General principles of antimicrobial therapy basicmedical key. Therefore, in choosing an antimicrobial agent for therapy, a crucial consideration is whether the drug can penetrate to the site of infection. Antimicrobial therapy is usually, but not always, the most important therapy for infectious diseases. Many of the same basic principles apply to antimicrobial, antiparasitic and anticancer chemotherapy.
General principles of antibiotic therapy the journal of the. Edson, md on completion of this article, you should be able to. Antimicrobial therapy in veterinary medicine wiley. Many infectious diseases once considered incurable and lethal are now amenable to treatment with a few pills. These guidelines should be applied in the context of host characteristics, response to therapy, and cost of therapy. General principles of antimicrobial therapy surbhi leekha, mbbs. Minimum effective concentrations are those needed to inhibit growth bacteriostaticconcentration, micor kill bacteriocidal concentration, mbc the. Review the basic principles in selection of optimal antimicrobial therapy in pediatrics. However, it also is important to provide a substantial treatment course so that an infection is treated adequately and relapse is prevented. Antimicrobial therapy in veterinary medicine, 5th edition wiley. American association of feline practitioners american. In critically ill patients, such as those in septic shock, febrile neutropenic patients, and patients with bacterial meningitis, empiric therapy should be initiated immediately after or concurrently with collection of diagnostic specimens. Basic principles of antimicrobial therapy javed iqbal, fcps, frcs professor of surgeryquaideazam medical college, bahawalpur. The terms antimicrobial, antibiotic, and antiinfective encompass a wide variety of pharmaceutical agents that include antibacterial, antifungal, antiviral, and antiparasitic drugs.
Selective toxicity refers to the ability of the drug to targets sites that are relative specific to the microorganism responsible for infection. The etest biomerieux ab biodisk is a commercial version available in the united states. Antimicrobial use differs from other medications by its potential for collateral damage, specifically the generation of antimicrobial resistance, in both the patient and the wider population. Divided into four sections covering general principles of antimicrobial therapy, classes of antimicrobial agents, special considerations, and antimicrobial drug use in multiple animal species, the text is enhanced by tables, diagrams, and photos. Jun 06, 2016 principles of antimicrobial therapy pharmacology 1.
Pharmacology of antimicrobial agents lecture outline general introduction scope of the topic, basic concepts general principles of antimicrobial therapy mechanisms of action of antimicrobials pharmacology of individual agents general clinical considerations. Neither mechanisms of action nor clinical summary tables are included in this chapter because this information is provided in. Goodman and gilmans manual of pharmacology and therapeutics, 2e new york, ny. In antimicrobial therapy, the relationship is often expressed as an inhibitory sigmoid emax model, to take into account the control bacterial population without treatment econ as a fourth parameter equation 481 and figure 481, where e is the effect as measured by microbial burden. Drugs used to treat infectious diseases constitute one of our most widely used families of medicines. Antimicrobial therapy in veterinary medicine, 5th edition. Given sufficient time and drug use, antibiotic resistance will emerge 2. Ama citation general principles of antimicrobial therapy. Principles of antimicrobial therapy laith mohammed abbas alhuseini m. The selection of antimicrobial therapy and the timing of its administration are important. General principles of antimicrobial therapy class notes dr. Although this chapter focuses on antibacterial agents, many of the principles discussed also apply to antifungal, antiviral, and antiparasitic drugs. General principles of antimicrobial therapy goodman and. General principles of antibiotic therapy study guide by kmb103 includes 85 questions covering vocabulary, terms and more.
Principles of antimicrobial therapy chanu rhee and michael klompas background in the past several decades, advances in the development of antimicrobial agents have supplied the physician with dozens of drugs effective against bacterial, fungal, and viral pathogens. D department of pharmacology and therapeutics antimicrobial agents are chemical substances that can kill. By following these general principles, all practicing physicians should be able to use antimicrobial agents in a responsible manner that benefits both the individual patient and the community. Principles of antimicrobial therapy anesthesia key.
A short or long course of antibiotics can be given to a patient, depending on the drug used, the severity of an infection. In this chapter, the discussion focuses on general principles and some unique aspects of antimicrobial therapy in older infected patients. In the past several decades, advances in the development of antimicrobial agents have supplied the physician with dozens of drugs effective against bacterial, fungal, and viral pathogens. Principles of antimicrobial chemotherapy basicmedical key. As such, many clinicians prefer prescribing a shorter treatment course. Basic guidelines of judicious therapeutic use of antimicrobials. Provide an update on the epidemiologic basis for antibiotic selection. Antimicrobial therapy in veterinary medicine wiley online books. Successful antimicrobial therapy occurs when an effective concentration of drug is delivered to the site of infection for a sufficient period of time. General principles of antimicrobial therapy sciencedirect. Mar 25, 2016 general principles of antimicrobial therapy 1. Important considerations when prescribing antimicrobial therapy include obtaining an accurate.
For example, mild impetigo affecting a small area of skin can be treated by shortterm topical antibiotic preparations. Pdf the sanford guide to antimicrobial saidi miden. Pharmacologic principles of antimicrobial therapy i. Principles of antimicrobial therapy free medical textbook. By following these general principles, all practicing physicians should be able to use antimicrobial agents in a responsible manner that benefits both the individual. The inevitable consequence of the widespread use of antimicrobial agents has been the emergence of antibioticresistant pathogens, fueling an everincreasing need for new drugs antibiotics are antibacterial. Chapter 37 principles of antimicrobial chemotherapy overview chemotherapy is defined as the use of drugs to eradicate pathogenic organisms or neoplastic cells in the treatment of infectious diseases or cancer. Deciding on the duration of antimicrobial therapy for an infection is neither straightforward nor simple. These agents in general have very poor activity against anaerobes.
Aug 16, 20 divided into four sections covering general principles of antimicrobial therapy, classes of antimicrobial agents, special considerations, and antimicrobial drug use in multiple animal species, the text is enhanced by tables, diagrams, and photos. Principles of antimicrobial therapy key points early and rapid diagnosis of infection and prompt initiation of appropriate antimicrobial therapy, if warranted, are fundamental to reducing the mortality and morbidity from serious infections prompt initiation of broader empirical coverage of suspected pathogens followed by the narrowing or. In an age where antimicrobial resistance amongst pathogens grows more prevalent, particularly in the hospital setting, antimicrobial stewardship is an evidencebased, proven. Introduction to the symposium on antimicrobial therapy.
Antimicrobial therapy takes advantage of the biochemical differences between microorganisms and humans antimicrobial drugs should have selective toxicity towards the invading microorganism without harming the cells of the host this selective toxicity is usually relative rather than absolute, requiring careful control of the drug concentration. Communitybased outpatient parenteral antimicrobial therapy copat. The amount of antimicrobial agent that reaches the extravascular tissues and fluids where the infection is usually present depends on basic pharmacokinetic principles see chapters 2 and chapter 3. It also discusses principles for the selection of an appropriate antibiotic, dose, dose schedule, and type of antibiotic therapy. The term antimicrobial defines an agent that kills microorganisms or stops their growth.
Principles of antimicrobial therapy canterbury scl. Organisms resistant to one antibiotic are likely to. Resistance is progressive, evolving from low levels through intermediate to high levels 3. The terms antimicrobial, antibiotic, and antiinfective encompass a wide variety of pharmaceutical agents that include antibacterial, antifungal. Important considerations when prescribing antimicrobial therapy include obtaining an accurate diagnosis of infection.
Antimicrobial therapy then refers to the treatment of infectious diseases using therapy that kills these harmful microorganisms, such as antibiotics. Considerable variation exists among the many antimicrobial agents, and the pharmacokinetic profile of the antimicrobials is an important factor in. The timing of initial therapy should be guided by the urgency of the situation. Author links open overlay panel surbhi leekha mbbs a christine l. Prevention of antimicrobial resistance in healthcare settings requires an integrated. Antimicrobial treatment of ventilatorassociated pneumonia. Basic principles of antimicrobial therapy are used to evaluate treatment. Request pdf general principles of antimicrobial therapy antimicrobial agents are some of the most widely, and often injudiciously, used. The antimicrobial gradient diffusion method uses the principle of establishment of an antimicrobial concentration gradient in an agar medium as a means of determining susceptibility. Co, md, fpps, fpsecp professorial lecturer in antimicrobial therapy, graduate school university of santo tomas executive director, center for drug research evaluation and studies, inc. Quizlet flashcards, activities and games help you improve your grades. In the first article, leekha et al1 discuss general principles of antimicrobial therapy, dispensing pearls of infectious diseases. Antimicrobial agents are among the most commonly used and misused of all drugs.
General principles of antimicrobial therapy mayo clinic. Comments will also be made on some of the more useful classes of antimicrobial agents for treating infections in the elderly. General principles of antimicrobial therapy society for healthcare. Antimicrobial agents are some of the most widely, and often injudiciously, used therapeutic drugs worldwide. Principles of antimicrobial therapy flashcards quizlet. Good antimicrobial stewardship is a practice to ensure optimal selection, dose, and duration of an antimicrobial therapy best clinical outcome producing the fewest toxic effects the lowest risk for subsequent resistance antibiotic stewardship refers to a multifaceted approach to. Antimicrobial agents provide the most dramatic examples of the advances of modern medicine. Principles of antimicrobial therapy key points early and rapid diagnosis of infection and prompt initiation of appropriate antimicrobial therapy, if warranted, are fundamental to reducing the mortality and morbidity from serious infections. Minimum effective concentrations are those needed to inhibit growth. The early diagnosis of infective endocarditis is important so that effective antibiotic treatment may be started without delay. The bestrecognized example of nonantimicrobial therapy in the treatment of infections is the use of operative drainage or debridement.
Chapter 79 basic principles of antimicrobial therapy. Chemotherapy is based on the principle of selective toxicity. General principles of antimicrobial therapy mayo clinic proceedings. Antimicrobial therapy takes advantage of the biochemical differences that exist between microorganisms and human beings. What special pharmacokinetic and pharmacodynamic properties of a. This chapter presents an overview of the classes of antimicrobial drugs and the principles involved in selecting antimicrobial therapy. This must be considered in addition to the challenges involved in finding an agent with the appropriate spectrum of antimicrobial activity that also achieves a sufficient concentration at the site of. The fifth edition of antimicrobial therapy in veterinary medicine, the most comprehensive reference available on veterinary antimicrobial drug use, has been thoroughly revised and updated to reflect the rapid advancements in the field of antimicrobial therapy. However, there is evidence that antimicrobial resistance can be reduced by adopting rational policies for antimicrobial use and optimising the duration of empirical treatment. Principles of antimicrobial therapy study guide by drhernandezmd includes 37 questions covering vocabulary, terms and more. General principles of the treatment of infective endocarditis. Encompassing all aspects of antimicrobial drug use in animals, the book provides detailed coverage of virtually all types of. Most recommendations in infectious disease guidelines are based on either expert opinions or evidencebased medicine. Evidencebased practice guidelines from the infectious diseases society of america1 can help direct appropriate therapy for specific infectious disease syndromes as well as for infections caused by specific microorganisms.
The basic guidelines to judicious therapeutic use of antimicrobials in companion animals are designed to provide information to aid practicing veterinarians in choosing appropriate antimicrobial therapy. Microorganisms of medical importance fall into 4 categories. General principles of antimicrobial therapy academia. The following five principles are the foundation to. General principles of antimicrobial therapy request pdf. Request pdf general principles of antimicrobial therapy antimicrobial agents are some of the most widely, and often injudiciously, used therapeutic drugs worldwide. Principles of antibiotic therapy bja education oxford. Likewise, antibiotics are broadly classified as 1 antibacterial. The most important concept underlying antimicrobial therapy is selective toxicity i.
Of these, antibacterial agents are by far the most commonly used and thus are the focus of this article, although similar principles apply to the other agents as well. Unfortunately, these advances have been paralleled by increasing antibiotic resistance and the emergence of new pathogens. Selective toxicity is achieved by exploiting the differences between the metabolism and structure of the microorganism and the corresponding features of human cells. Selective toxicity selective toxicity refers to the ability of the drug to targets sites that are relative specific to the microorganism responsible for infection. For example, the antibiotic levofloxacin achieves skin tissueplasma peak concentration ratio of 1. Antimicrobial stewardship pdf download medical books.
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