Antibiotics administration

Antibiotic administration during contraceptive use may decrease the efficacy of many combined contraceptives. 

Ethinyl estradiol is metabolized in the liver via the cytochrome P-450 system. It is metabolized primarily via CYP450 3A4. When reviewing drug interactions of oral contraceptives, it is important to keep in mind that antibiotic administration during contraceptive use may decrease the efficacy of many combined contraceptives. Refer to Table 45-4 for a list of common drug interactions seen with oral contraceptives.1,31... 

Correct timing of antibiotic administration is imperative to preventing SSI. 

Intravenous antibiotic administration is the most common delivery method for surgical prophylaxis. Intravenous administration ensures complete bioavailability while minimizing the impact of patient-specific variables. Oral administration is also used in some bowel operations. Non-absorbable compounds like erythromycin base and neomycin are given up to 24 hours prior to surgery to cleanse the bowel. Note that oral agents are used adjunctively and do not replace IV agents. 

Correct timing of antibiotic administration is imperative to preventing SSI. The National Surgical Infection Prevention Project recommends infusing antimicrobials for surgical prophylaxis within 60 minutes of the first incision. Exceptions to this rule are fluoroquinolones and vancomycin, which can be infused 120 minutes prior to avoid infusion-related reactions.1 No consensus has been reached on whether the infusion should be complete prior to the first incision. However, if a proximal tourniquet is used, antibiotic administration should be complete prior to inflation. 

Serum bactericidal titer The lowest titer of serum and antibiotic obtained from the patient, usually at the peak or trough of antibiotic administration, that results in a 99.9% kill of bacteria. 

There are two principal ways of antibiotic administration, which may be used (i) the local, intracisternal application and/or (ii) systemic injection or infusion. For clinical mastitis, cure rates based on visual assessment of symptoms after either local or systemic administration of antibiotics were... 

Animal and human studies support the use of antibiotics for the prevention of infectious morbidity and mortality in severe ANP. The most effective antimicrobial agents are the fluoroquinolones, imipenem-cilastatin, and metronidazole, which achieve adequate penetration into pancreatic juice and necrotic tissue and inhibit the growth of enteric bacteria. Although a recent meta-analysis [185] suggested that prophylactic antibiotic administration reduces sepsis and mortality and this approach has been recommended by recent guidelines and consensus state-... 

The route of antibiotic administration might be crucial. Animal studies [193, 194] have shown that enteral administration (either by oral or rectal route) of antimicrobials reduces the rate of bacterial translocation and early mortality in rats or mice with experimentally induced pancreatitis. Indeed, in patients with ANP, selective bowel decontamination with oral and rectal antibiotics decreased the infection rate [195]. 

Sharma VK, Howden CW Prophylactic antibiotic administration reduces sepsis and mortality in acute necrotizing pancreatitis A meta-analysis. Pancreas 2001 22 28-31. 

As the patient improves the route of antibiotic administration should be reevaluated. Switch to oral therapy is an accepted practice for many infections. Criteria favoring switch to oral therapy include ... 

Parenteral antibiotic administration is favored because of its reliability in achieving suitable tissue concentrations. 

Extending antibiotic administration beyond 48 hours does not lower SSI rates. 

The importance of the gut microflora in the metabolism of isoflavones has been demonstrated. Antibiotic administration blocks isoflavone metabolism and germfree animals do not excrete metabolites. Moreover, only germfree rats colonized with microflora from a good equol producer excrete equol when fed soy. ... 

Treatment cf these disease states may be based on vaccination or drugs. In some cases, e.g. swine dysentery, no vaccines are available, so antibiotic treatment is essential. Antibiotic administration may be prophylactic or therapeutic with pigs, in particular, agents to control dysentery are routinely added to feedstuff or drinking water. The route of administration may also be highly important. For instance, in ruminants the preferred mode is injection, e.g. parenterally. The oral route, which introduces antibiotics directly into the rumen, may upset the delicate balance of rumen bacteria which are necessary to ferment carbohydrates to fatty acids — an essential component of the energy supply of ruminants. 

Mechanism of Action. The mechanisms by which antibiotic administration at subtherapeutic levels enhance growth rate and efficiency of gain in growing animals have not been clarified. Possible modes of action include disease control, nutrient sparing, and metabolic effects. There is extensive evidence that the principal benefit from subtherapeutic use of antibiotics results from the control of harmful microoiganisms. 

Bergogne-Berezin, E., and A. Bryskier. 1999. The suppository form of antibiotic administration Pharmacokinetics and clinical application. J Antimicrob Chemother 43 177. 

Correct answer = D. It is important to increase the cardiac output to improve oxygen delivery and thus minimize anaerobic metabolism and improve CNS and renal perfusion. Since this patient apparently does not have a heart condition, such as congestive heart failure, she could benefit from fluid therapy. An inotropic agent, such as dopamine, would lead to an increased cardiac output and dilation of the renal vasculature. [Note At high doses, however, it may constrict the renal beds due to interaction on a receptors.] Antibiotic administration is also important but will not improve the patient s hemodynamics. 

Cefazolin has been extensively studied and is currently considered the drug of choice. Patients weighing 80 kg should receive 2 g cefazolin rather than 1 g. Doses should be administered no earlier than 60 minutes before the first incision and no later than the beginning of induction of anesthesia. Extending antibiotic administration beyond 48 hours does not lower SSI rates. Vancomycin use may be justified in hospitals with a high incidence of SSI with MRSA or when sternal wounds are to be explored for possible mediastinitis. 

Marshall DA, McGeer A, Gough J, Grootendorst P, Buitendyk M, Simonyi S, Green K, Jaszewski B, MacLeod SM, Low DE. Impact of antibiotic administrative restrictions on trends in antibiotic resistance. Can. J. Public Health 2006 97 126-131. 

Antibiotics Administration of antibiotics (e.g. cefotaxime) is advisable, starting 2 days prior to and continuing for about 3 days after shunt placement. 

In spite of the fact that most trials of antibiotics in pregnancy have shown that antibiotic administration prolongs pregnancy, the mechanism is unclear. However, it is well established that several antibiotics can alter intracellular calcium concentrations (1-3) or inhibit some enzymes, including various phospholipases (4). It is also well established that bacterial products, such as phospholipases and... 

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