Infections antibiotic selection

Antibiotics are appropriate for pancreatic necrosis, which can be infected initially or be susceptible to a secondary infection.21 Selected intravenous antibiotic regimens are shown in Table 20-2. If necrosis is confirmed, antibiotics are insufficient as sole therapy surgical debridement is necessary for cure. 

Kollef MH (2000) Ventilator-associated pneumonia the importance of initial empiric antibiotic selection. Infect Med 17 278-283... 

D. Treatment of bacterial infections Antibiotics that selectively affect bacterial function and have minimal side effects in humans are usually selected to treat bacterial infections. Rifampicin, which inhibits the initiation of prokaryotic RNA synthesis, is used to treat tuberculosis. Streptomycin, tetracycline, chloramphenicol, and erythromycin inhibit protein synthesis on prokaiyotic ribosomes and are used for many infections. Chloramphenicol affects mitochondrial ribosomes and must be used with caution. 

The proper route of administration for an antimicrobial depends on the site of infection. Parenteral therapy is warranted when patients are being treated for febrile neutropenia or deep-seated infections such as meningitis, endocarditis, and osteomyelitis. Severe pneumonia often is treated initially with intravenous antibiotics and switched to oral therapy as clinical improvement is evident. Patients treated in the ambulatory setting for upper respiratory tract infections (e.g., pharyngitis, bronchitis, sinusitis, and otitis media), lower respiratory tract infections, skin and soft tissue infections, uncomplicated urinary tract infections, and selected sexually transmitted diseases may receive oral therapy. 

Pichichero ME. Empiric antibiotic selection criteria for respiratory infections in pediatric practice. Pediatr Infect Dis J 1997 16 860-64. 

Duff P. Antibiotic selection in obstetric patients. Infect Dis Clin North Am 1997 11 1-12. 

Understanding antibiotic selection and the issues surrounding antibiotic penetration will assist in meeting the goals of treatment, which include eradication of infection with amelioration of signs and symptoms and prevention of neurologic sequelae, such as seizures, deafness, coma, and death. 

Staphylococcal endocarditis is not a homogeneous disease appropriate management requires consideration of several questions, such as. Is the organism methicillin resistant Should combination therapy be used Is the infection on a native or prosthetic valve Does the patient have a history of IVDA Is the infection on the left or right side of the heart Another consideration in staphylococcal endocarditis is that some organisms may exhibit tolerance to antibiotics. However, similar to streptococci, the concern for tolerance among staphylococci should not affect antibiotic selection. ... 

Cunha BA. Antibiotic selection for diabetic foot infections a review. J. Foot Ankle Surg. 2000 39 253-257. 

Ebert SC. Pharmacokinetic and pharmacodynamic considerations in antibiotic selection for different pneumonia settings. Infect Dis Clin Pract 1997 6 S43-S48. 

After a culture and sensitivity report is received, the strain of microorganisms causing the infection is known, and the antibiotic to which these microorganisms are sensitive and resistant is identified. The primary health care provider then selects the antibiotic to which the microorganism is sensitive because that is the antibiotic that will be effective in the treatment of the infection. 

Promoting Optimal Response to Therapy The results of a culture and sensitivity test take several days because time must be allowed for the bacteria to grow on the culture media However, infections are treated as soon as possible In a few instances, the primary health care provider may determine that a penicillin is the treatment of choice until the results of the culture and sensitivity tests are known. In many instances, the primary health care provider selects a broad-spectrum antibiotic (ie, an antibiotic that is effective against many types or strains of bacteria) for initial treatment because of the many penicillin-resistant strains of microorganisms. 

Antibiotics possess antibacterial activity and are used in the treatment of eye infections. Sulfonamides possess a bacteriostatic effect against a wide range of gram-positive and gram-negative microorganisms. They are used in the treatment of conjunctivitis, comeal ulcer, and other superficial infections of the eye. See the Summary Drug Table Select Ophthalmic Preparations and Chapter 6 for additional information on the sulfonamides. 

Quenzer RW, Pettit KG, Arnold RJ, Kaniecki DJ. Pharmacoeconomic analysis of selected antibiotics in lower respiratory tract infection. Am J Manag Care 1997 3 1027-36. 

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