Patients who will soon be in a situation that commonly results in a specific infection (e.g., patients undergoing GI surgical procedures, which may introduce GI bacteria into the bloodstream or peritoneum; patients traveling to other countries with endemic bacteria that are not in their home area) may be given antibiotics before they are exposed to the bacteria. Bacteria have survived for hundreds of years because they can adapt to their environment. They do this by altering their cell wall or enzyme systems to become resistant to (e.g., protect themselves from) unfavorable conditions or situations. o Bacteria that were once very sensitive to penicillin have developed an enzyme called penicillinase, which effectively inactivates many of the penicillin-type drugs. The longer an antibiotic has been in use, the greater the chance that the bacteria will develop into a resistant strain. In most cases the superinfection is an irritating adverse effect (e.g., vaginal yeast infection, candidiasis, diarrhea), but in some cases the superinfection can be more severe than the infection that was originally being treated. o Treatment of the superinfection leads to new adverse effects and the potential for different superinfections. A vicious cycle of treatment and resistance is the result. Explain to patients that saving antibiotics to take later, when they think they need them again, may lead to earlier development of an allergy, which will negate important tests that could identify the bacteria making them sick.
The aminoglycosides are a group of powerful antibiotics used to treat serious infections caused by gram-negative aerobic bacilli. o Aminoglycosides include amikacin (Amikin), gentamicin (generic), neomycin (Mycifradin), streptomycin (generic), and tobramycin (TOBI, TobrexOpthalmic). The aminoglycosides are bactericidal. o They inhibit protein synthesis in susceptible strains of gram-negative bacteria. They irreversibly bind to a unit of the bacteria ribosomes, leading to misreading of the genetic code and cell death. These drugs are used to treat serious infections caused by susceptible strains of gram- negative bacteria, including Pseudomonas aeruginosa, Escherichia coli, Proteus spp., the Klebsiella–Enterobacter–Serratia group, Citrobacter spp., and Staphylococcus spp. such as Staphylococcus aureus. Aminoglycosides are indicated for the treatment of serious infections that are susceptible to penicillin when penicillin is contraindicated, and they can be used in severe infections before culture and sensitivity results have been obtained. The aminoglycosides are poorly absorbed from the GI tract but rapidly absorbed after intramuscular (IM) injection, reaching peak levels within 1 hour.
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- Spring '14
- Pharmacology, Blood sugar, Clinical trial, U.S. Food and Drug Administration