wk 7 assgn - 1 Running Head ANTIMICROBIAL THERAPY...

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Running Head: ANTIMICROBIAL THERAPY
Antimicrobial Therapy: Being a Good Steward
Walden University
NURS 6251N Advanced Pharmacology
October 20, 2018

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ANTIMICROBIAL THERAPY
Antimicrobial Therapy: Being a Good Steward
Healthcare in the 20
th
century was forever changed when antibiotics were discovered
(Barlam et al., 2016). Antibiotics reduced infectious diseases ability to cause morbidity and
mortality and gave way for significant developments in medicine (Barlam et al., 2016). However
misuse and overuse have led to the increase of antibiotic resistant strands of organisms and
antibiotic development is struggling to keep up (Barlam et al., 2016; Arcangelo, Peterson,
Wilbur, & Reinhold, 2017). The need to optimize antibiotic use is clear (Barlam et al., 2016).
The goal of antibiotic stewardship is to systematize interventions to improve and quantify the
correct use of antimicrobial agents by encouraging the selection of the most favorable regimen
(Barlam et al., 2018). The purpose of this paper is to discuss the many categories and differences
of antimicrobial agents and relay the importance of proper identification of the causative
microorganism in antimicrobial therapy selection.
Antimicrobial Agents
Since the first successful isolation of the penicillin were found to treat streptococcal and
staphylococcal infections, 19 more categories of antimicrobial agents were discovered
(Arcangelo et al., 2017). Each category has a different target of action and some contain many
different agents (Arcangelo et al, 2017) The 20 categories of antimicrobial agents are:
Penicillins, beta-lactam/beta-lactamase inhibitor combinations, four generations of
cephalosporins, monobactams, carbapenems, fluroquinolones (FQ), macrolides,
aminoglycosides, tetracyclines, glycylcyclines, sulfonamides, glycopeptides, oxazolidinones,
lipopeptides, streptogramins, antianaerobic agents, and miscellaneous agents (Arcangelo et al.,
2017).

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ANTIMICROBIAL THERAPY
Pencillin G is the first-line therapy for syphilis and gonorrhea (Becker, 2013). To combat
the developing resistance to penicillins via beta lactamase degradation, the beta-lactamase
inhibitor clavulanic acid (Arcangelo et al., 2017; Becker, 2013). Clavulanic acid combined with
amoxicillin effectively enhanced antimicrobial activity by stopping the disintegration of the beta-
lactam (Arcangelo et al., 2017).
Cephalosporins are separated into generations by spectrum of activity (Becker, 2013;
Arcangelo et al., 2017). Cephalosporins are similar to penicillin in structure but are a part of the
beta-lactam group (Arcangelo et al., 2017). Cefazolin is a first generation cephalosporin that