Antimicrobial treatment

Microbiologists have developed the following hierarchy to categorize the expected level of performance of antimicrobial treatments ... 

Kollef MH, Sherman G, Ward S, Fraser VJ. Inadequate antimicrobial treatment of infections A risk factor for hospital mortality among critically ill patients. Chest 1999 115(2) 462M74. 

Discuss the pathophysiology of CNS infections and the impact on antimicrobial treatment regimens (such as dosing and CNS penetration). 

Anon JB, Jacobs MR, Poole MD, et al. Antimicrobial treatment guidelines for acute bacterial rhinosinusitis. Otolaryngol Head Neck Surg 2004 130(1 suppl) lM5. 

The duration of antimicrobial treatment should be for a total of 5 to 7 days for most intraabdominal infections. 

For most patients, antimicrobial treatment can be completed orally with amoxicillin-clavulanate or the combination of ciprofloxacin and metronidazole. 

Five to seven days of antimicrobial treatment are sufficient for most intraabdominal infections of mild to moderate severity. 

On the fifth day of antimicrobial treatment, determine if parenteral antimicrobial agents can be switched to oral agents to complete therapy. 

The goals of antimicrobial treatment in UTIs are to eradicate the offending organism and prevent recurrence of infection. Uncomplicated UTIs may be managed with 3-day or even 1-day regimens, while complicated UTIs should be treated for at least 7 days, and sometimes up to 2 weeks. 

Warren JW, Abrutyn E, Hebei JR, et al. Guidelines for antimicrobial treatment of uncomplicated acute bacterial cystitis and acute pyelonephritis. Clin Infect Dis 1999 29 745-758. 

In order to understand current approaches for prevention and control of biofilms, we must first consider the reasons for the failure of conventional antimicrobial protocols. There are thought to be three main reasons as to why biofilm bacteria out-survive their planktonic counterparts during antimicrobial treatments (reviewed by McBain et a/.16).These are i) poor penetration of antimicrobial compounds due to the presence and turn-over of exopolymer slime (glycocalyx) ii) the imposition of extreme nutrient limitation within the depths of the biofilm community and the co-incident expression of metabolically-dormant, recalcitrant phenotypes and (iii) the expression of attachment-specific phenotypes that are radically different and intrinsically less susceptible than unattached ones. 

Table 6 Performance of equivalent bromine antimicrobial treatments against biofilms in well-controlled laboratory experiments to simulate industrial applications % Removal % Decrease in Fluid Biofilm Disinfection Oxidizing of Biomass Frictional Resistance (Log Reduction in...

Antimicrobial agents may adversely affect the light fastness of nylon dyeings or cause yellowing of the fibre. The six antimicrobial treatments listed in Table 10.51 have been... 

The oral bacterium Streptococcus mutans, containing the luciferase gene of Pyrophorus plagiophtalatus, was used as rapid assay to estimate the effects of various antimicrobial treatments [93],... 

Although treatment is minimally effective if used for 7 days, 10-14 days of treatment is recommended. The antisecretory drug may be continued beyond antimicrobial treatment in patients with a history of complicated ulcer (e g., bleeding or in heavy smokers). In the setting of an active ulcer, acid suppression is added to hasten pain relief. 

Table 42-4 presents recommended and alternative regimens for selected situations. These are general guidelines, not rules, because there are many factors that cannot be incorporated into such a table. Guidelines for initial antimicrobial treatment of specific intraabdominal infections are presented in Table 42-5. 

Most cases of pharyngitis are self-limited however, antimicrobial therapy will hasten resolution when given early to proven cases of group A Streptococcus. Symptoms generally resolve by 3 to 4 days even without therapy. Children should be kept home from daycare or school until afebrile and for the first 24 hours after antimicrobial treatment is initiated,... 

The spectrum of respiratory tract infections (RTI) can vary from the common cold to acute or chronic bronchitis to community-acquired pneumonia to nosocomial pneumonia and aspiration pneumonia to ventilator-associated pneumonia to chronic pneumonia (in cystic fibrosis, histoplasmosis, tuberculosis, etc.). Important complications are lung abscess and pleural empyema that will often need drainage and prolonged antimicrobial treatment (>6 weeks). 

Although the cause of non-specific urethritis in males is unknown, several microbiological etiologies have been postulated and a trial course of antimicrobial treatment is usually given. A single dose of azithromycin 1 g or a 7 days course of 2 x 200 mg ofloxacin daily have been advocated. 

The theoretical basis of light-induced antimicrobial treatment is described, followed by examples of its application for the cleaning and disinfection of surfaces. All available information supports the idea that PDT could offer a very efficient and cost-effective way to combat microbial contamination of foods. The advantages and pit-falls of the technique are discussed. Directions of future research needed for bringing the technology to commercial reality are identified. 

FIGURE 3.8 Major classes of photosensitizers used for antimicrobial treatment. 

Paper and textile production retention, coagulation, flocculation, wet strength, dry strength improvement, dewatering, color fastness, dye fixation, antistatic agents, antimicrobial treatment... 

Optimal therapy of patients with peptic ulcer disease (both duodenal and gastric ulcers) who are infected with K pylori requires antimicrobial treatment. To document infection with fcL pylori, endoscopic biopsy of the gastric mucosa or various noninvasive methods are available, including serologic tests and breath tests for urea. Figure 24.2 shows a biopsy sample with i . pylori closely associated with the gastric mucosa. Eradication of FL pylori results in rapid healing... 

Correct answer = D. Elevated blood pressure would not be expected to markedly influence the type of antimicrobial treatment employed. Anticancer drugs often suppress the immune function, and these patients require additional antibiotics to eradicate infections. Impaired renal function may lead to accumulation of toxic levels of antimicrobial drugs. Renal and hepatic function are often decreased among the elderly. Impaired liver function may lead to the accumulation of toxic levels of antimicrobial drugs. 

Some of the chemical strategies used in weatherproofing have been applied to the preservation of cellulosics for indoor storage and display. The historical Wasa sails of 1628 were preserved by copolymerizing acrylates and styrene onto this material (36). Antimicrobial treatment of cotton goods by polymerization in situ of a urea-mercury compound with formaldehyde or immersion in a quaternary ammonium salt solution protected the fabric for up to three years storage provided it did not need to be laundered (37). 

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