SOLUTIONS 2025
Narrow Specturm -
Answer-Treat limited # of organisms, Less likely to disrupt normal flora, organism identified.
Broad Specturm -
Answer-Treats multiple organisms, more likely to disrupt normal flora, causative agent unknown.
Why would you select abx? -
Answer-Is antimicrobial therapy indicated, make a clinical diagnosis, collection of specimens for a cx or
lab test, make microbial diagnosis, select drug.
Extended spectrum -
Answer-treats multiple organisms, more likely to disrupt normal flora, used when causative organism is
unknown.
Gram positive -
Answer-Purple, thick layer
Example of gram positive -
Answer-Group A beta-strep Strep PNA
Gram negative -
Answer-Red or pink, thin layer
Example of gram negative -
Answer-H. influenza
N. Gonoccocus
Atypical Organism -
Answer-colorless, no layer
,Example of Atypical organism -
Answer-Macrolides- erythromycins
, True or False: Atypical bacteria are resistent to becta-lactum abx -
Answer-True
Risk factors for Drug Resistant Strep PNA (DRSP) -
Answer-Recent abx use Older >65
Multiple Comorbidtities ( COPD, DM, HF, renal failure)
Daycare worker
Alcoholism
Immunosuppressed (including chronic steroid use >10 mg/day long term).
Treatment for Drug Resistant Strep PNA -
Answer-High dose amoxicillin 3-4g/day Respiratory fluoroquinolones: moxifloxican,
gemifloxican, levofloxacin.
Tehlithromycin: use limited due to hepatoxicity
Factors to determine when selecting an abx... -
Answer-Allergy history (PCN- risk of cross allergy with cephalosporins)
Age- (Renal function- neonates and elderly)
Pregnancy
Immunocompromised status
Affordability
Taste and convenience
What are 2 abx contraindicated in pregnancy? -
Answer-tetracyclines fluoroquinolone
Do immunocompromised patients get bactericidal or baceriostiatic? -
Answer-Bactericidals