Slides E ID I.pptx - INFECTIOUS DISEASES I BASIC PRINCIPLES OF ANTIMICROBIAL THERAPY ANNUAL BURDEN OF ANTIBIOTIC RESISTANCE IN THE UNITED STATES CDC

Slides E ID I.pptx - INFECTIOUS DISEASES I BASIC PRINCIPLES...

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INFECTIOUS DISEASES I
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BASIC PRINCIPLES OF ANTIMICROBIAL THERAPY
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ANNUAL BURDEN OF ANTIBIOTIC RESISTANCE IN THE UNITED STATES CDC website 2013
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CELL WALL FACTOR Many antibiotics exert their effects through actions on cell walls; determines whether certain antibiotics will be effective Difference on cell wall Peptidoglycan Results from Gram stains 1. Gram (+) 2. Gram (-) 3. Atypical
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GRAM POSITIVE BACILLI COCCI Aerobic Anaerobic Aerobic Anaerobic Bacillus spp Diphtheroids Listeria Corynebacte rium Lactobacillus Propionibacter Actinomyces Clostridium difficile Staphylococcus aureus S. epidermidis S. saprophyticus Streptococcus pyogenes S. agalactiae S pneumoniae S. viridans S. bovis Enterococcus faecalis Peptostreptococcu s
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GRAM NEGATIVE BACILLI COCCI Aerobic Anaerobic Bordetella pertussis Campylobacter spp Citrobacter E. Coli Enterobacter Haemophilus influenzae Helicobacter pylori Klebsiella spp Legionella spp Pseudomonas aeruginosa Acinetobacter Morganella Proteus Providencia Serratia Salmonella Shigella Stenotrophomon as Yersinia enterocolitica Bacteroides species (including B. Fragilis) Fusobacterium Provotella Neisseria gonorrhoeae N. Meningitidis Moraxella catarrhalis Pasteurella multocida
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CLASSIFICATION OF ANTIBIOTICS Drugs work on: Cell wall synthesis Cell membrane permeability Protein synthesis (lethal) Nonlethal inhibitors of protein synthesis Synthesis of nucleic acids Antimetabolites Viral enzyme inhibitors
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ACQUIRED RESISTANCE TO ANTIMICROBIAL DRUGS Over time, organisms develop resistance May have been highly responsive and then became less susceptible to one or more drugs
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MICROBIAL MECHANISMS OF DRUG RESISTANCE Four basic actions Decrease the concentration of a drug at its site of action Inactivate a drug Alter the structure of drug target molecules Produce a drug antagonist
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SELECTION OF ANTIBIOTICS Identify organism Drug sensitivity of organism Host factors Drug may be ruled out owing to Allergy Inability to penetrate the site of infection Patient variables
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Copyright © 2015 Wolters Kluwer • All Rights Reserved CHAPTER 37 Figure 37.3
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IDENTIFYING THE INFECTION ORGANISM Match the drug with the bug Gram-stained preparation Determining drug susceptibility Disk diffusion test Broth dilution procedure
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EMPIRIC THERAPY Antibiotic therapy for patients before causative organism is positively identified Drug selection based on Clinical evaluation Timing Knowledge of microbes most likely to have caused infection
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PROPHYLACTIC USE OF ANTIMICROBIALS
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