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  • NR 566
  • NR 566
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NR 566 week 1

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7 páginas
2024/2025 Escrito para el año académico
Institución NR 566
Grado NR 566
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What are the major antibiotic drug classes Beta-lactams: penicillins Beta-lactams: Cephalosporins fluoroquinolones tetracyclines and macrolides sulfonamides, trimethoprim, &nitrofurantoin What is the primary goal of antibiotic therapy kill bacteria without harming host tissue Bactericidal antibiotics directly kill bacteria bacteriostatic antibiotics. Antibiotics that do not actually kill bacteria but rather inhibit bacterial proliferation while the hosts immune system does the killing which antibiotics are preferred for immunocompromised patients: bactericidal or bacteriostatic bactericidal which antibiotics are preferred for patients with an overwhelming infection: bactericidal or bacteriostatic bactericidal broad spectrum antibiotics affect a broad range of gram-positive or gram-negative bacteria narrow spectrum antibiotics Effective against specific bacteria which is used for empiric therapy: narrow or broad broad spectrum Risks of Broad-Spectrum disruption of normal floral increases risk of development of antibiotic resistance which antibiotics increase the risk of antibiotic resistance: narrow or broad spectrum and whyBroad spectrum because they kill more competing organisms than narrow spectrum drugs is narrow or broad-spectrum antibiotics preferred narrow is preferred when possible. broad spectrum only used when pathogen is unknown or when multiple types of bacteria is suspected Bactericidal drugs Aminoglycosides Beta-lactams fluoroquinolones Metronidazole Vancomycin streptogramins most antimycobacterial agents (rifampin, isoniazid, streptomycin, etc.) bacteriostatic drugs clindamycin macrolides sulfonamides tetracyclines When is empiric therapy used? when treatment is started without cultures or when culture results are not back yet who needs empiric therapy critically ill pts after first set of cxs hospitalized pts until CSS are available ambulatory pts based on clinical presentation Penicillin’s MO inhibit cell wall synthesis; bactericidal penicillin primarily excreted how in urine what needs to be monitored when giving penicillin’s renal function

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NR 566 week 1
kk kk kk




Whatkkarekkthekkmajorkkantibiotickkdrugkkclasses Beta-lactams:kkpenicillins
Beta-lactams:kkCephalosporins
fluoroquinolones
tetracyclineskkandkkmacrolides
sulfonamides,kktrimethoprim,kk&nitrofurantoin
Whatkkiskkthekkprimarykkgoalkkofkkantibiotickktherapykkkillkkbacteriakkwithoutkkharmingkkhostkktissue
Bactericidalkkantibioticskkdirectlykkkillkkbacteria
bacteriostatickkantibiotics.kkAntibioticskkthatkkdokknotkkactuallykkkillkkbacteriakkbutkkratherkkinhibitkkbacte
rialkkproliferationkkwhilekkthekkhostskkimmunekksystemkkdoeskkthekkkilling
whichkkantibioticskkarekkpreferredkkforkkimmunocompromisedkkpatients:kkbactericidalkkorkkbacteriostati
c bactericidal
whichkkantibioticskkarekkpreferredkkforkkpatientskkwithkkankkoverwhelmingkkinfection:kkbactericidalkkorkk
bacteriostatic bactericidal
broadkkspectrumkkantibiotics affectkkakkbroadkkrangekkofkkgram-positivekkorkkgram-negativekkbacteria
narrowkkspectrumkkantibiotics Effectivekkagainstkkspecifickkbacteria
whichkkiskkusedkkforkkempirickktherapy:kknarrowkkorkkbroad broadkkspectrum
RiskskkofkkBroad-Spectrum disruptionkkofkknormalkkfloralkk
increaseskkriskkkofkkdevelopmentkkofkkantibiotickkresistance
whichkkantibioticskkincreasekkthekkriskkkofkkantibiotickkresistance:kknarrowkkorkkbroadkkspectrumkkandkkw
hyBroadkkspectrumkkbecausekktheykkkillkkmorekkcompetingkkorganismskkthankknarrowkkspectrumkkdrugs
iskknarrowkkorkkbroad-spectrumkkantibioticskkpreferred narrowkkiskkpreferredkkwhenkkpossible.kk

broadkkspectrumkkonlykkusedkkwhenkkpathogenkkiskkunknownkkorkkwhenkkmultiplekktypeskkofkkbacteriakkisk
ksuspected

Bactericidalkkdrugs Aminoglycosides
Beta-lactams
fluoroquinolones
Metronidazole
Vancomycin
streptograminskk
mostkkantimycobacterialkkagentskk(rifampin,kkisoniazid,kkstreptomycin,kketc.)
bacteriostatickkdrugs clindamycin
macrolides
sulfonamides
tetracyclines
Whenkkiskkempirickktherapykkused?
whenkktreatmentkkiskkstartedkkwithoutkkcultureskkorkkwhenkkculturekkresultskkarekknotkkbackkkyet
whokkneedskkempirickktherapy criticallykkillkkptskkafterkkfirstkksetkkofkkcxs
hospitalizedkkptskkuntilkkCSSkkarekkavailable
ambulatorykkptskkbasedkkonkkclinicalkkpresentation
Penicillin’skkMOkkinhibitkkcellkkwallkksynthesis;kkbactericidal
penicillinkkprimarilykkexcretedkkhowkkinkkurine
whatkkneedskktokkbekkmonitoredkkwhenkkgivingkkpenicillin’skkrenalkkfunction

, whatkkhappenskkifkkrenalkkinsufficiencykkoccurskkwhilekkgivingkkpenicillin’s prolongedkkhalf-
lifekkleadingkktokktoxicity
Penicillinkkdistribution -Wellkkdistributedkktokkmostkkbodykktissues
-PenetrationkktokkCSFkkandkkeyekktissueskkpoorkkinkkabsencekkofkkinflammation
narrow-spectrumkkpenicillinasekksensitivekkdrugs penicillinkkG
penicillinkkV
narrow-spectrumkkpenicillinasekksensitivekksusceptiblekkpathogens
streptococci,kkNeisseria,kkanaerobes
narrow-spectrumkkpenicillinasekkresistantkkdrugs naficillin
oxacillin
dicloxacillin
narrow-spectrumkkpenicillinasekkresistantkksusceptiblekkpathogens S.kkAureus
streptococci
Broad-spectrumkkpenicillins Ampicillin
Amoxicillin
broad-spectrumkkpenicillinskksusceptiblekkpathogens E.coli
proteuskkmirrabilliskk
enterococci
neisseriakkgonorrheae
Extendedkkspectrumkkpenicillins Piperacillin
extended-spectrumkkpenicillinskksusceptiblekkpathogens
E.Coli,kkproteuskkmirabillis,kkenterococci,kknesseriakkgonorrhoeae,kkpseudomonas,kkenterbacte
r,kkklebsiella
Penicillin/Betakklactamasekkcombinations Ampcillin/sulbactamkk(unasyn)
amoxicillin/clavulanatekk(augmentin)
piperacillin/tazobactamkk(zosyn)
Ifkkakkpatientkkhaskkakkmildkkallergykktokkpenicillinkkwhatkkiskkankkappropriatekkdrugkkalternative
cephalosporin
ifkkakkpatientkkhaskkakkseverekkallergykktokkpenicillinskkwhatkkiskkankkappropriatekkdrugkkalternative
NOTkkCEPHALOSPORINS
vancomycin
erythromycin
clindamycin
Lifespankkconsiderationskkforkkpenicillinskk:kkInfant,kkchildren,kkpregnantkkwomen,kkbreastfeeding,kkold
erkkadults Infant:kksafe
children:kksafe/common
pregnant:kkevidencekksuggestskknokksecondkkorkkthirdkktrimesterkkfetalkkriskkk
breastfeeding:kkamoxicillinkkiskksafekkdatakklackingkkforkkotherkkpenicillins
olderkkadult:kkdosekkadjustmentkkforkkrenalkkdysfunction
highkkriskkkpatientskkforkkpenicillins
ptskkw/kkhxkkofkkseverekkreactionkktokkpenicillins,kkcephalosporins,kkorkkcarbapenems
Whichkkdrugskkarekkchemicallykkrelatedkktokkpenicillins cephalosporins
BetakkLactamskk(cephalosporins)kkmoa bactericidalkkw/lowkktoxicity
1stkkgenerationkkcephalosporinskkdrugs Cefazolin
cephalexin(keflex)
1stkkgenerationkkcephalosporinskkmainkkuse skinkkandkksoftkktissuekkinfection

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