Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Surgery M4 part 1 > Prophylactic Antibiotics > Flashcards

Prophylactic Antibiotics Flashcards

1
Q

What antibiotic is used for prophylaxis before & after surgical procedures?

A

perioperative cefazolin to prevent SSI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the recommendation for prevention & treatment of infections in splenectomized patients?

A
  • influenza immunization
  • pneumococcal immunization
  • lifelong prophylactic antibiotics
    - phenoxymethylpenicillin
    - erythromycin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

why are preoperative antibiotic prophylaxis administered?

A
  • to decrease risk of postoperative infection
  • not substitute for proper aseptic technique
  • administered IV
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the principles of using preoperative antibiotic prophylaxis?

A
  • should be active against common surgical wound pathogens (reserve broad-spectrum antibiotics for therapy resistant infections)
  • use shortest possible course
  • least expensive
  • must achieve concentrations greater than MIC of pathogens
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the significant components in the prevention of SSI?

A
  • organisms implicated
  • timing of administration
  • antibiotic selection
  • monitoring
  • redosing
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the most important organisms implicated in SSIs?

A

GRAM +ve

  • Staph. aureus
  • Staph edpidermidis

GRAM -ve

  • E. coli
  • pseudomonas
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

How to determine appropriate antibiotic selection?

A

achieve narrow spectrum of activity while ensuring most common organisms are covered

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are the most common SSI causing organisms in clean procedures?

A

SKIN FLORA

  • Staph aureus
  • Staph epidermidis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the organisms found in clean-contaminated SSIs?

A

Skin flora & gram negative bacteria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

When should the prophylactic antibiotic concentration be at its highest?

A

at the start & during surgery

  • at least 30mins before but not more than 60mins before skin incision
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

When should vancomycin & levofloxacin be administered?

A

120 mins before skin incision

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What should be done for a patient already receiving an antibiotic for another infection before surgery & its suitable for prophylaxis?

A

give another dose within 60 mins of incision

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the preoperative antibiotic selection based on?

A
  • cost
  • anatomic region
  • safety
  • ease of administration
  • BACTERIOCIDAL
  • hospital resistance patterns
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the activity of clindamycin?

A

bacteriostatic at lower doses

bacteriocidal at higher doses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the aim in surgeries incase of prophylactic antibiotic administration?

A

reaching the bactericidal concentration in the blood & tissues before skin incision

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

When are beta-lactam antibiotics contraindicated?

A

if a patient has an IgE mediated allergy to penicillin
AVOID - penecillins
- cephalosporins
- carbapenems

17
Q

cephalosporins & carbapenems are considered safe in which patients?

A

patients who have not had a type-1 reaction or erythroderma

18
Q

Cefazolin is used for surgical prophylaxis in?

A
  • gram +ive bacteria
  • patients with no history of beta-lactam allergy
  • no history of MRSA infection
19
Q

if a patient has a beta-lactam allergy, what are the alternative antibiotics used?

A

clindamycin

vancomycin

20
Q

What drug should be used in a patient with high risk for MRSA?

A

vancomycin

21
Q

What antibiotics should be used for a patient requiring additional microbe coverage?

A

cefazolin + metronidazole OR carbapenem

22
Q

What antibiotic should be used in SSI in a clean wound?

A
  • low risk of MRSA: cefazolin

- high risk of MRSA or allergy to beta-lactam: vancomycin or linezolid

23
Q

what antibiotic should be used in SSI in a clean-contaminated wound or clean over perineal region?

A
  • cephalosporin + metronidazole or crabapenem
24
Q

What are the mechanisms of antibiotic resistance?

A
  • production of inactivating enzymes
  • decreased drug entry & accumulation
  • alteration of target receptor
  • development of alternative metabolic pathway
25
Q

Why is limiting duration of al antibiotics important?

A

any antimicrobial usage can change hospital & patient bacterial flora leading to colonization resistance or clostridium defficile

26
Q

What are the 3 antibiotics used where weight-based dosing is recommended?

A

cefazolin
vancomycin
gentamycin

27
Q

if there is an increase in resistance of clindamycin, what alternative should be administered?

A

vancomycin

28
Q

if there’s an increasing number of carbapenem resistance, what alternative should be administered?

A

cefoxitin in colorectal surgeries

29
Q

What are the factors that could affect the half life of a drug?

A

renal dysfunction & extensive burns

30
Q

When should redosing be considered?

A
  • if anything is affecting its half-life
  • length of procedure
    - cefazolin should be readministered 4 hours after
    initial dose
    - cefoxitin should be administered again 2 hours after
    initial dose
  • if there was significant blood loss or dilution during surgery
31
Q

How long should weight based dosing administration continue?

A
  • within 1 hour of surgical incision

- 24 hours post-op

32
Q

When should another dose be administered in a surgery?

A
  • if surgery is longer than 4 hours

- if there’s blood loss over 1.500mL

33
Q

if a post-op infection occurs, how should it be treated?

A
  • empiric antibiotic therapy immediately

- after detection of organism definitive treatment should be administered according to culture & sensitivity

34
Q

When should empiric antibiotic therapy be used?

A
  • skin infections: cellulitis, necrotizing fasciitis
  • bone/joints: osteomyelitis, septic arthritis
  • any cause of sepsis
35
Q

What are the factors that might affect the success of empiric antibiotic therapy?

A
  • circumstance of infection
  • relative contraindications
  • site of infection
  • PREVIOUS ANTIBIOTIC THERAPY
36
Q

What are the common antibiotics useful in treatment of post-op infections?

A
  • ceftriaxone or cefotaxime +/- gentamycin
  • piperacillin/tazobactam +/- tobramycin
  • clindamycin or metronidazole in anaerobic infections
  • vancomycin +/- gentamycin for MRA or enterococci

Surgery M4 part 1 (47 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions