antibiotics in critically ill patients clinical pharmacology

87 Pages·2016·3.78 MB·English

ANTIBIOTICS IN CRITICALLY ILL
PATIENTS
CLINICAL PHARMACOLOGY
Lenka Součková
Control of infectious disease
MMWR, Achievements in Public Health, 1900-1999: Control of Infectious Diseases, 1999 / 48(29);621-629
Great antibiotic
Clear Cure the
Pathogen
solution patient
Is always ATB great?
Clear Cure the
Pathogen
solution patient
Critical steps in antibiotic therapy
Determine

the right time initiating antibiotic therapy - golden hour of sepsis

ATB selection

the correct dose - dose optimisation - iv to oral switch

the correct time interval

duration of antibiotic therapy - de escalation

inappropriate or redundant antibiotics (dual anaerobic cover etc)

Recognize different types of ADRs of individual antibiotics and

suitably replace
Identify where the use of antibiotics inappropriate / unwanted

Normal flora
Normal Conditional
Pathogen
Pathogen Pathogen
Microbes that engage in mutual or commensal

associations - normal (resident) flora, indigenous flora,
microbiota
Infection- a condition in which pathogenic microbes

penetrate host defenses, enter tissues and multiply
Disease – any deviation from health, disruption of a

tissue or organ
Caused by microbes or their products – infectious

disease

Symbiosis,
natural
protection
Eradicate
all
pathogens
Innate Resistance to Infection
Nonspecific physical, anatomical, and chemical
•
barriers prevent colonization of the host by
most pathogens
Lack of these defenses results in susceptibility
•
to infection and colonization by a pathogen.
Anatomic barriers breached (IV’s, foleys, vents etc.)

Exposure to virulent pathogens

many resistant to multiple antibiotics
