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.pharmocology > Principles of Antimicrobial Therapy > Flashcards

Principles of Antimicrobial Therapy Flashcards

1
Q

What are the 3 important factors of antimicrobials?

A

Host, Bacterial Pathogen, Antimicrobial drugs

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2
Q

Goals of antimicrobial treatment

A

To kill bacteria, avoid resistance and avoid toxicity

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3
Q

Categories of antimicrobial therapy

A
  1. Prophylaxis (prevention)- no infection
  2. Pre-emptive (preventing spread)- infection
  3. Empiric* (resistance builds)- symptoms
  4. Definitive- pathogen isolation
  5. Suppressive- Resolution
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4
Q

Empiric selection

A

Without IDing the causative organisms and patterns
Serious disease (life-threatening)

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5
Q

When shouldn’t antimicrobials be used?

A

Fever or leukocytosis alone
Cats with lower UT symptoms
Diarrheas in dogs and cats
Pancreatitis

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6
Q

What helps with IDing microbes and drugs?

A

The source of infection

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7
Q

Genitourinary tract infections

A

Gram - aerobes

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8
Q

Abdominal infections

A

Initially gram - aerobes followed by anaerobes

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9
Q

Skin infections

A

Staph. spps (gram +)

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10
Q

Abscess infections

A

Anaerobes and Pasteurella spp.

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11
Q

UTIs

A

E. coli (60-65%)
Proteus mirabillis (15-20%)

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12
Q

T/F: You shouldn’t need to treat Kennel cough with antimicrobials

A

TRUE
Most uncomplicated cases are self-limiting

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13
Q

1st tier (1st line) antimicrobial drugs

A

Clear diagnosis
No risk factors for resistance

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14
Q

2nd tier (2nd line) antimicrobial drugs

A

Antimicrobial susceptibility tests are mandatory if needed

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15
Q

3rd tier (3rd line) antimicrobial drugs

A

Reserved for highly resistant infections
Strongly discouraged
If necessary, use in consult with specialists

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16
Q

Considerations when using antimicrobial drugs

A

Reserved drugs
Multidrug resistance, ESBL
Safety
Convenience

17
Q

Bactericidal concentration required in case of…

A
  1. Existing immunosuppression/ neutropenia
  2. Life-threatening/ serious infections
18
Q

Drug concentration in tissue depends on …

A

Concentration in blood
Protein binding in plasma
Lipid solubility
Ionic charge (pH)
Binding to exudate or tissue
Presence of inflammation
Excretion pathway

19
Q

Bacteriostatic drugs

A

Need to maximize the serum peak concentration to ↑ efficacy and reduced resistance
Peak concentration several fold MIC

20
Q

Drug toxicity to the host

A

Hypersensitivity
Direct toxicity
Inhibition of normal microflora
Immunosuppression
Drug interactions

21
Q

Therapeutic index (TI)

A

Dose toxic to host : effective therapeutic dose

22
Q

Consider _______________ in food animals

A

Withdrawal time

23
Q

Resistance avoidance

A

Use only if necessary
Perform susceptibility tests when applicable
ID optimal duration for treatment
Envision drug combos
Favor synthetic drugs when possible

24
Q

MIC (minimum inhibitory concentration)

A

Lowest concentration of the antibiotic that results in inhibition of visible growth
Below MIC = no effect

25
Q

MBC (minimum bactericidal concentration)

A

Lowest concentration of the antibiotic that kills 99.9% of the original inoculum in a given time (lab)

26
Q

If the MBC/MIC is over 4 then the antibiotic is _______

A

Bacteriostatic

27
Q

If the MBC/MIC is = to or less than 4 then the antibiotic is _______

A

Bacteriocidal

28
Q

MPC (mutant prevention concentration)

A

High dose gets rid of all bacteria- severe infections (measured in serum)

29
Q

Post antibiotic effect

A

Persistent suppression of bacterial growth after short exposure to the abx
Exhibited by conc. dependent drugs

30
Q

Concentration (dose dependent drugs)

A

Cmax : MIC = dose 10-12 x more than MIC (can be over, never under)

31
Q

Time-dependent drugs

A

T> MIC 50-100%

32
Q

Transfer of bacterial resistance

A

Horizontal gene transfer
Vertical gene transfer
Gene amplification
Mutation

33
Q

Horizontal gene transfer

A

Most common
Conjugation, transduction and transformation

34
Q

Vertical gene transfer

A

Parent to offspring during bacterial reproduction

35
Q

Gene amplification

A

Resistance gene is present in multiple copies within the bacterium, ↑ its expression and leading to ↑ resistance

36
Q

Mutation

A

Mutation in a gene that codes for a target protein of abx

.pharmocology (21 decks)

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