System-Based Approach to Empirical Antimicrobial Selection

Question 1

what are some gram positive aerobes?

Answer 1

Staphylococcus
Streptococcus

Question 2

what is a gram positive anaerobe?

Answer 2

Clostridia

Question 3

what are some gram negative aerobes?

Answer 3

E. coli
respiratory
Pseudomonas: opportunistic

Question 4

where are infections most common?

Answer 4

skin
urinary system
respiratory system
lesser extent: gastrointestinal tract and mammary glands

Question 5

how can you identify that a bacterial pathogen is present?

Answer 5

history/clinical signs
laboratory testing
radiographs (pneumonia)
cytology
culture and susceptibility testing

Question 6

what are some drugs that are eliminated renally?

Answer 6

beta lactams
fluoroquinolones
aminoglycosides
sulfonamides
some tetracyclines

Question 7

what do we think about with penetration?

Answer 7

CNS: small, lipophilic, low protein binding
prostate: lipophilicity
bronchus: larger molecules better
biliary system: no rule, depends on agent

Question 8

what are some reasonable choices for the respiratory system?

Answer 8

macrolides
tetracyclines
fluoroquinolones
lower penetration of penicillins
some cephalosporins
aminoglycosides into parenchyma, not secretions