PC 2 mod 1.2 lec 1

systemic signs and symptoms of infection

--> fever

--> malaise

--> chills rigor

--> _____

--> _____

--> ______

- tachypnea

- tachycardia

- hypotension

normal WBC is ____ and elevation is sign of infection, inflammation, stress, leukemia, drugs (NOT ALWAYS INFECTION)

4,500-10,000

will everyone with infection have leukocytosis?

no... elderly, severe sepsis, cancer, immunocompromised won't

bacterial infection is associated with INCREASED/DECREASE granylocytes (neutrophils)

increased

segmented neutrophils are also called _____ and these are MATURE/IMMATURE

- polymorphonuclear leukocytes

- mature

______ shift of WBC is normal infection

left

______: elevated in presence of inflammation mostly produced by liver

(nonspecific test)

acute phase reactants

acute phase reactant is nonspecific test that is elevated in presence of ______ mostly produced by _____

- inflammation

- liver

3 types of community acquired pneumonia

- strep pneumoniae

- haemophilis influenzae

- staphylococcus aureus

3 atypical types of pneumonia

- mycoplasma pneumonia

- chlamydia pneumonia

- legionella pneumophila

mycobacterium TB can cause ______ infection

pneumonia

3 common causes of skin infection

- staphylococcus aureus

- strep pyogenes

- pseudomonas aeruginosa

4 common causes for UTI

- e. coli

- other enterobacteriaceae

- staphylococcus saprophyticus

- pseudomonas aeruginosa

primary prophylaxis is treatment to prevent an infection process from ______

developing

secondary prophylaxis is treatment to prevent infection _______

recurrence

tertiary prophylaxis is treatment to decrease _______ of infection

effects or spread

empiric therapy is based on presumptive infectious disease, so it is important to know the _____ of infection

site

aids in the selection of empiric antimicrobial regimen while awaiting culture/susceptibility results and is institution specfic

antibiogram

antibiograms are _______ specific

institution (resistance rates differ)

aminoglycoside based on _____/MIC ratio

peak

fluoroquinolones based on ______/MIC ratio

AUC

beta-lactams based on ______/MIC ratio

time

peak/MIC is for...

aminoglycosides

AUC/MIC is for...

fluoroquinolones

T/MIC is for...

beta-lactam

empiric therapy is BROAD/NARROW coverage and this can select for _______

- broad

- resistance

failure of treatment is considered if... (3)

- suboptimal/partial response

- recurrence

- reinfection

potential causes for therapeutic failure...

--> inadequate _______

--> ______ pathogen

--> inadequate _______

--> unaddressed ______

--> _______ cause of fever

- dose

- resistant

- drug level

- source of infection

- non-infectious

bactericidal agents are preferred in patients who are...

immunocompromised

bacteriostatic agents rely on _____ to clear tissues on infecting microorganisms

host defense

3 bactericidal agents (not including ones we learned)

- metronidazole

- daptomycin

- glycopeptides/lipoglycopeptides

5 bacteriostatic agents

- macrolides

- sulfonamides

- clindamycin

- linezolid

- tetracycline/tigecycline

vancomycin is a _____/MIC killing

AUC/MIC

_______ killing means rate of killing increases as antibiotic conc. increases

(2 types)

- concentration dependent

- peak/MIC and AUC/MIC

in time dependent killing, rate and extent of killing DOES/DOES NOT increase with higher drug conc, and efficacy is enhanced when duration is over MIC is maximized about ___%

50%

_______ is when there is persistent suppression of bacterial growth even after brief exposure to antibiotic, even after drug concentration falls below MIC

post-antibiotic effect (PAE)

post antibiotic effect allows for ____ administration of antibiotic to maintain antibacterial activity

less frequent

antibiotics with post antibiotic effects against gram positive (4)

- vancomycin

- daptomycin

- penicillins

- cephalasporins

antibiotics with post antibiotic effects against gram negatives (2)

- aminoglycosides

- polymyxins

antibiotics with post antibiotic effect against gram+ and gram- (2)

- carbapenems

- fluoroquinolones

if bacteriostatic and bacteriocidal agents are given together, this results in...

antagonism

is blood usually colonized?

is CSF?

is urine?

is lower resp?

- no

- no

- no

- no