Principles of Infectious Disease

Question 1

Host Factors to consider when selecting therapy

Answer 1

Drug allergies. age, pregnancy, renal and hepatic function, site of infection, concomitant drug therapy, underlying disease states

Question 2

Drug factors to consider when selecting therapy

Answer 2

antimicrobial activity, spectrum of activity,. pharmacokinetics, pharmacodynamics, tissue penetration, adverse effect profile, cost and convenience

Question 3

2 areas that antimicrobials work at

Answer 3

inhibiting cell wall and protein synthesis

Question 4

Definition of MIC

Answer 4

MIC is the lowest antimicrobial concentration that prevents visible growth of an organism after 24 hours of incubation (measure of how sensitive or resistant an organism is)

Question 5

How much more should the peak serum concentration be compared to the MIC

Answer 5

2-4x to be susceptible

Question 6

Gram + cocci

Answer 6

Staph, strep, Enterococcus (harder to tx)

Question 7

Gram - cocci

Answer 7

H. flu, Neisseria, M.cat

Question 8

Enterobacteriacea (lives in gut)

Answer 8

EKP: E. coli, Klebsiella, Proteus
ESP: Enterobacter, Serratia,Providencia

Question 9

Final 2 bacteria not included in any category

Answer 9

Pseudomonas aeruginosa (hardest to kill) and B. fragilis (anaerobe)

Question 10

Acute Otitis Media pathogens

Answer 10

S. pneumoniae, H. flu, M.cat

Question 11

Miningitis

Answer 11

S. pneumoniae, H. flu, N. meningitidis

Question 12

Sinusitis

Answer 12

S. pneumoniae, H. flu, M.cat

Question 13

Chronic Bronchitis

Answer 13

S/C/M pneumoniae, H. flu, M.cat

Question 14

Pneumonia

Answer 14

S/M pneumoniae, H. flu, Pseudomonas, Staph aureus

Question 15

Appendicitis

Answer 15

E. coli, Klebsiella, Enterococcus, Pseudomonas, Bacteriodes

Question 16

UTI

Answer 16

EKP, Enterococcus

Question 17

Osteromylitis

Answer 17

Staph

Question 18

What signs/sxs/labs can help you monitor if treatment is working or failing?

Answer 18

1. Efficacy (Vitals like Temp, clinical exam/PE, site specific sxs)
2. Toxicity (any adverse effects present)
3. Imaging if needed
4. Labs (WBC, PCT, other inflammatory markers like ESR, CRP)

Question 19

Why might treatment fail and how do you manage that?

Answer 19

• Noninfectious cause? – reevaluate
• Maybe another source of untreated infection
• Consider if appropriate drug dosing, patient-specific reactions
• Change antimicrobial therapy based on findings