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1Running Head: ANTIMICROBIAL THERAPYAntimicrobial Therapy: Being a Good StewardWalden UniversityNURS 6251N Advanced PharmacologyOctober 20, 2018
2ANTIMICROBIAL THERAPYAntimicrobial Therapy: Being a Good StewardHealthcare in the 20thcentury 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). Howevermisuse 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 AgentsSince 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).
3ANTIMICROBIAL THERAPYPencillin 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