antimicrobials Flashcards
(28 cards)
antimicrobials
meds that slow or inhibit growth of bacteria, or kill bacteria
naturally occurring in nature
synthetic or semi-synthetic
bacteriostatic
medications that slow or inhibit bacterial growth
bactericidal
medications that kill bacteria
super infection
infection that occurs during treatment for a primary infection
(ex: infection from ATB treating C. diff)
prophylactic ATB use
ATB used to prevent infections
-surgical procedures: orthopedic, cardiac, abd
-dental procedures in pt at risk for endocarditis (bacteria through bloodstream –> heart): valve disease of prostetic valves
-immunocompromised patients: HIV, chemo, immunosuppression
MOA of ATB’s
inhibit cell wall synthesis
increase cell wall permeability
lethal/nonlethal inhibition of protein synthesis
inhibit/alter DNA/RNA synthesis or function
disrupt specific metabolic or biochemical reactions
cell diagram *** PPT p. 7
how to choose an ATB
-community (viral) vs. HAI/nosocomial (bacterial)
-site of infection
-suspected organism
what to do before starting ATB?
cultures –> meningitis, sepsis
*helps identify infectious organism
sputum culture
gram stain
culture & sensitivity
urine culture
urinalysis
C&S
blood culture
aerobic/anaerobic bottles
2 bottles –> one should be peripheral
skin organisms can contaminate**
disk-diffusion test
determine what antimicrobial will be effective
minimum inhibitory concentration (MIC)
lowest amount of drug that inhibits bacterial growth (doesn’t kill organism)
minimum bactericidal concentration (MBC)
lowest amount that kills that organism
(lowest concentration that decreases size of bacterial colonies by 99.9%)
how are cultures usually reported?
susceptible or resistant
determined by MIC and MBC
patient characteristics of ATB allergy
anaphylaxis, rash, welts
**NOT N/V
*penicillin/cephalosporin: anaphylactic or not
*sulfa: bactrim
*age extremes (need lower concentrations)
*renal and liver fxn (pt tolerance to ATB)
dose and length of treatment is dependent on…
-patient/host defense
-site infection
-organism causing infection
-how sick pt is (local or systemic infection)
-time vs. concentration
nosocomial infections
HAI
increased severity of organisms - *drug resistant strains (MRSA)
*resistance to antimicrobial class (CRE)
*resistance to multiple drugs/classes (MDRO)
common HAI infections
CLABSI: central line associated bloodstream infection
CAUTI: catheter-associated UTI
NG tubes
surgery
invasive procedures
medical illness
post-op infections
- respiratory:
atelectasis: collapse of alveoli
risk of PNA - wounds:
dehiscence: opening is easy entry for bacteria - UTI
antimicrobial resistance
organisms are able to live and grow in an environment where antimicrobials are present
-innate resistant (since birth)
-sharing of genetic material between organisms
-mutations: exposure to antimicrobial agent OR not given or taken long enough to kill all of the organisms
multi drug resistant organisms (MDROs)
ESKAPE
e- enterococcus faecium
s- staphylococcus aureus
k- klebsiella pneumoniae
a- acinetobacter baumannii
p- pseudomonas aeruginosa
e- enterobacter spp.
ATB prescribing - what should you teach your patient?
URI: bronchitis mostly viruses
1 in 4000 chance ATB will help acute URI
1 in 1000 chance ATB will send you to the ED (rash, allergic rxn, diarrhea)
