fits all” dosing mentality (weight isn’t taken into account)
What is the best treatment method for antibiotics?
Aggressively and fast
What are 4 requirements from stepping down to oral antibiotics?
- Adequate response to initial IV treatment
- Appropriate oral antibiotic available
- Reliable patient adherence
- Appropriate follow-up
