Sepsis and Antibiotics Flashcards
Define infection
the invasion and growth of germs in the body resulting in a harm
Pathological process caused by pathogenic or potentially pathogenic microorganisms
Where is procalcitonin released from
from various tissues (parafollicular C cells of thyroid and neuroendocrine cells in lungs and intestine) when they are infected by bacteria
Why is there hyperglycemia during infection
as a consequence of the inflammatory response and stress (increase cortisol means neoglucogenesis)
normal ranges of procalcitonin
0.25- 1 mg/dl
Most common sources of sepsis
lungs
intestine
urinary tract
Define sepsis
life threatening organ dysfunction due to a dysregulated host response to infection
The SOFA score consists of
Brain: consciousness (GCS)
Lungs:PaO2/FiO2
Liver: bilirubin
Kidneys: creatinine concentration
Blood: platelets
Heart: ABP
What does quick SOFA include
rr >22
altered consciousness
SBP<100mmHg
Define septic shock
Sepsis with circulatory and cellular metabolism abnormalities profound
enough to substantially increase mortality
Sepsis plus lactate >2mmol and MAP<65 with use of vasopressors
Sepsis six
Take 3: urine output, blood cultures, blood exams (lactate)
Give 3: crystalloids, antibiotics, oxygen
When are you giving antibiotics to a septic shock pt
within one hour
What is the one hour bundle
- measure lactate levels
- get blood cultures
- give broad spectrum antibiotics
- give crystalloids
- evaluate need for vasopressors
If severe sepsis dont use
quinolones
third gen cephalosporins
Which antibiotics for an unknown site of infection
vancomycin
pip/tazobacta
carbapenem
RF for ESBL producing organisms
- tx in the last 3 months with quinolones or cephalosporins
- 4 cycles of antibiotic tx in the last year
- previous isolation of ESBL producing organisms
- living in a long term care facility
