Podcast
Questions and Answers
Which of the following is NOT a characteristic of Empiric therapy?
Which of the following is NOT a characteristic of Empiric therapy?
- Antibiotic selection based on knowledge of typical pathogens
- May involve combination therapy to target most common pathogens
- Therapy started before culture results are available
- Always involves monotherapy with a narrow-spectrum antibiotic (correct)
Which bacterial genus is a Gram-positive cocci and is commonly associated with skin infections?
Which bacterial genus is a Gram-positive cocci and is commonly associated with skin infections?
- Clostridium
- Corynebacterium
- Streptococcus
- Staphylococcus (correct)
Which bacterial genus is a Gram-positive rod that is commonly associated with food poisoning and can be a serious concern for pregnant women?
Which bacterial genus is a Gram-positive rod that is commonly associated with food poisoning and can be a serious concern for pregnant women?
- Corynebacterium
- Listeria (correct)
- Clostridium
- Enterococcus
Which of the following is NOT a characteristic of Definitive therapy?
Which of the following is NOT a characteristic of Definitive therapy?
Which of the following statements accurately describes the differences between Gram stain and bacterial culture?
Which of the following statements accurately describes the differences between Gram stain and bacterial culture?
Which of the following is an atypical bacteria that is NOT a spirochete?
Which of the following is an atypical bacteria that is NOT a spirochete?
Which of the following statements is TRUE about the use of antibiotics?
Which of the following statements is TRUE about the use of antibiotics?
What makes the treatment of fungal infections challenging?
What makes the treatment of fungal infections challenging?
Why are many antifungal drugs designed to slow the growth of the fungus rather than killing it?
Why are many antifungal drugs designed to slow the growth of the fungus rather than killing it?
Which of the following is NOT an opportunistic fungal infection?
Which of the following is NOT an opportunistic fungal infection?
Which of the following is NOT a characteristic of ergosterol?
Which of the following is NOT a characteristic of ergosterol?
Which of the following bacterial species is typically associated with urinary tract infections (UTIs)?
Which of the following bacterial species is typically associated with urinary tract infections (UTIs)?
Which of the following is a commensal fungal species that is part of the normal flora of humans?
Which of the following is a commensal fungal species that is part of the normal flora of humans?
Which of the following antibiotics is most likely to be bactericidal?
Which of the following antibiotics is most likely to be bactericidal?
Which of the following antibiotic classes is known to be effective against a broad spectrum of bacteria, including Gram-positive, Gram-negative, and atypical organisms?
Which of the following antibiotic classes is known to be effective against a broad spectrum of bacteria, including Gram-positive, Gram-negative, and atypical organisms?
Which of the following statements is TRUE about bacteriostatic antibiotics?
Which of the following statements is TRUE about bacteriostatic antibiotics?
Which one of these bacterial species is known to be a nitrite reducer?
Which one of these bacterial species is known to be a nitrite reducer?
Which of the following antibiotics is a narrow-spectrum antibiotic?
Which of the following antibiotics is a narrow-spectrum antibiotic?
Which of the following bacterial species is considered a non-fermenter?
Which of the following bacterial species is considered a non-fermenter?
Which of the following statements best describes a patient who should NOT receive a bacteriostatic antibiotic?
Which of the following statements best describes a patient who should NOT receive a bacteriostatic antibiotic?
Which of the following is NOT a key principle of effective antibiotic use?
Which of the following is NOT a key principle of effective antibiotic use?
Which of the following antibiotic classes primarily targets bacterial protein synthesis?
Which of the following antibiotic classes primarily targets bacterial protein synthesis?
Which of the following mechanisms of antibiotic resistance involves the alteration of the target site?
Which of the following mechanisms of antibiotic resistance involves the alteration of the target site?
Which of the following antibiotic classes is commonly affected by reduced permeability in gram-negative bacteria?
Which of the following antibiotic classes is commonly affected by reduced permeability in gram-negative bacteria?
Which of the following mechanisms of antibiotic resistance is commonly associated with multidrug resistance (MDR) efflux pumps?
Which of the following mechanisms of antibiotic resistance is commonly associated with multidrug resistance (MDR) efflux pumps?
Which of the following antibiotic classes is specifically mentioned as being resistant in cases of Rifampin resistance due to alterations in the binding site?
Which of the following antibiotic classes is specifically mentioned as being resistant in cases of Rifampin resistance due to alterations in the binding site?
Which of the following is NOT a mechanism of antibiotic resistance discussed in the provided text?
Which of the following is NOT a mechanism of antibiotic resistance discussed in the provided text?
Which of the following is a crucial step in the systematic approach to selection of antimicrobial agents?
Which of the following is a crucial step in the systematic approach to selection of antimicrobial agents?
Which of the following is NOT a common approach to guiding empiric antibiotic therapy?
Which of the following is NOT a common approach to guiding empiric antibiotic therapy?
Which of the following is a critical aspect of monitoring therapeutic response in patients receiving antimicrobial treatment?
Which of the following is a critical aspect of monitoring therapeutic response in patients receiving antimicrobial treatment?
Which of the following mechanisms of antibiotic resistance is particularly common in gram-negative bacteria, especially Pseudomonas, and often affects beta-lactams, fluoroquinolones, and aminoglycosides?
Which of the following mechanisms of antibiotic resistance is particularly common in gram-negative bacteria, especially Pseudomonas, and often affects beta-lactams, fluoroquinolones, and aminoglycosides?
Which of the following is NOT a consequence of Reverse Transcriptase's error-prone nature?
Which of the following is NOT a consequence of Reverse Transcriptase's error-prone nature?
What is the primary target of Antiretroviral Therapy (ART) in HIV patients?
What is the primary target of Antiretroviral Therapy (ART) in HIV patients?
Which of the following statements accurately describes the function of Integrase?
Which of the following statements accurately describes the function of Integrase?
What is the primary reason why HIV cannot be cured with current treatments?
What is the primary reason why HIV cannot be cured with current treatments?
What is the main reason why continuous ART is necessary for managing HIV?
What is the main reason why continuous ART is necessary for managing HIV?
Which of the following is NOT a characteristic of a retrovirus?
Which of the following is NOT a characteristic of a retrovirus?
Which of the following is NOT a consequence of HIV's rapid mutation rate?
Which of the following is NOT a consequence of HIV's rapid mutation rate?
Which of the following best describes the goal of achieving undetectable levels of HIV-RNA in patients undergoing ART?
Which of the following best describes the goal of achieving undetectable levels of HIV-RNA in patients undergoing ART?
Why is it important to suppress HIV replication to maximal levels in patients receiving ART?
Why is it important to suppress HIV replication to maximal levels in patients receiving ART?
Which enzyme is NOT unique to retroviruses?
Which enzyme is NOT unique to retroviruses?
Which type of shock is characterized by a loss of vascular tone leading to vasodilation and hypoperfusion, despite a normal cardiac output?
Which type of shock is characterized by a loss of vascular tone leading to vasodilation and hypoperfusion, despite a normal cardiac output?
Which of the following statements accurately describes the pathophysiology of Septic Shock?
Which of the following statements accurately describes the pathophysiology of Septic Shock?
Which of the following is NOT a characteristic of Septic Shock?
Which of the following is NOT a characteristic of Septic Shock?
Which of the following is a key component of treatment for Sepsis?
Which of the following is a key component of treatment for Sepsis?
What is the primary reason for the use of vasopressors in the treatment of Septic Shock?
What is the primary reason for the use of vasopressors in the treatment of Septic Shock?
Which of the following is a hallmark of a patient with Septic Shock who is receiving appropriate care?
Which of the following is a hallmark of a patient with Septic Shock who is receiving appropriate care?
Which of the following is NOT a typical sign of tissue hypoperfusion in a patient with shock?
Which of the following is NOT a typical sign of tissue hypoperfusion in a patient with shock?
What is the primary cause of the decreased venous return seen in Hypovolemic Shock?
What is the primary cause of the decreased venous return seen in Hypovolemic Shock?
Which of the following BEST summarizes the concept of 'The Tank is Empty' in the context of Hypovolemic Shock?
Which of the following BEST summarizes the concept of 'The Tank is Empty' in the context of Hypovolemic Shock?
Which of the following antibiotic classes is primarily known for its bactericidal activity against a wide range of bacteria, including Gram-positive, Gram-negative, and atypical organisms?
Which of the following antibiotic classes is primarily known for its bactericidal activity against a wide range of bacteria, including Gram-positive, Gram-negative, and atypical organisms?
Which of the following scenarios would be LEAST appropriate for the use of a bacteriostatic antibiotic?
Which of the following scenarios would be LEAST appropriate for the use of a bacteriostatic antibiotic?
Which of the following groups of bacteria are commonly associated with urinary tract infections (UTIs) and are known as nitrite producers?
Which of the following groups of bacteria are commonly associated with urinary tract infections (UTIs) and are known as nitrite producers?
Which of the following antibiotic classes is known to be effective against a broad spectrum of bacteria, including Gram-positive, Gram-negative, and atypical organisms, making them useful for empiric therapy?
Which of the following antibiotic classes is known to be effective against a broad spectrum of bacteria, including Gram-positive, Gram-negative, and atypical organisms, making them useful for empiric therapy?
What type of patient should not receive a bacteriostatic antibiotic?
What type of patient should not receive a bacteriostatic antibiotic?
Which of the following best describes a non-fermenter bacteria, such as Pseudomonas, as it relates to its metabolic characteristics?
Which of the following best describes a non-fermenter bacteria, such as Pseudomonas, as it relates to its metabolic characteristics?
Which of the following statements accurately describes a key principle of effective antibiotic use?
Which of the following statements accurately describes a key principle of effective antibiotic use?
What is the primary mechanism of action for Nucleotide Reverse Transcriptase Inhibitors (NRTIs)?
What is the primary mechanism of action for Nucleotide Reverse Transcriptase Inhibitors (NRTIs)?
Which class of antiretroviral drugs is particularly associated with increased risk of developing a rash that may lead to serious conditions like DRESS or SJS?
Which class of antiretroviral drugs is particularly associated with increased risk of developing a rash that may lead to serious conditions like DRESS or SJS?
For patients with a CD4 count less than 200, what is the recommended first-line prophylactic therapy against Pneumocystis jirovecii pneumonia (PCP)?
For patients with a CD4 count less than 200, what is the recommended first-line prophylactic therapy against Pneumocystis jirovecii pneumonia (PCP)?
What is a common consequence when using Integrase Strand Transfer Inhibitors (InSTIs) and antacids together?
What is a common consequence when using Integrase Strand Transfer Inhibitors (InSTIs) and antacids together?
What is a major limitation in the use of non-nucleotide reverse transcriptase inhibitors (NNRTIs) in HIV treatment?
What is a major limitation in the use of non-nucleotide reverse transcriptase inhibitors (NNRTIs) in HIV treatment?
What is a crucial safety concern associated with the use of Ganciclovir and Valganciclovir?
What is a crucial safety concern associated with the use of Ganciclovir and Valganciclovir?
Which of the following statements about Acyclovir is incorrect?
Which of the following statements about Acyclovir is incorrect?
What is the primary mechanism by which Remdesivir acts against viral infections?
What is the primary mechanism by which Remdesivir acts against viral infections?
For which patient population is Daily Suppressive Therapy for HSV most recommended?
For which patient population is Daily Suppressive Therapy for HSV most recommended?
Which class of antiviral drugs is primarily used to treat Cytomegalovirus infections?
Which class of antiviral drugs is primarily used to treat Cytomegalovirus infections?
What is a common adverse effect of Remdesivir that requires monitoring during treatment?
What is a common adverse effect of Remdesivir that requires monitoring during treatment?
What distinguishes Valacyclovir from Acyclovir?
What distinguishes Valacyclovir from Acyclovir?
Which of the following is NOT a recommended treatment for COVID-19?
Which of the following is NOT a recommended treatment for COVID-19?
Why are Adamantanes not recommended for treating influenza?
Why are Adamantanes not recommended for treating influenza?
What is the primary role of Reverse Transcriptase in the lifecycle of a retrovirus?
What is the primary role of Reverse Transcriptase in the lifecycle of a retrovirus?
What consequence does the poor fidelity of Reverse Transcriptase have on HIV?
What consequence does the poor fidelity of Reverse Transcriptase have on HIV?
What is the role of Integrase in HIV infection?
What is the role of Integrase in HIV infection?
Why is ART (Antiretroviral Therapy) required to be taken continuously?
Why is ART (Antiretroviral Therapy) required to be taken continuously?
What are the primary goals of ART in HIV patients?
What are the primary goals of ART in HIV patients?
What challenge arises from the integration of HIV DNA into the host’s chromosome?
What challenge arises from the integration of HIV DNA into the host’s chromosome?
In what way does the retrovirus lifecycle differ from typical viral replication?
In what way does the retrovirus lifecycle differ from typical viral replication?
What is primarily targeted by ART to reduce HIV replication?
What is primarily targeted by ART to reduce HIV replication?
What makes developing a vaccine against HIV particularly complicated?
What makes developing a vaccine against HIV particularly complicated?
What percentage of people with HIV are estimated to be unaware of their infection?
What percentage of people with HIV are estimated to be unaware of their infection?
Flashcards
Pathogenic Fungi
Pathogenic Fungi
Fungi that can cause diseases in healthy individuals.
Candidiasis
Candidiasis
A common fungal infection caused by Candida species.
Opportunistic Fungi
Opportunistic Fungi
Fungi that infect those with weakened immune systems.
Ergosterol
Ergosterol
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Challenges in Treating Fungal Infections
Challenges in Treating Fungal Infections
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Bactericidal
Bactericidal
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Bacteriostatic
Bacteriostatic
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Broad Spectrum Antibiotics
Broad Spectrum Antibiotics
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Narrow Spectrum Antibiotics
Narrow Spectrum Antibiotics
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Nitrite Producers
Nitrite Producers
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Antibiotic Resistance
Antibiotic Resistance
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Gram-negative bacteria
Gram-negative bacteria
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PCN and Cephalosporins
PCN and Cephalosporins
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Effective Antibiotic Use
Effective Antibiotic Use
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Retrovirus
Retrovirus
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Reverse Transcriptase
Reverse Transcriptase
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HIV Mutation
HIV Mutation
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Integrase
Integrase
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Antiretroviral Therapy (ART)
Antiretroviral Therapy (ART)
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Maximal Suppression
Maximal Suppression
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Immune Function Restoration
Immune Function Restoration
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Latent Infection
Latent Infection
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Drug Resistance in HIV
Drug Resistance in HIV
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Undetectable HIV Levels
Undetectable HIV Levels
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Antibiotic
Antibiotic
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Cell Wall Synthesis Inhibitors
Cell Wall Synthesis Inhibitors
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Beta-Lactams
Beta-Lactams
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Antibiotic Resistance Mechanisms
Antibiotic Resistance Mechanisms
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MRSA
MRSA
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Efflux Pumps
Efflux Pumps
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Biofilms
Biofilms
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Aminoglycosides
Aminoglycosides
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Sepsis
Sepsis
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Pseudomonas
Pseudomonas
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Empiric Therapy
Empiric Therapy
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Definitive Therapy
Definitive Therapy
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Gram Stain
Gram Stain
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Gram Positive Bacteria
Gram Positive Bacteria
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Combination Therapy
Combination Therapy
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Bactericidal vs. Bacteriostatic
Bactericidal vs. Bacteriostatic
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When to use Bactericidal
When to use Bactericidal
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When to use Bacteriostatic
When to use Bacteriostatic
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Key considerations for Antibiotic Use
Key considerations for Antibiotic Use
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Cell Wall & DNA Synthesis Inhibitors
Cell Wall & DNA Synthesis Inhibitors
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Shock
Shock
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Signs of Tissue Hypoperfusion
Signs of Tissue Hypoperfusion
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Hypovolemic Shock
Hypovolemic Shock
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Cardiogenic Shock
Cardiogenic Shock
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Obstructive Shock
Obstructive Shock
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Distributive Shock
Distributive Shock
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Septic Shock
Septic Shock
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Treatment of Sepsis
Treatment of Sepsis
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HIV-RNA Levels
HIV-RNA Levels
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NRTIs
NRTIs
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Opportunistic Infections (OI)
Opportunistic Infections (OI)
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Bactrim
Bactrim
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HIV Treatment Challenges
HIV Treatment Challenges
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Reverse Transcriptase Mutations
Reverse Transcriptase Mutations
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Integrase Function
Integrase Function
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Continuous ART Importance
Continuous ART Importance
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HIV RNA Levels Goal
HIV RNA Levels Goal
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Effects of HIV Mutation
Effects of HIV Mutation
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Role of RNA-Dependent DNA Polymerase
Role of RNA-Dependent DNA Polymerase
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Latent HIV Infection
Latent HIV Infection
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Antiretroviral Therapy Goals
Antiretroviral Therapy Goals
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HIV Evading Immune Response
HIV Evading Immune Response
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Acyclovir
Acyclovir
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Valacyclovir
Valacyclovir
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Ganciclovir
Ganciclovir
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CMV
CMV
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Remdesivir
Remdesivir
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Paxlovid
Paxlovid
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HIV Infection
HIV Infection
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Chronic Suppressive Therapy
Chronic Suppressive Therapy
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Adverse Effects of Acyclovir
Adverse Effects of Acyclovir
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COVID-19 Medications
COVID-19 Medications
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Study Notes
Antimicrobial Therapy
- Antibiotics are life-saving drugs.
- Antibiotics only treat bacterial infections.
- Many sore throats do not require an antibiotic.
- Some ear infections do not require an antibiotic.
- Green colored mucus is not a sign that an antibiotic is needed.
- Risks exist when taking prescription drugs.
- Consult a clinician about safe antibiotic use.
Some Semantics
- Antibiotics inhibit or kill pathogens.
- Antibacterial drugs target bacteria.
- Antifungal drugs target fungi.
- Antiviral drugs target viruses.
Empiric Therapy
- Empiric therapy is the common use of antibiotics in clinical medicine.
- Therapy is started before culture and sensitivity results are known.
- Antibiotic selection is based on typical pathogens associated with an infection.
- Definitive identification of a causative organism takes up to 48 hours.
- Delay in treatment can be harmful.
- Combination therapy is sometimes used.
- Broader spectrum antibiotics are often used.
Definitive Therapy
- Definitive therapy is tailored to culture and sensitivity results.
- The provider knows exactly which antibiotics will work.
- Adjustments to empiric therapy may be needed.
- Monotherapy is preferred.
- Narrow spectrum antibiotics are preferred to reduce drug resistance.
Gram Stain vs. Bacterial Culture
- Gram stain indicates the possible bacterial cause of an illness.
- It differentiates bacteria based on cell wall characteristics.
- Gram stain results are quicker than bacterial culture results.
- Bacterial culture can take 24-48 hours.
- Culture results allow for targeted therapy against the specific organism.
Bacteria Review
- Gram-positive bacteria are one type of bacteria.
- Gram-negative bacteria are another type of bacteria.
- Atypical bacteria include Spirochetes, Rickettsia, Mycobacteria, Mycoplasma, and Legionella.
Gram-Positive Cocci
- Staphylococcus aureus
- Staphylococcus epidermis
- Streptococcus pneumonia
- Streptococcus pyogenes (GAS)
- Streptococcus agalactiae (GBS)
- Enterococci
- E. faecalis
Gram-Positive Rods
- Clostridia
- C. tetani
- C. botulinum
- C. difficile
- Corynebacterium
- C. diphtheria
- Listeria
- L. monocytogenes
Gram-Negative Bacteria
- Enterobacteriaceae
- E. coli
- Proteus
- Klebsiella
- Shigella
- Salmonella
- Yersinia
- Citrobacter
- UTI
- Pneumonia
- Diarrhea
- Sepsis
- Nitrite producers
- Non-fermenters
- Moraxella
- Pseudomonas
- Antibiotic resistance
- Neisseria
- Chlamydia
- Haemophilus
- H. pylori
Gram Positive vs. Gram Negative
- Gram-positive bacteria have a thick peptidoglycan layer.
- Gram-negative bacteria have a thin peptidoglycan layer.
Bactericidal vs. Bacteriostatic
- Bactericidal drugs kill bacteria.
- Bacteriostatic drugs prevent bacteria from growing and reproducing.
- Penicillins, Cephalosporins, Aminoglycosides, Vancomycin, Fluoroquinolones, and Metronidazole are bactericidal drugs.
- Bactericidal drugs frequently interrupt cell wall or DNA synthesis.
- Chloramphenicol, Erythromycin, Clindamycin, Sulfonamides, Trimethoprim, and Tetracyclines are bacteriostatic.
Mnemonic
- ECSTaTiC – refers to bacteriostatic drugs
- Very ProFicient At Complete Cell Murder – refers to bacteriocidal drugs
Spectrum of Activity
- Broad spectrum covers a wide range of bacteria (gram +, gram-, and atypicals).
- This is good for empiric therapy, but increases infections and resistance.
- Narrow spectrum is preferred when the causative organism is known.
- It reduces resistance and superinfections, and is targeted therapy.
Keys to Effective Antibiotic Use
- Identify the organism causing the disease.
- Confirm if the drug is effective against the organism.
- Evaluate if there are any risks to the patient.
- Confirm the drug can reach the site of infection in the body.
- Assess if the drug stays in the body long enough for effectiveness.
Antibiotic Targets
- Cell wall synthesis, Folate synthesis, Nucleic acid synthesis, Cell membrane, Protein synthesis.
Mechanisms of Antibiotic Resistance
- Enzymatic or metabolic inactivation.
- Alteration of target site
- Efflux pumps
- Reduced permeability
- Alteration of metabolic pathways
- Biofilms formation
- Horizontal Gene Transfer
How Antibiotic Resistance Happens
- Resistant germs exist and when antibiotics kill pathogens, they also kill beneficial bacteria in the body, weakening the body's ability to resist infection.
- Antibiotic-resistant bacteria increase and take over.
- Resistant bacteria can spread that resistance to other bacteria, creating further issues.
Other sections (as provided in the prompt)
- All the other sections (MRSA, Pseudomonas, EMRA Antibiotic Guide...etc) are here with the provided information.
- Note:* There was no new information provided about these sections to add more details.
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