Antimicrobial prophylaxis against bacterial infections is indicated in selected patients undergoing surgical procedures and in those with cardiac valvular disease. Principles of antimicrobial therapy administer a drug to an infected person that destroys the infective agent without harming the hosts cells antimicrobial drugs are produced naturally or synthetically 3 the ideal antimicrobial drug terminology 4 5 origins of antimicrobial drugs antibiotics are common metabolic products of aerobic. Antimicrobial therapy in veterinary medicine wiley. Successful antimicrobial therapy occurs when an effective concentration of drug is delivered to the site of infection for a sufficient period of time. Antimicrobial use differs from other medications by its potential for collateral damage, specifically the generation of antimicrobial resistance, both in the patient and the wider population.
Principles of antimicrobial therapy structural and biochemical differences exist between humans and microorganisms. The bestrecognized example of nonantimicrobial therapy in the treatment of infections is the use of operative drainage or debridement. Basic principles of antimicrobial therapy chapter 83. Selective toxicity selective toxicity refers to the ability of the drug to targets sites that are relative specific to the microorganism responsible for infection. Principles of antimicrobial therapy pharmacology 1. Principles of antimicrobial therapy free medical textbook. Guidelines exist that list minimum criteria for initiation of antimicrobial therapy, particularly in longterm care facilities. General principles of antimicrobial therapy goodman. More information about antiparasitic, antifungal, and antiviral agents. In critically ill patients, such as those in septic shock, febrile neutropenic patients, and patients with bacterial meningitis, empiric therapy should be initiated immediately after or concurrently with collection of diagnostic specimens. Sep 21, 2010 principles of antimicrobial therapy principle 1. In this article, we describe general principles applicable to the selection and use of antimicrobial agents for the treatment of infections.
Many of the same basic principles apply to antimicrobial, antiparasitic and anticancer chemotherapy. Rational antibiotic use requires the most specific diagnosis that can be made, knowledge of commonly used antimicrobial agents, and appropriate monitoring of therapy. Basic principles of antimicrobial therapy chapter 83 basic. Antimicrobial therapy is usually, but not always, the most important therapy for infectious diseases. Principles of antimicrobial therapy elderly patients. On completion of this article, you should be able to. Principles of antimicrobial therapy key points early and rapid diagnosis of infection and prompt initiation of appropriate antimicrobial therapy, if warranted, are fundamental to reducing the mortality and morbidity from serious infections. This must be considered in addition to the challenges involved in finding an agent with the appropriate spectrum of antimicrobial activity that also achieves a sufficient concentration. Scribd is the worlds largest social reading and publishing site. Basic principles of antimicrobial therapy are used to evaluate treatment.
Chapter 79 basic principles of antimicrobial therapy free download as word doc. Neither mechanisms of action nor clinical summary tables are included in this chapter because this. These guidelines should be applied in the context of host characteristics, response to therapy, and cost of therapy. The term antimicrobial defines an agent that kills microorganisms or stops their growth. Principles of antimicrobial drug selection and use. Antimicrobial drugs are effective in the treatment of infections because of their selective toxicity. Principles and practices of adequate antibiotic therapy a. The current measurement of antimicrobial drug activity against bacterial pathogens relies on measurement of the mic and, by comparison with established breakpoints, bacteria are classified as susceptible, intermediate, or resistant.
Im michelle manzo, infectious diseases editorial director at medscape, and i would like to welcome you to our live web conference on principles and practices of adequate antibiotic therapy. Learn vocabulary, terms, and more with flashcards, games, and other study tools. Recognition of certain agerelated physiologic, pharmacokinetic, and pharmacodynamic changes can help optimize antimicrobial dosage regimens and minimize adverse effects. Principles and practice of antimicrobial susceptibility. Chapter 37 principles of antimicrobial chemotherapy overview chemotherapy is defined as the use of drugs to eradicate pathogenic organisms or neoplastic cells in the treatment of infectious diseases or cancer. The inevitable consequence of the widespread use of antimicrobial agents has been the emergence of antibioticresistant pathogens, fueling an everincreasing need for new drugs antibiotics are antibacterial. However, it should be stressed that, although antibiotic combinations do have a valuable therapeutic role, routine use of two or more antibiotics should be discouraged. Antimicrobial therapy then refers to the treatment of infectious diseases using therapy that kills these harmful microorganisms, such as antibiotics. Principles of antimicrobial therapy antibiotics antimicrobial. Important considerations when prescribing antimicrobial therapy include obtaining an accurate diagnosis of infection. Start studying general principles of antimicrobial therapy. Upon assessing the patient, the nurse notices the individual has developed oral thrush. General principles of antimicrobial therapy request pdf. Quizlet flashcards, activities and games help you improve your grades.
Antimicrobial resistance makes the treatment of patients difficult, costly and sometimes impossible. Principles of antimicrobial therapy key points early and rapid diagnosis of infection and prompt initiation of appropriate antimicrobial therapy, if warranted, are fundamental to reducing the mortality and morbidity from serious infections prompt initiation of broader empirical coverage of suspected pathogens followed by the narrowing or. Minimal bactericidal concentration lowest concentration of antibiotic that reduces the number of viable cells by at least fold the mbc of a truly bactericidal agent is equal to or just slightly above its mic aal. Bacteriostatic drug may work if host defenses are adequate 3.
General principles of antimicrobial therapy basicmedical key. Of these, antibacterial agents are by far the most commonly used and thus are the focus of this article, although similar principles apply to the other agents as well. Antimicrobial therapy takes advantage of the biochemical differences between microorganisms and humans antimicrobial drugs should have selective toxicity towards the invading microorganism without harming the cells of the host this selective toxicity is usually relative rather than absolute, requiring careful control of the drug concentration. Describes the principles of antimicrobial therapy as they apply to elderly patients and includes important issues of pharmacokinetic differences related to aging. Varley and others published principles of antibiotic therapy find, read and cite all the research you need on researchgate. Although even appropriate antibiotic therapy drives resistance, inappropriate therapy may also have adverse effects on the individual patient, as well as on the bacterial ecology. Antimicrobial agents are some of the most widely, and often injudiciously, used therapeutic drugs worldwide. Empiric therapy immediate treatment with an antibiotic which was selected because it is known to combat the microorganism known to be the most common cause of that particular infection. If your institution subscribes to this resource, and you dont have a myaccess profile, please contact your librarys reference desk for information on how to gain access to this resource from offcampus.
Chemotherapy is based on the principle of selective toxicity. Minimum effective concentrations are those needed to inhibit growth. The terms antimicrobial, antibiotic, and antiinfective encompass a wide variety of pharmaceutical agents that include antibacterial, antifungal, antiviral, and antiparasitic drugs. They can also be classified according to their function. Principles governing antimicrobial therapy in the intensive. Edson, md on completion of this article, you should be able to. Under these welldefined conditions, use of multiple drugs may be lifesaving. Principles of antimicrobial therapy brilliant nurse. General principles of antimicrobial therapy workbook and. The timing of initial therapy should be guided by the urgency of the situation.
Optimal use of antimicrobial agents requires consideration of a number of important factors that may influence the choice of an appropriate agent and that determine the most effective dose and route of administration. Principles of antibiotic therapy in severe infections. For example, antibiotics are used against bacteria, and antifungals are used against fungi. Cox msn, acnpbc, acnpc, fccm penn state hershey medical center neuroscience critical care unit. Therapy with a combination of antimicrobial agents is indicated only in specific situations. History of antimicrobial agents and resistant bacteria jmaj 522. Antimicrobial drugs are effective in treatment of infections because of their selective toxicity source of infection are. It also discusses principles for the selection of an appropriate antibiotic, dose, dose schedule, and type of antibiotic therapy. The goal of therapy is always to maximize efficacy while limiting patient harm. Antimicrobial agents are among the most commonly used and misused of all drugs. Simplifying systemic antibiotics blair lonsberry, ms, od, med. This must be considered in addition to the challenges involved in finding an agent with the appropriate spectrum of antimicrobial activity that also. Cost of antimicrobials and antimicrobial administration other issues in selection bibliography there are at least five basic principles on which successful antimicrobial. Principles of antimicrobial chemotherapy basicmedical key.
Posted on february 11, 2017 may 12, 2017 by anne caporal. The longer antibiotics are given, the greater is the danger of selection of resistant bacteria, side effects, and toxicity. Rational antibiotic use require proper selection of antimicrobial agent, dosing, route, and duration of therapy. Principles of antimicrobial therapy simplifying systemic. In the past several decades, advances in the development of antimicrobial agents have supplied the physician with dozens of drugs effective against bacterial, fungal, and viral pathogens.
Basic principles of antimicrobial therapy test bank multiple choice 1. Pharmacologic principles of antimicrobial therapy i. Antimicrobial therapy antimicrobial therapy principles. Principles of antimicrobial therapy anesthesia key. Antimicrobial agents provide the most dramatic examples of the advances of modern medicine. In this chapter, the discussion focuses on general principles and some unique aspects of antimicrobial therapy in older infected patients. Principles of antimicrobial therapy chanu rhee and michael klompas background in the past several decades, advances in the development of antimicrobial agents have supplied the physician with dozens of drugs effective against bacterial, fungal, and viral pathogens. A variety of microorganisms were elucidated to cause infectious diseases in the latter half of the 19th century.
If antibiotic therapy is unnecessary, discontinue it immediately. Mar 25, 2016 empirical therapy patient is infected but organism and susceptibility not known in the mean time until investigation reports are available principles establish infection, evidence of infection and probable site obtain samples for investigations before antibiotic initiation consider most common microbiological. The most commonly used antimicrobial agents and promising new agents will be discussed in detail in subsequent articles in this symposium. Principles of antimicrobial therapy flashcards quizlet. Introduction to antimicrobial therapy columbia university. Most local antibiotics can be replaced by antiseptics chap. Principles of antimicrobial therapy study guide by drhernandezmd includes 37 questions covering vocabulary, terms and more. Odonnell the selection of an appropriate antimicrobial agent to treat an infection is guided by a number of factors. History of antimicrobial agents and resistant bacteria. Antimicrobial resistance has been observed and reported with practically all the newly discovered antimicrobial molecules till date. Comments will also be made on some of the more useful classes of antimicrobial agents for treating infections in the elderly. When dealing with particularly resistant microbes, infections at sites that are difficult to reach, polymicrobial infections, or when it is necessary to decrease emergence of resistance, what type of antimicrobial therapy should be used. Co, md, fpps, fpsecp professorial lecturer in antimicrobial therapy, graduate school university of santo tomas executive director, center for drug research evaluation and studies, inc. Antimicrobial therapy takes advantage of the biochemical differences between microorganisms and humans antimicrobial drugs should have selective toxicity towards the invading microorganism without harming the cells of the host this selective toxicity is usually relative rather than absolute, requiring careful.
Proper use of antimicrobial helps in clinical cure or prevention of infection as. Antimicrobial therapy part 1 principles of antimicrobial therapy effective in the treatment of infections selective toxicity ability to kill microorganism without harming the cells of the host microorganisms source of infection bacteria viruses fungi topics antibacterial agents antitb drugs antifungal antiviral uti chain of infection. The nurse has been caring for a patient who has been taking antibiotics for 3 weeks. Basic principles of antimicrobial therapy clinical gate. General principles of antimicrobial therapy surbhi leekha, mbbs. Volume of distribution and pharmacokinetics principle 3. Chapter 79 basic principles of antimicrobial therapy.
Antimicrobial therapy in veterinary medicine is an essential resource for anyone concerned with the appropriate use of antimicrobial drugs, including veterinary practitioners, students, public health veterinarians, and industry and research scientists. General principles of antimicrobial therapy article in mayo clinic proceedings 862. Emergence of antimicrobial resistance in pathogens has become a matter of great public health concern. Many infectious diseases once considered incurable and lethal are now amenable to treatment with a few pills. General principles of antimicrobial therapy sciencedirect. To correctly administer these compounds, clinicians must understand the indications, spectrum, pharmacodynamics, potential for druginduced adverse reactions and drugdrug interactions, and relative cost 1. In antimicrobial therapy, the relationship is often expressed as an inhibitory sigmoid emax model, to take into account the control bacterial population without treatment econ as a fourth parameter equation 481 and figure 481, where e is the effect as measured by microbial burden. Antimicrobial agents are used to prevent infection, manage established infections, and treat presumptive infections. The attainable antibiotic level is the concentration of the drug that can be reached in the. Bacterial cell wall bacterial ribosomes avoiding resistance bacterial resistance is a natural result of mutation. An antimicrobial is an agent that kills microorganisms or stops their growth.
Much of what is discussed here regarding antimicrobial action and resistance is based on antibacterial agents, but the principles generally apply to almost all antiinfective agents. Antimicrobial therapy takes advantage of these differences, e. May 12, 2017 antimicrobial therapy takes advantage of the biochemical differences that exist between microorganisms and human beings. Antimicrobial use differs from other medications by its potential for collateral damage, specifically the generation of antimicrobial resistance, in both the patient and the wider population. The use of combination antimicrobial therapy is indicated in several circumstances. Principles of antimicrobial therapy free download as powerpoint presentation. Empirical therapy patient is infected but organism and susceptibility not known in the mean time until investigation reports are available principles establish infection, evidence of infection and probable site obtain samples for investigations before antibiotic initiation consider most common microbiological. Antimicrobial therapy antimicrobial therapy principles of drug management antimicrobial prescription consideration patient factors documentation of.
General principles of antimicrobial therapy goodman and. Antimicrobial medicines can be grouped according to the microorganisms they act primarily against. Evidencebased practice guidelines from the infectious diseases society of america1 can help direct appropriate therapy for specific infectious disease syndromes as well as for infections caused by specific microorganisms. In antimicrobial therapy, the relationship is often expressed as an inhibitory sigmoid e max model, to take into account the control bacterial population without treatment e con as a fourth parameter equation 481 and figure 481, where e is. The pernicious advent of resistance over decades of antimicrobial use reveals that, despite their safety to the patient, antimicrobials are not innocuous drugs. Jun 06, 2016 principles of antimicrobial therapy pharmacology 1. Adjunctive treatments to antimicrobial therapy are essential in promoting healing. Typically, empiric antimicrobial therapy is based on the epidemiology of the suspected infection, with therapy directed toward the most likely organisms. Unfortunately, these advances have been paralleled by increasing antibiotic resistance and the. Principles of antimicrobial therapy basicmedical key. Principles of antimicrobial therapy part 1 penicillin. Introduction to antimicrobial therapy christine kubin, pharm.
General principles of antimicrobial therapy flashcards. By following these general principles, all practicing physicians should be able to use antimicrobial agents in a responsible manner that benefits both the individual patient and the community. The bestrecognized example of synergistic antimicrobial therapy is in treatment of enterococcal endocarditis, in which treatment with penicillin or ampicillin alone has been associated with a high rate of relapse when compared with therapy with penicillin or ampicillin in combination with streptomycin or gentamicin. Antimicrobial therapy takes advantage of the biochemical differences that exist between microorganisms and human beings. A read is counted each time someone views a publication summary such as the title, abstract, and list of authors, clicks on a figure, or views or downloads the fulltext. Principles and practice of antimicrobial susceptibility testing microbiology technical workshop 25 th september 20. Principles of antimicrobial therapy canterbury scl.
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