NURSING > Presentation > Antibiotic Classification Presentation (78 Pages) (All)

Antibiotic Classification Presentation (78 Pages)

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Infectious Disease Pathogen Drug Toxicity Patient PharmacokineticsMechanism of Action • Cell wall synthesis inhibitors – Penicillins and cephalosporins • RNA or DNA synthesis inhibitors – Rifampin and Fluoroquinolones • Protein synthesis inhibitors – Tetracycline and Macrolides • Antimetabolites – SulfonamidesGeneral Approach to Therapy • Prophylactic Therapy – Antibiotics used to prevent an infection that has not yet occurred – Example: Abdominal surgery • Empiric Therapy – Antibiotics used to treat a known/suspected infections where the organism is not known – Example: Urinary tract infections • Definitive/Directed Therapy – Antibiotics used after culture and sensitivity known – Narrowing therapy from 3 antibiotics to one in a patient with hospital acquired pneumoniaGuidelines • Make sure antibiotics are only being used for an approved indication • Use the most narrow spectrum agent appropriate for the patient’s infection • Use the proper dose • Use the shortest effective duration of therapyAntibiotic Selection • Effectiveness against the pathogen • Site of infection – Can the antibiotic get to the site of infection • Host defenses – Bactericidal vs. Bacteriostatic • Allergy • Patient variables – Age – Pregnancy – Genetic variations in metabolismAntimicrobial ResistanceBad Bugs, No Drugs As Antibiotic Discovery Stagnates . . . A Public Health Crisis BrewsAntimicrobial Resistance • Bacteria possess many mechanisms for antibiotic resistance • Selection of resistance can occur during treatment • Importance of the right drug, dose and streamlining/discontinuation of antibiotics as soon as possible • ↑ in resistance nationwide, ↓ in antibiotics developmentProblematic Resistant Organisms • Gram-positives – Multiple Drug Resistant Staph Aureus (MRSA) – Vancomycin Resistant Enterococci – Drug resistant Strep pneumoniae • Gram-negatives – Fluoroquinolone resistance – β-lactams • Extended Spectrum β-lactamases (ESBLs) • Carbapenemases – Pseudomonas aeruginosa • Multiple mechanisms Classification of AntibioticsClassification of Antibiotics • Beta-Lactams – Penicillins – Cephalosporins – Carbapenems – Monobactams • Glycopeptides • Aminoglycosides • Fluoroquinolones • Macrolides • Tetracyclines • Miscellaneous

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