GH 5036                    

 

Antibiotics

Key concepts

     Resistance

     Epidemiology

     "Triples"

   

Introduction  - Indications 

Pharmacology - Drugs 

ManagementComplications

 

     

 


 

 

Introduction

 

Antibiotics are used to prevent as well as treat infections in 5036. 

 

    Epidemiology  

 

Multiple organisms alone, but more commonly in combination, infect patients in 5036.

The vast majority of infections in the Neurosurgical ICU are by bacteria.  Staph is the most common bacterial infection.

 

    Resistance

 

Pathogens develop defenses against antibiotics.  Antibiotics designed to kill many species of bacteria at once can kill all of the normal beneficial bacteria that live in the patient making it possible for bacteria and fungus that normally would not be dangerous to colonize and multiply.

 

 

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Indications

 

Antibiotics are indicated in at least 3 scenarios in 5036:

 

1. Peri-operative 

         Pre-Op:  antibiotics may be ordered "on-call" to OR.

         Post-Op:  24 - 48 hours

2. Pre-morbid 

         Pneumonia, skin, urine infections

3. Aspiration

         Empiric antibiotics

4. Nosocomial

     

     Clinical 

 

Fever

Elevated white blood cell count

 

 

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Pharmacology

 

Antibiotics, like most drugs, are deactivated and broken down for elimination by the liver and kidneys.  

Patients with liver disease may have problems breaking down and using (i.e. metabolizing) come kinds of antibiotics.  

In patients with kidney disease who cannot break down an antibiotic and excrete it (in the urine) the antibiotic will continue to circulate and as subsequent doses are given, to accumulate.  Toxic levels of some antibiotics can injure some organs.  Higher concentrations of antibiotics may make some patients more likely to have allergic reactions.

 

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Drugs

 

The 5 most commonly used antibiotics are:

Doug and Traci: what are these.  What are they used for?

 

 

 

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Management

 

Administer at intervals

Monitor for complications

 

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Complications

 

 

C difficile superinfection

Allergic reaction

Steven's Johnson

Other

 

 

 

 

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