Use and Mis-Use of antimicrobial agents Flashcards
Causes of misuse of antibiotics?
no infection
wrong drug
inadequate or excessive dose
expensive agent when cheaper is available
Adverse events from antibacterials?
GI upset Acute anaphylaxis Fever and Rash Hepatitis Renal Dysfunction
What to consider when prescribing antimicrobials (CHAOS)?
C - choice of correct antimicrobials
H - Host characteristics
A - antimicrobial susceptibilities
O - organism itself
S - site of infection
use narrow spectrum, bactericidal, patient characteristics, route, dose, cost
What is the minimum inhibitory concentration?
This is the minimum drug concentration that is required to inhibit the growth of the organism in a culture
iF the MIC of an organism is higher than a value then the bacteria is RESISTANT
What is the protocol for using empirical antibiotics
Always collect specimens for culture before stating empirical antibiotic therapy
use a broad spec agent that can cover most likely organisms
then change to a more specific agent when the culture results come back
When should empiric antibiotics be first choice?
Nosocomial Pneumonia
Severe Sepsis
How to identify the infecting organism?
Gram Stain: get from CSF, Joint aspirate, pus
Rapid antigen detection - immunofluorescence - PCR
What will determine if the patient needs antimicrobials?
fever raised CRP increased WBC duration of symptoms source of infection risk facotrs
Routes of administration?
IV - deep seated infection
PO - avoid if vomiting or poor GI function
IM - not for long term or bleeding disorder
Topical - limited application and can cause local sensitisation
If no response to antibiotics in 48 hours?
Do they have infection?
Is there a persistent cuase
Is there a deep seated collection that needs drainage
Bacterial endocarditis?
Another infection?
Right dose?
