T3-Antimicrobial Meds: Basic Principles

Question 1

Directly lethal to bacteria at clinically achievable concentrations

Answer 1

Bactericidal

Question 2

Slow bacterial growth but do not cause cell death

Answer 2

Bacteriostatic

Question 3

Active against a wide variety of microbes (“Throwing the grenade”)

Answer 3

Broad spectrum

Question 4

Active against a few species of microorganisms (“Sniper rifle”)

Answer 4

Narrow spectrum

Question 5

Educated guess based off evidence (certain characteristics or clues noted to tell the doc. what the culprit may be based on type, location)

Answer 5

Empiric therapy

Question 6

Certain bacteria are either gram+, gram-, or both

Answer 6

Gram stain

Question 7

Color of positive gram stain?

Answer 7

Dark purple

Question 8

Color of negative gram stain?

Answer 8

Pink

Question 9

Infections acquired in the hospital that were not present before

Answer 9

Nosocomial infection

Question 10

Use of antibiotics promotes the emergence of drug resistant microbes; antibiotics create selection pressure favoring growth by killing off sensitive organisms

Answer 10

Resistance

Question 11

A new infection that appears during the course of treatment for a primary infection (bc antibiotic has eliminated the inhibitory influence of normal flora)

Answer 11

Superinfection

Question 12

Chemical that is produced by one microbe and has the ability to harm other microbes

Answer 12

Antibiotic

Question 13

Defined as any agent, natural or synthetic that has the ability to kill or suppress microorganisms

Answer 13

Antimicrobial

Question 14

What is the basic process for starting someone on an antibiotic?

Answer 14

1. Suspected infection
2. Culture the site (begin empiric therapy)
3. Gram stain
4. Identification
5. Susceptibility (change to definitive therapy)

Question 15

Before you start an antibiotic, you have to get _____.

Answer 15

A specimen!!!

Question 16

What are the top 3 antibiotics that cause allergic reactions?

Answer 16

1. Penicillin
2. Sulfanomide
3. NSAIDs

Question 17

What are the most notorious for causing an allergic reaction?

Answer 17

Penicillins

Question 18

3-5% of the time if you are allergic to PCN, you are allergic to ______ too.

Answer 18

Cephalasporins (PCN’s cousin)

*this allergic reaction too is known as cross-reactivity

Question 19

If someone tells you they’ve had a pervious reaction, what do you ask them?

Answer 19

ALWAYS CLARIFY. Ask them what the reaction was too and what happened to them during their reaction!

Question 20

What is a situation in which a nurse must temporarily postpone administering an antibiotic?

Answer 20

If they have NOT taken the blood culture yet (must do this first ALWAYS), then treat!!!!

Question 21

____ of antibiotic use is for prophylactic treatment.

Answer 21

30-50%

Question 22

What are the 4 prophylactic uses of antibiotics?

Answer 22

Surgery
Bacterial endocarditis
Neutropenia
Recurrent UTIs

Question 23

Why is a person prophylactically given an antibiotic for surgery? What antibiotic is used a lot in this case? What surgery is this actually considered a “treatment” for?

Answer 23

• To decrease infection
• Cephalosporin
• Abdominal surgery

Question 24

Why is a person prophylactically given an antibiotic for bacterial endocarditis?

Answer 24

In bacterial endocarditis, the heart VALVES are inflamed, which make great “sponges for bacteria”

• Congenital or valvular heart disease
• Prosthetic heart valves

Question 25

What is neutropenia?

Answer 25

The presence of few neutrophils in the blood aka not enough cells to adequately fight an infection

Question 26

What are some diseases where neutropenia may be present?

Answer 26

HIV, sickle cell (spleen is removed and the spleen helps with infection filtering)

Question 27

If you are experiencing recurrent UTIs, you will take the antibiotic ____ until the UTI recurrences are better under control

Answer 27

Daily

Question 28

What are some antibiotic misuses?

Answer 28

1. Viral infections 2. Treatment for fever of unknown origin 3. Improper dosage 4. Treatment in the absence of adequate bacteriologic information 5. Omission of surgical drainage

Question 29

Why can't we give an antibiotic for someone with a viral infection?

Answer 29

The majority of viral infections (mumps, chickenpox, common cold) do not respond to the available antibiotics. When drug therapy for these patients is indicated, they are exposed to all the risk of the drug but have NO chance of receiving benefits!

Question 30

What are examples of viral infections we can't give an antibiotic to?

Answer 30

Mumps Chicken pox Common cold

Question 31

Is fever a sign of infection?

Answer 31

Yes

Question 32

Unless the cause of fever is a proven infection, antibiotics ____ be employed.

Answer 32

SHOULD NOT

Question 33

What if the fever is not due to an infection and we give an antibiotic?

Answer 33

They would expose the patient to unnecessary toxicity and delay correct diagnosis of the fever's cause

Question 34

T/F: If the fever is caused by the infection, antibiotics could hamper later attempts to identify the infecting organism.

Answer 34

True

Question 35

What is the only situation in which fever, by itself, constitutes a legitimate indication for antibiotic use?

Answer 35

When fever occurs in the SEVERELY IMMUNOCOMPROMISED host (fever can indicate infection and infection can be lethal in an immunocompromised patient)

Question 36

What happens if we give an antibiotic and the dose is too low?

Answer 36

The patient will be exposed to a risk of adverse effects without benefit of antibacterial effects

Question 37

What happens if the dose is too high?

Answer 37

There is a risk of superinfection and adverse effects become unnecessarily high

Question 38

Proper antimicrobial therapy requires information on the ___ and drug ____ of the infecting organism!

Answer 38

Identity and drug sensitivity

Question 39

Antibiotics may have counted efficacy in the presence of foreign material, necrotic tissue, or exudate. Hence, when appropriate, ____ & _____ should be performed to promote antimicrobial effects.

Answer 39

Surgical drainage and cleansing

Question 40

Obtain cultures ____ starting antibiotics.

Answer 40

BEFORE

Question 41

What does "match the drug with the bug" mean?

Answer 41

Narrow-spectrum is preferred over broad-spectrum

Question 42

When do we need to postpone the antibiotic?

Answer 42

If the blood culture hasn't been preformed!