Principles of antimicrobial therapy 1 Flashcards
(4 cards)
What are the questions we need to ask ourselves when we prescribe antibiotics (1 st slide)
1) is an antimicrobial agent based on clinical findings
2) is it prudent to wait until such clinical findings become apparent
3) have appropriate clinical specimens been obtained to microbiological diagnosis?
4) what are the likely aetiological actions for the patient’s illness?
5) what measures should be taken to protect individuals exposed to the index case to prevent secondary cases and what measures have been implemented to prevent further exposure?
6) is there clinical evidence that antimicrobial therapy will confer clinical benefit for the patient?
Further questions for consideration when giving out antimicrobial therapy
1) If a specific microbial pathogen is identified, can a narrow-spectrum agent be substituted for the initial empirical drug?
2) Is one agent or a combination of agents necessary?
3) What are the optimal dose, route of administration, and duration of therapy?
4) What specific tests should be undertaken to identify patients who will not respond to treatment?
5) What adjunctive measures can be undertaken to eradicate the infection?
What is presumptive (empirical) antimicrobial therapy?
When you use an antimicrobial agent (an antibiotic) before the pathogen is responsible for the particular illness or the suspect ability to a particular antimicrobial agent is known as empirical or presumptive theory
It is based on the principle that early intervention will improve the outcome, e.g. treatment of febrile episodes in neutropaenic cancer patients with empirical antimicrobial therapy has been demonstrated to provide morbidity and mortality benefits even though the specific bacterial agent responsible for fever is determined for only a minority of such episodes.
At the time that the pathogenic organism responsible for the illness is identified, empiric therapy is usually modified to Definitive Therapy, which is typically narrower in coverage.
