PHA3801 Lecture Notes - Lecture 19: Broadspectrum, Rifampicin, Ciprofloxacin
24 Jul 2018
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Inc life span since introduction of antimicrobial therapy. Criteria of indication: restrict use of ab"s to unavoidable situations. Risk of resistance, unwanted side effects (allergies, alteration of normal intestinal flora resulting in diarrhoea or in superinfection w opportunistic pathogens. Whenever possible, identify and test resistance of bacteria, specifically when a severe infection is present. Selective toxicity: toxic for the pathogenic organism, but innocuous to the pt. Relies on qualitative or quantitative differences b/w the host and the pathogen. Patient: age, renal + hepatic function, drug sensitivity, resistance to infection, pregnancy, lactation. Drug: pharmacokinetics, adverse effects, antimicrobial prophylaxis, combination therapy. Documentation of infection: clinical suspicion should be supported by lab dx. Drug sensitivity: ask about previous exposure to drugs penicillins + cephalosporins hypersensitivity (anaphylaxis). Diminished resistance to infection: pt w malignant disease, on cytotoxic drugs and immunosuppressants (ddi"s) Streptomycin, tetracyclins, gentamicin, kanamycin = harmful to fetus.
