What are the considerations when choosing antibiotic therapy - ANSWER *The HOST
-history of allergy, cross allergy or intolerance
-preexisting conditions: HIV, cancer, autoimmune disorders, diabetes
-renal/hepatic function-cr clearance
-Age, pregnancy and lactation, recent antibiotic use, exposure history (wt based dosing for pediatric and
geriatric population)
*The SYNDROME or PRESENTING ILLNESS
-what system is impacted
-how aggressive the infection
-consider non-bacterial causes
-carefully examine clinical presentation of illness
*The PATHOGEN
-obtaining culture and sensitivity/resistance
-how susceptibility is determined
, AST/Petri dish growth
When prescribing macrolides what is the patient teaching - ANSWER Take with food to reduce G.I.
disturbances
Which antibiotic should have a culture done before therapy begins - ANSWER Vancomyosin,
Carbapenem, Penicillin
Which antibiotics do not require a culture prior to start of therapy - ANSWER Tetracyclines and
macrolides
Situations when PO or IV antibiotics should be prescribed - ANSWER critical or severe infections Iv
Mild/moderate or a patients admitted for other diagnoses who have an infection PO
When can IV antibiotics be switched to PO? - ANSWER WHen pt is stable
Bactericides antibiotics - ANSWER Directly kill bacteria
Examples include aminoglycosides Beta lactums, Fluoroquinolones, metronidazole, most
antimycobacterial agents, streptogramins, and vancomycin
Bacteriostatic agents - ANSWER Inhibit bacterial proliferation while the hosts immune system does the
killing
Examples include Clindamycin, macrolides sulfonamides and tetracyclines
Broad-spectrum antibiotic uses - ANSWER Target wider number of bacteria types
Acts on both Graham negative and gram-positive organisms
Commonly used for empiric therapy when the pathogen is unknown or infection with multiple types of
bacteria and suspected
commonly used for empiric therapy when the pathogen is unknown or infection with multiple types of
bacteria and suspected
Risks of using broad-spectrum antibiotics - ANSWER Disruption of normal flora and development of
anabiotic resistance
Narrow spectrum antibiotic uses - ANSWER Affective against a specific bacteria type used when infecting
pathogens are known
reduces risk of disruption of normal flora and
reduce development of anabiotic resistance
What is the preferred antibiotic narrow spectrum or broad-spectrum - ANSWER Narrow spectrum
Conjunctivitis is most likely caused by which bacteria - ANSWER Staphylococcus or streptococcus
tx polymyxin-trimethoprim opthalamic drops for 7-10 days
What are the causative agent of community acquired pneumonia - ANSWER S. Pneumonia (gram +)
mycoplasma pneumoniae (atypical pneumonia)
Viruses
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