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What does MIC mean?
lowest concentration of an antibiotic that completely inhibits the growth of a microorganism in vitro; expressed as a concentration
What is a breakpoint?
discriminatory antimicrobial concentrations used in the interpretation of results of susceptibility testing to define isolates as susceptible, intermediate or resistant
What is MBC?
lowest concentration of the antibiotic which results in a 99.9% reduction in colony forming units in a given time
How do you interpret an MIC breakpoint of susceptible?
clinical success can be expected if treated with usual doses
How do you interpret an MIC breakpoint of intermediate?
clinical success may be possible if:
high doses of antibiotics are used
antibiotic concentrates at the site of infection
possible combination agents are used
How do you interpret an MIC breakpoint of resistant?
treatment failure is expected
What is broth microdilution?
a known quantity of bacteria is paced into each tube with an increasing antibiotic concentration, the lowest concentration of an antimicrobial that results in the inhibition of visible growth of a microorganism is the MIC
What is the infectious disease triad?
bacteria, drug, and host
What is the relationship in the infectious disease triad of the drug to the host?
toxicodynamic
What is the relationship in the infectious disease triad of the host to the drug?
pharmacokinetics
What is the relationship in the infectious disease triad of the host to the bacteria?
host defenses
What is the relationship in the infectious disease triad of the bacteria to the host?
infection
What is the relationship in the infectious disease triad of the bacteria to the drug?
resistance
What is the relationship in the infectious disease triad of the drug to the bacteria?
pharmacodynamics and efficacy
What bacteria most commonly causes bacterial meningitis?
streptococcus pneumonia
What bacteria most commonly causes otitis media?
streptococcus pneumoniae
What bacteria most commonly causes community acquired pneumonia?
streptococcus pneumonia
What is the most common bacteria that causes skin infections?
staphylococcus aureus
What bacteria most commonly causes eye infections?
staphylococcus aureus
What bacteria most commonly causes an upper respiratory tract infection?
streptococcus pyogenes
What ranking does infectious and parasitic diseases have in terms of global death burden?
2
True or False: antibiotic resistance is inevitable.
true
Why are we constantly behind the curve of antibiotic resistance?
they evolve fast; bacteria double every 20-40 mins; they have a much shorter lifespan
What patient considerations should be made in infectious diseases?
host, infection (site and severity), MICs, treatment regimens
How do you maximize efficacy in infectious disease treatment?
bacterial killing, positive outcomes in patients
How do you minimize toxicity in infectious disease treatment?
avoid toxicities/ADRs (usually through TDM), minimize resistance
What is the timing/order of information you gain from a bacteria culture?
gram stain → organism identification → organism susceptibilities
How long does it take to figure out the susceptibility of a culture?
72-96 hours
What kind og antibiotics cause collateral damage?
broad spectrum (will kill some good bacteria also)
What does a 100 mean on an antibiogram?
this drug will be effective against those bacteria 100% of the time
What does a 0 mean on an antibiogram?
the medication will be effective 0% of the time on those particular bacteria
What antibiotic on a antibiogram can be used to see % of MRSA?
oxacillin
If imipenem has 100%/high effectiveness on gram-negative bacteria, what kind of antibiotic would it be classified as?
broad spectrum antibiotic
If ampicillin has 0% effectiveness against most gram-negative bacteria except for 1 or 2, what class of antibiotic is this?
narrow spectrum antibiotic
How are breakpoints set?
by the clinical and laboratory standards institute for each medication