Podcast
Questions and Answers
What does R4 stand for in the 5 Rights of antibiotic prescribing?
What does R4 stand for in the 5 Rights of antibiotic prescribing?
Fever is always present in patients with bacterial infections.
Fever is always present in patients with bacterial infections.
False
What are two factors to consider when selecting the right antibiotic?
What are two factors to consider when selecting the right antibiotic?
Identifications of the infecting organism and patient factors
In immunocompromised patients, the use of ___ agents is necessary as the hosts immune system is not capable of final elimination of the bacteria.
In immunocompromised patients, the use of ___ agents is necessary as the hosts immune system is not capable of final elimination of the bacteria.
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Match the antibiotic with its potential risk in specific populations:
Match the antibiotic with its potential risk in specific populations:
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What parameter is NOT typically associated with bacterial infections?
What parameter is NOT typically associated with bacterial infections?
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Empirical antibiotic therapy is only necessary after identifying the infectious organism.
Empirical antibiotic therapy is only necessary after identifying the infectious organism.
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The ___ test is an example of a special test that may be used to confirm bacterial infection.
The ___ test is an example of a special test that may be used to confirm bacterial infection.
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Which type of antibiotic is preferred for providing prophylactic coverage in surgical procedures?
Which type of antibiotic is preferred for providing prophylactic coverage in surgical procedures?
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Antibiotics should be continued for a minimum of 5 days after achieving apparent cure to avoid relapse.
Antibiotics should be continued for a minimum of 5 days after achieving apparent cure to avoid relapse.
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What are the three concepts on which the selection of the correct dose of antibiotics is based?
What are the three concepts on which the selection of the correct dose of antibiotics is based?
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The tight junctions in the capillary walls of certain tissues create a barrier to drug delivery known as the _______.
The tight junctions in the capillary walls of certain tissues create a barrier to drug delivery known as the _______.
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Match the following antibiotic classes with their killing mechanisms:
Match the following antibiotic classes with their killing mechanisms:
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What is the recommended timing for administering antibiotics for surgical prophylaxis?
What is the recommended timing for administering antibiotics for surgical prophylaxis?
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The continuation of antimicrobial prophylaxis beyond the closure of the wound is usually beneficial.
The continuation of antimicrobial prophylaxis beyond the closure of the wound is usually beneficial.
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What is the primary goal of prophylactic antibiotics during surgery?
What is the primary goal of prophylactic antibiotics during surgery?
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Antibiotics should be administered intravenously to achieve a more reliable and _______ concentration in serum and tissues.
Antibiotics should be administered intravenously to achieve a more reliable and _______ concentration in serum and tissues.
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Which antibiotics are suitable for broader gram-negative and anaerobic coverage?
Which antibiotics are suitable for broader gram-negative and anaerobic coverage?
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Study Notes
Surgical Antibiotic Prophylaxis
- Administered before contamination of previously uninfected tissues or fluids
- Goal is to prevent surgical site infection (SSI)
- Choice of antibiotic depends on the type of surgical procedure, most likely pathogenic organisms, safety and efficacy
Microbiology
- Commonly includes gram-positive coverage, as organisms like S. aureus and Staphylococcus epidermidis are common skin flora
- First-generation cephalosporins (particularly cefazolin) are preferred
- In cases requiring broader gram-negative and anaerobic coverage, antianaerobic cephalosporins such as cefoxitin or cefotetan are appropriate
Principles of Antimicrobial Prophylaxis
Route of Administration
- Intravenous administration is preferred as it produces a more reliable and predictable serum and tissue concentration than intramuscular administration
- Oral administration is also used in some bowel operations, non-absorbable compounds like erythromycin base and neomycin are given up to 24 hours prior to surgery
Timing of First Dose
- Should be started within 60 minutes of the first incision
- A single dose of antibiotic should be administered within 30 minutes to one hour before incision
- Exceptions include fluoroquinolones and vancomycin, which can be infused 120 minutes prior to avoid infusion-related reactions
- Beginning the infusion after the first incision is of little value in preventing SSI
Dosing and Redosing
- Goal of antimicrobial dosing is to maintain antibiotic concentrations above the minimum inhibitory concentration (MIC) of suspected organisms for the duration of the operation
- If an operation exceeds two half-lives of the selected antimicrobial, then another dose should be administered, repeat dosing has been shown to lower rates of SSI
Duration
- Continuing antimicrobial prophylaxis beyond wound closure is unnecessary
- Studies have shown no benefit for additional doses of antibiotic
- Duration should not exceed 24 hours
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Description
This quiz covers the principles and practices of surgical antibiotic prophylaxis. It highlights the importance of preventing surgical site infections through proper antibiotic choice and administration routes. Key topics include microbiology considerations, preferred antibiotics, and administration methods.
