Antimicrobial Therapy

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Questions and Answers

What is the main goal of definitive therapy in antimicrobial treatment?

To adjust the dosage of empiric therapy without pathogen data.
To select the antibiotic regimen based on pathogen identification and susceptibility. (correct)
To initiate treatment based on a patient's symptoms.
To reduce the overall number of antibiotics used in treatment.

Why is it crucial to consider drug penetration when selecting an antimicrobial agent?

The drug must reach specific pathological compartments for effective treatment. (correct)
Drugs need to be less potent to avoid toxicity.
Most antibiotics are administered intravenously, ensuring full absorption.
Antibiotics are typically taken with food, affecting absorption.

Which of the following factors does NOT typically influence the selection of an optimal definitive antibiotic regimen?

Identification of the pathogen.
Susceptibility results of the pathogen.
The efficacy of the drug in other patients.
The overall cost of the antibiotic. (correct)

In the context of levofloxacin's pharmacokinetics, which ratio is important in evaluating its efficacy in treating skin infections?

Skin tissue to plasma ratio (B) Signup and view all the answers

Selecting an optimal definitive regimen typically does not require adjustments if:

The empiric therapy was adequate and the pathogen is susceptible. (D) Signup and view all the answers

What is a key consideration when determining the effectiveness of antibiotic therapy in a specific organ?

The ability of the drug to reach the site of infection. (D) Signup and view all the answers

Which of the following is NOT an organ where a pathogen typically causes disease?

The blood cells (C) Signup and view all the answers

In the context of antimicrobial therapy, what does empiric therapy refer to?

Initiating treatment before knowing the pathogen and its susceptibility. (B) Signup and view all the answers

What is the main goal of empiric therapy when treating infections?

To initiate therapy when the causative organism and susceptibility are unknown (C) Signup and view all the answers

What does streamlining or de-escalation refer to in antimicrobial therapy?

Narrowing the spectrum of antibiotics after identifying the pathogen (B) Signup and view all the answers

Why are narrower-spectrum antibiotics preferred over broader-spectrum agents in empiric therapy?

They minimize antimicrobial resistance in patients and populations (C) Signup and view all the answers

What is typically delayed by at least 24 to 48 hours in infections?

The definitive identification and susceptibility of the causative organism (C) Signup and view all the answers

Which scenario would typically warrant the use of combination antibiotic therapy?

Only when compelling data supports its usage (D) Signup and view all the answers

What potential outcomes are considered when selecting empiric therapy?

Costs, practicality, and risk of drug interactions (D) Signup and view all the answers

What is typically preferred once a pathogen has been isolated and identified?

Use of monotherapy unless otherwise justified (A) Signup and view all the answers

In the context of infectious diseases, what should be minimized according to therapy guidelines?

The contribution to population-level antimicrobial resistance (D) Signup and view all the answers

What adverse effects may be considered when administering empiric antibiotics?

Potential toxicities and drug interactions (C) Signup and view all the answers

What is crucial to avoid when choosing an initial empiric regimen for treatment?

Delaying treatment until laboratory results return (A) Signup and view all the answers

What distinguishes suppressive therapy from definitive therapy in the treatment of certain infections?

Suppressive therapy utilizes a lower dose or different route of administration. (D) Signup and view all the answers

Under what conditions might suppressive therapy be discontinued for immunocompromised patients?

When the patient’s immune system reconstitutes. (C) Signup and view all the answers

What is a potential risk associated with prolonged use of suppressive therapy?

Increased toxicity from antibiotic use. (B) Signup and view all the answers

Why might patients often remain on empiric therapy despite not identifying the causative organism?

The pathogen may be known based on symptom presentation. (C) Signup and view all the answers

What role do newer technologies, such as MALDI-TOF MS and nucleic amplification techniques, play in antimicrobial therapy?

They provide microbiological information more rapidly than traditional methods. (D) Signup and view all the answers

What is the potential outcome for patients who have achieved pathogen eradication but remain at high risk for new infections?

They may require ongoing antibiotic use for secondary prophylaxis. (C) Signup and view all the answers

In which situation might monitoring for symptomatic response be critical in antimicrobial therapy?

When the treatment is empirical and the organism is never determined. (A) Signup and view all the answers

Which type of infections often necessitate the use of suppressive therapy due to the inability to remove the source?

Infections involving implanted prosthetic materials. (C) Signup and view all the answers

What defines a potential need for more aggressive approaches in determining microbiological etiology?

If there is a lack of symptomatic response with ongoing treatment. (D) Signup and view all the answers

What is a common challenge faced with microbiological sampling in the treatment of infections?

High invasiveness and cost can limit their use. (A) Signup and view all the answers

What is the main purpose of preemptive therapy in surgical settings?

To prevent contamination of incision sites (C) Signup and view all the answers

Which pathogens are most commonly associated with incision site infections after clean surgery?

Staphylococcus aureus and coagulase-negative staphylococci (A) Signup and view all the answers

In clean-contaminated surgery of the abdomen and pelvis, which microorganisms are notably important in addition to staphylococci?

Enterococcus species and gram-negative rods (C) Signup and view all the answers

What type of antimicrobial therapy is primarily used to prevent CMV disease after hematopoietic stem cell transplants?

Preemptive therapy (B) Signup and view all the answers

What is the primary advantage of using a combination of sulfonamide and DHFR inhibitor in treatment?

It acts synergistically by targeting different stages of folate synthesis. (A) Signup and view all the answers

How does the predictive value of Gram staining vary?

It is influenced by the type of infection and specimen type. (B) Signup and view all the answers

What can be inferred if a Gram stain identifies gram-positive organisms in a clinical sample?

Empiric regimen may need adjustment for better gram-positive coverage. (D) Signup and view all the answers

What role does the simple thick-and-thin blood smear play in diagnosis?

It provides a basis for immediate treatment decisions in malaria cases. (A) Signup and view all the answers

What does posttreatment suppressive therapy aim to address?

Control of infection when eradication is not possible. (A) Signup and view all the answers

Which statement about combination anti-HIV regimens is accurate?

They are commonly combined into single daily pills for convenience. (D) Signup and view all the answers

What is the focus of site-specific infection management in antimicrobial therapy?

Identifying and addressing the unique features of infections in specific body areas. (B) Signup and view all the answers

Why is rapid point-of-care diagnostic testing becoming more important in clinical settings?

It speeds up the identification of pathogens and facilitates early appropriate therapy. (C) Signup and view all the answers

What challenge can occur if an infection is controlled but not completely eradicated?

It may lead to reinfection or complications due to remaining pathogens. (D) Signup and view all the answers

What is a key consideration when selecting an empiric regimen for infection treatment?

It needs to cover a broad spectrum while considering possible organism types. (C) Signup and view all the answers

Flashcards

Definitive therapy

The best antibiotic treatment plan for a specific infection, chosen after identifying the pathogen and its susceptibility.

Pathogen

A disease-causing microorganism.