Antimicrobial Agents and Definitions

• Antimicrobial agents are substances that kill or inhibit the growth of microorganisms.

Definitions

• Antimicrobial agent: Kills or inhibits growth of microorganisms including antibacterial, antiviral, antifungal, antiprotozoal, antihelmintic types
• Disinfectant: Chemical that kills many, but not all microorganisms on non-living objects and surfaces such as Chlorine, Quaternary Ammonium Compound, and CuSO4.
• Biocide: A broad-spectrum chemical agent that inactivates/kills microorganisms.
• Cidal agent: Kills organisms including bactericidal, fungicidal, sporicidal, and virucidal agents.
• Static agent: Inhibits the growth of microorganisms.
• Sanitization: Process of reducing the number of microorganisms to a level officially approved as safe, involving methods such as heat (wet or dry), ultraviolet radiation (not commonly used in food service), and chemicals (chlorine, iodine, quaternary ammonium at proper concentrations).
• Septic: From the Greek word for "decay" or "putrid", it indicates bacterial contamination characterized by the presence of pathogenic microorganisms in living tissue.
• Antiseptic: A chemical product that kills or inhibits the growth of microorganisms in or on living tissue, acts as a mild disinfectant, is non-toxic for superficial applications to living tissue (including mucus membrane, broken skin, wound), and can be bacteriocidal or bacteriostatic. Examples include mercurials, silver nitrate, iodine, alcohol, and detergent.
• Preservative: A substance that prevents the multiplication of microorganisms in formulated products like food or drugs.

Preservation

• Preservation is the state of being preserved to a specified degree, involving the activity or process of keeping something valued alive, intact, or free from damage or decay and keeps organic things safe from decomposition
• Food preservation is defined as process of treating and handling food to stop or greatly slow down spoilage, preventing foodborne illness and maintaining
• Methods for preservation: Evaporation, drying, freezing, refrigeration, salt solution, sugar solution/honey, vinegar and oil

Antibiotics

• Antibiotics are naturally occurring or synthetic organic compounds that inhibit or destroy selective bacteria, usually at low concentrations, and can be broad-spectrum or narrow-spectrum.
• Broad spectrum Drugs are active against several types of microorganisms e.g. Tetracyclins
• Narrow spectrum Drugs are active against one or few types of microorganisms e.g. Vancomycin
• Selective toxicity involves the selective inhibition of growth of microorganisms without damaging the host cell.

Protocols of Antibiotic Use

• Antibiotic Policy provides guidelines and protocols for healthcare professionals on the appropriate use of antibiotics.
• It highlights the importance of prescribing antibiotics only when necessary, selecting the right drug and dose, and ensuring the proper duration of treatment.
• Empirical antibiotic use and Restricted Antibiotic Policy are also components.
• Restricted antibiotics ordered by a physician require HOD department approval, who may disapprove or modify the duration of use.
• Antibiotic stewardship: Measures and improves how antibiotics are prescribed by clinicians and used by patients through a coordinated systematic approach
• Antibiotic stewardship Includes timely and optimal selection, dose, and duration of an antimicrobial for the best clinical outcome of treatment or prevention of infection with minimal toxicity with minimal impact on resistance
• Antibiotic stewardship requires regular review, tracking and education of involved health-care staff and patient to ensure appropriate continuum of rational antimicrobial use practice
• Antibiotic stewardship team includes clinicians, hospital pharmacists, and clinical microbiologists
• Implementation of antibiotic stewardship programs takes place in community pharmacies and primary, secondary and tertiary healthcare facilities
• Antibiotic usage guidelines:
  • Prescribe only when indicated/needed
  • Test for allergies to antibiotics.
  • Start preliminary / empirical antibiotics
  • Conduct culture sensitivity testing.
  • Use of Appropriate antibiotic to which the microbe is sensitive
  • Antibiotics are ineffective against viruses
  • Take antibiotics exactly as prescribed
  • Do not share antibiotics with others or save them for later
  • Incorrect medicine for future use may delay the correct treatment and may cause severe side effects.
  • Do not take antibiotics prescribed for someone else, as it may delay the best treatment for you, make you sicker, or cause side effects.
• Benefits of antibiotics usually outweigh the risks of side effects and antimicrobial resistance, but common side effects range from minor (rash, dizziness, nausea, diarrhea, yeast infections) to severe/life-threatening (allergic reactions, antimicrobial-resistant infections).

Disposal of Medicines

• For expired or unused medications, dispose of medicine through drug take-back programs, often in community pharmacies or place medicines in a plastic bag with dirt/kitty litter/used coffee grounds before throwing away.

Role of Nurses

• It involves regular patient contact and medicine administration.
• Nurses ensure antimicrobials are taken according to prescription, monitor patient response (including adverse effects), ensure patient safety/report and ensure timely administration.
• Nurses actively involved in antimicrobial management, advise/educate patients, utilize protocols/tools to detect severe infections, and remind clinicians to reassess treatment after 48-72 hours.

Other Info

• Chemoprophylaxis involves prevention of disease through use of antibiotics prior to surgery, for those exposed to certain pathogens, and for immunocompromised patients.
• Successful prophylactic use depends on high patient risk of infection, known likely infecting organisms/susceptibilities, and timed administration
• Probiotics: Live nonpathogenic bacteria