Transcript Chapter 48 Antidysrhythmic Drugs

Chapter 79
Basic Principles of
Antimicrobial Therapy
Copyright (c) 2004 Elsevier Inc. All rights reserved.
Basic Principles of
Antimicrobial Therapy
• Define
– Chemotherapy
– Antibiotic
– Antimicrobial agent
– Selective toxicity
– Narrow spectrum antibiotic
– Broad spectrum antibiotic
Copyright (c) 2004 Elsevier Inc. All rights reserved.
Classification of Antibiotics
• Drugs work on
– Cell wall synthesis
– Cell membrane permeability
– Protein synthesis (lethal)
– Nonlethal inhibitors of protein synthesis
– Synthesis of nucleic acids
– Antimetabolites
– Viral enzyme inhibitors
Copyright (c) 2004 Elsevier Inc. All rights reserved.
Mechanisms of Microbial
Drug Resistance
• Enterococcus faecalis, Enterococcus faecium,
Staphylococcus aureus, Staphylococcus
epidermidis, Streptococcus pneumoniae,
Klebsiella pneumoniae
• Spontaneous mutation
• Conjugation
Copyright (c) 2004 Elsevier Inc. All rights reserved.
Delaying Emergence of Drug
Resistance
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Vaccinate
Get the catheters out
Target the pathogen
Access the experts
Practice antimicrobial control
Use local data
Copyright (c) 2004 Elsevier Inc. All rights reserved.
Delaying Emergence of Drug
Resistance (cont.)
•
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Treat infection, not contamination
Treat infection, not colonization
Know when to say “no to vanco”
Stop treatment when infection is cured or
unlikely
• Isolate the pathogen
• Break the chain of contagion
Copyright (c) 2004 Elsevier Inc. All rights reserved.
Selection of Antibiotics
•
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Identify organism
Drug sensitivity of organism
Host factors
Allergy
Penetration to site of infection
Patient variables
Copyright (c) 2004 Elsevier Inc. All rights reserved.
Misuses of Antimicrobial
Drugs
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Untreatable infection
Fever of unknown origin
Improper dosage
Lack identification of organism
Omission of surgical drainage
Copyright (c) 2004 Elsevier Inc. All rights reserved.