Host factors, antimicrobial drugs

Host factors can help to ensure selection of the most appropriate antimicrobial agent. Age is an important factor in antimicrobial selection. With regard to dose and interval, renal and hepatic function varies with age. Populations with diminished renal function include neonates and the elderly. Hepatic function in the neonate is not fully developed, and drugs that are metabolized or eliminated by this route may produce adverse effects. For example, sulfonamides and ceftriaxone may compete with bilirubin for binding sites and may result in hyperbilirubinemia and kernicterus. Gastric acidity also depends on... 

To select rational antimicrobial therapy for a given infection, a variety of factors must be considered, including the severity and acuity of the disease, host factors, factors related to the drugs used, and the necessity for use of multiple agents. 

Several host factors should be considered when evaluating apatient for antimicrobial therapy. The most important factors are drug allergies, age, pregnancy, genetic or metaboUc abnormalities, renal and hepatic function, site of infection, concomitant drug therapy, and underlying disease states. 

Numerous factors, such as underlying disease, immunosuppressive drug therapy, and antimicrobial administration, determine the immunocompromised host s risk of developing infection. Several risk factors are present concomitantly in many patients (see Table 120-1). 

The application of collagen to topical drug delivery has been relatively limited for growth factors, but much more success has been in its application as a vehicle for topical antimicrobial compounds [129]. A widespread application of the antimicrobial agents is used on the open burn wound surface and other extreme trauma. They can substantially reduce and prevent the microbial biobru-den load and risk of infection/ reinfection and colonization of bacteria which interfere with wound healing processes by inducing an inflammatory host response [130,131] (Table 13.2). 

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