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Systemic vs topical therapy systemic treatment of

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Unformatted text preview: oxicity - Often Dose and Time Related – Skin, GI, Kidney, Liver, Blood, Neurological reactions, Ototoxicity OBJECTIVE 7: OBJECTIVE • Discuss important factors in selecting an antiinfective agent. Systemic Vs. Topical Therapy Systemic • Treatment of existing infection – Generally, systemic therapy more effective • Exceptions: Burns, superficial fungal infections, or in patients who have resistance or intolerance to systemic antimicrobials. • Prophylactic Antisepsis before surgery – Topical • Environmental pathogens (instruments, hands, etc.) • Patient's skin (Important, but less so than instruments) – Systemic - recommended only for some surgeries. • "Clean" surgeries have only a 5% risk of infection (cefazolin). If bowel involved, cefoxitin may be a better choice. Antimicrobial Selection: Antimicrobial • The Organism • The Drug • The Patient Classification of Common Pathogens Classification of Common Pathogens • Gram Stain (hematoxylin stain) Gram Positive / Gram Negative • Shape Cocci / Bacilli • Tolerance or need for oxygen Aerobic / Anaerobic / Facultatively Anaerobic • Site of re...
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