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Questions and Answers
What is the optimal time for administering prophylactic antibiotics in surgery?
Which antibiotic combination is used to protect against beta-lactamase producing bacteria?
Which type of bacteria is penicillin particularly effective against?
What is the role of Clavulanic acid in antibiotic therapy?
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In what scenario should prophylactic antibiotics be continued after surgery?
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Which can be used to cover a broad spectrum of both Gram-positive and Gram-negative bacteria?
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Which patient group should receive prophylactic antibiotics to prevent prosthesis contamination?
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How often should prophylactic antibiotics be repeated in long surgical operations?
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Study Notes
Prophylactic Antibiotics Overview
- Used to prevent infection in cases of potential wound contamination based on classification: clean, clean-contaminated, contaminated, and dirty wounds.
- Antibiotics are prescribed when commensals become opportunistic pathogens; rotation of antibiotics is necessary to prevent resistance development.
Timing and Administration
- Administered ideally at the first incision to ensure maximum blood and tissue concentrations throughout surgery.
- No need for continued administration post-surgery unless sepsis occurs.
- Intravenous antibiotics are typically given during anesthesia induction; repeated every 4 hours for lengthy surgeries.
Special Considerations
- Patients with valvular heart disease or prosthetic devices require prophylactic antibiotics to prevent contamination.
Types of Antibiotics
- Bactericidal: Penicillins and aminoglycosides effectively kill bacteria.
- Bacteriostatic: Tetracyclines and erythromycins inhibit bacterial growth.
Specific Antibiotics and Their Use
- Penicillin: Effective against gram-positive organisms (streptococci, clostridia, staphylococci) that do not produce beta-lactamase.
- Flucloxacillin: Targets penicillinase-producing staphylococci; ineffective against beta-lactamases. Used for soft tissue infections and osteomyelitis.
- Ampicillin/Amoxicillin: Effective against Enterococcus faecalis and group D streptococci; not effective against Klebsiella or Pseudomonas.
- Clavulanic Acid: Inactivates beta-lactamases when added to amoxicillin; itself lacks antibacterial activity.
Broad-Spectrum Antibiotics
- Piperacillin: Aureidopenicillin with broad-spectrum activity against gram-positive/negative and anaerobic bacteria. Used with tazobactam to inhibit beta-lactamases.
- Ticarcillin: Another broad-spectrum ureidopenicillin, used with clavulanic acid, effective against septicaemia, pneumonia, and severe urinary infections; not effective against MRSA.
Cephalosporins
- Susceptible to beta-lactamases; includes cefuroxime, cefotaxime, and ceftazidime.
- Effective for skin and soft tissue infections, particularly against staphylococci and enterobacteriaceae; ineffective against Enterococcus faecalis.
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Description
This quiz focuses on the use of prophylactic antibiotics in surgical procedures and the classification of wounds. It covers the importance of timely administration and the need to rotate antibiotics to prevent resistance from opportunistic pathogens. Test your knowledge on guidelines and best practices regarding antibiotic prophylaxis.
