MICU Antibiotics and Associated Drug Interactions

Size: px
Start display at page:

Download "MICU Antibiotics and Associated Drug Interactions"

Transcription

1 MICU Antibiotics and Associated Drug Interactions

2 Resistant Bacteria MICU patient are at risk for resistant organisms: Recent hospitalizations From a skilled nursing facility Immunocompromised patients Transplant population Chronic steroid use

3 Organisms of Concern Gram Negative organisms Pseudomonas aeruginosa Acinetobacter Klebsiella pneumoniae ESBL E.Coli ESBL Staph Aureus MRSA Enterococcus faecalis & faecium VRE

4 Antibiotic Management Program (AMP) Patient safety initiative to address: The infections related to C. difficile Increasing antimicrobial resistance Increasing antimicrobial cost

5 Commonly Used Restricted Antibiotics Must call AMP to get an approval code (Full list on page 12 of Guide to Antimicrobial Chemotherapy) Commonly used agents Ciprofloxacin Moxifloxacin Linezolid Ceftriaxone Ceftazidime Aztreonam Daptomycin Clindamycin Meropenem Imipenem Oral Vancomycin unless you fill out a C.diff order set

6 Not Restricted in the ICU Vancomycin Zosyn (piperacilin/tazobactam) Cefepime Aminoglycosides Gentamicin Tobramycin

7 Pharmacodynamics Concentration dependant killing Goal: maximize the concentration AUC/MIC ratio and Peak/MIC are predictors of efficacy Antibiotics kill with increasing antibiotic concentrations at a greater rate and extent Aminoglycosides Fluoroquinolones Metronidazole

8 Pharmacodynamics Time dependent killing Goal: Maximize duration of exposure T > MIC correlates best with efficacy Antibiotics kill bacteria at the same rate and extent once an appropriate a threshold concentration is achieved Increasing concentration does not augment the antibacterial activity Vancomycin, clindamycin, macrolides and ß-lactams

9 Pharmacodynamics of Time Dependant Killers: (Beta-Lactams and Macrolides) Craig et al, Ped Infect Dis 15: 255, 1996

10 Concentration vs. Time dependant Killing

11 Post Antibiotic Effect The continued suppression of antibacterial growth After the administration of antibiotic has ceased Serum concentrations have fallen below the minimum inhibitory concentration

12 Post Antibiotic Effect 3 hour PAE Antibiotic is stopped

13 Specific Antibiotics

14 Vancomycin Indications (pg. 17 Abx book) Treatment of: Serious infections due to beta-lactam resistant gram positive microorganisms Gram positive infections in patients with allergies to beta-lactam antimicrobials When antibiotic-associated colitis fails to respond to metronidazole, or if it is severe and life threatening (PO Vancomycin only) Prophylaxis AS recommended by the American Heart Association, for endocarditis after certain procedures in patients at high risk for endocarditis Surgical procedures involving implantation of prosthetic materials or devices at institutions with a high rate of infections due to MRSA or MRSE Patients with severe penicillin allergy

15 Vancomycin Loading Dose needed? Seriously ill patients and patients with complicated infections Morbidly obese patients (fill extravascular compartment rapidly) mg/kg x1 (actual body weight) Determine Maintenance Dose: mg/kg IV Q12 hours Use actual body weight Higher end of dosing range for CNS, endocarditis, osteomyelitis Determine Interval Adjust frequency for renal function CVVHD Dosing: 1 g IV q 24 hr Intermittent dialysis: Administer doses after dialysis session Oral formulation NOT absorbed; use for local GI tract infection, ie. Clostridium difficile

16 Checking Vancomycin Troughs Trough: measure for efficacy Draw 30 minutes before the 4 th dose in patients with normal renal function Patients on HD-draw a level after each dialysis session Intermittent Hemodialysis: During a typical 4 hr session, 30-50% of vanco is removed Drawn a level 4-6 hrs after completion of dialysis to allow for redistribution Trough Targets Target trough: mg/l for pneumonia, endocarditis, meningitis mg/l most other sites Oral formulation NOT absorbed; use for local GI tract infection, ie. Clostridium difficile

17 Vancomycin Adverse Effects Eosinophilia, reversible neutropenia, thrombocytopenia Ototoxicity (associated with high peaks) Red Man s Syndrome Not an allergy, but a release of histamine due to the rate of the infusion SOLUTION: Infuse the drug over a longer time period (2 hrs instead of 1hour)

18 Linezolid Effective against MRSA Indicated to treat infections due to Gram positive organisms Dose: 600 mg q12 hrs. for both IV and PO high bioavailability Monitoring Thrombocytopenia (black box warning) Peripheral neuropathy Drug interactions Linezolid has MAO-I-like properties Interaction with SSRI, TCAs Serotonin syndrome: fever, mental status changes, tremors No renal adjustment Expensive: $82/tablet

19 Daptomycin Spectrum of activity: Gram positives i.e MRSA Poor activity in the lungs due to inactivation DO NOT use for pneumonia IV only Adverse effects: Myopathy at high doses, monitor CPK Adjust dose for renal function

20 Extended-Spectrum PCNs + ß lactamase Inhibitor Zosyn (pipercillin/tazobactam) Coverage: Most Gram positives, Gram negative including Pseudomonas Anaerobic coverage Dose: 4.5 g IV with frequency based upon renal function CVVHD: 4.5 g IV q8 Adverse Effects: Thrombocytopenia, lowers seizure threshold, diarrhea

21 4 th Generation Cephalosporin Cefepime Gram Positive and Gram Negative coverage Covers Pseudomonas Dosing: Serious systemic infection 2 g IV q12 Other infections (pneumonia) 1 g IV q12 **Frequency is based upon renal function** CVVHD: 1 g IV q12h Adverse effects: Diarrhea, thrombocytopenia, lowers seizure threshold

22 5 th generation cephalosporin Ceftaroline fosamil Non-formulary restricted requiring Antibiotic Management Program or ID/ P&T Chair Approval (as per institution policy) Ceftaroline fosamil is a semi-synthetic prodrug of ceftaroline, a broadspectrum cephalosporin and the first available beta-lactam to demonstrate bactericidal activity against methicillin resistant Staphylococcus aureus (MRSA). Ceftaroline inhibits bacterial cell wall synthesis by binding to penicillin binding proteins (PBPs), leading to inhibition of bacterial cell wall synthesis. 1 Ceftaroline has improved activity against MRSA due to increased affinity for PBP 2a. 2

23 Ceftaroline fosamil Non-formulary approvable uses may include: Alternative for complicated skin and skin structure infections: Staphylococcus aureus (including MSSA and MRSA), Streptococcus pyogenes, Streptococcus agalactiae, Escherichia coli, Klebsiella pneumonia and Klebsiella oxytoca when other options are not appropriate due to organism resistance, drug allergy or adverse events. (1B) Alternative for community acquired bacterial pneumonia with a PORT score III-IV due to: Streptococcus pneumoniae (including cases with concurrent bacteremia), Staphylococcus aureus (MSSA isolates only), Haemophilus influenzae, Klebsiella pneumoniae, Klebsiella oxytoca, and Escherichia coli. when other options are not appropriate due to organism resistance, drug allergy or adverse events. (2A) Data are currently insufficient to support the use of ceftaroline fosamil for the treatment of bacterial pneumonia due to methicillin resistant Staphylococcus aureus (MRSA).

24 Ceftariline fosamil Usual dosage range: IV: 600 mg every 12 hours Indication-specific dosage: IV: Pneumonia, community-acquired: 600 mg every 12 hours for 5-7 days Skin and skin structure, complicated: 600 mg every 12 hours for 5-14 days Adjust dose in renal impairment CrCl >50 ml/minute: No dosage adjustment necessary. CrCl >30-50 ml/minute: 400 mg every 12 hours CrCl ml/minute: 300 mg every 12 hours CrCl <15 ml/minute: 200 mg every 12 hours ESRD patients receiving hemodialysis: 200 mg every 12 hours; dose should be given after hemodialysis on dialysis days

25 Aztreonam Aerobic Gram negatives only Pearls: Many hospitals with resistant organisms, not good empiric choice UPMC susceptibilities Pseudomonas only 56% Acinetobacter 0% Consider double coverage until sensitivities are available Very low cross-sensitivity with ß-lactams Can be useful in allergy situations Time-dependent killing Kidney insufficiency - decrease dose, maintain interval Adverse effects: Rash, diarrhea, thrombocytopenia

26 Aminoglycosides IV Gentamicin Tobramycin Amikacin Streptomycin (IM) PO Neomycin Not sig. absorbed Used for hepatic encephalopathy

27 Gram Negative activity Aminoglycosides Synergy with a Beta Lactam for Gram Positives Endocarditis Common ADEs: Elevated trough concentrations Otoxicity Nephrotoxicity Elevated Peak concentrations Neuromuscular blockade Concomitant use of NMB, myasthenia gravis, hypocalcemia Narrow therapeutic window Monitor levels Especially with changing kidney function since eliminated unchanged in the urine

28 Dosing Extended interval dosing Once daily dosing for gentamicin & tobramycin For gram negative infections Developed to maximize killing due to Concentration dependent killing Post Antibiotic effect Less toxicity Gentamicin & tobramycin doses: 7 mg/kg Dosing weight to use: Smaller weight of Ideal vs. actual Use the adjusted BW if obese In renal insufficiency: maintain dose, increase interval with kidney insufficiency Narrow therapeutic window drug/ Monitoring levels needed: Utilize Hartford nomogram Target Trough <2 mcg/ml

29 Hartford Nomogram Use nomogram to assess frequency of dosing 1. obtain a random level 6-12 hrs after administration 2. Plot level on the nomogram 3. Determine resultant frequency Note: renal function must remain Obtain a trough before redosing to ensure correct frequency

30 Hartford Nomogram (for gentamicin and tobramycin 7mg/kg, not amikacin) Antimicrob Agents Chemother. 1995;39:650-5.

31 Antifungal Agents

32 Major Fungi Candida 4 th common cause of nosocomial bloodstream infections Crude mortality of 39% with attributable mortality of % Emergence of resistant C. albicans and a shift to less susceptible or resistant non-c. albicans species Aspergillus Cryptococcus

33 Antifungals Azoles Fluconazole, voriconazole, posaconazole, Itraconazole, ketoconazole Eichinocandins Caspofungin, mycafungin, anidulafungin Polyenes Amphotericin B deoxycholate, Lipid-based amphotericin Significant toxicities (renal, infusion reactions) Flucytosine

34 Antifungal Activity Fungus Flu Vori Posa Eichino Polyene C. albicans C. glabrata +/ C. tropicalis C. parapsilosis C. krusei A. fumigatus A. flavus A. terreus C. neoformans

35 Fluconazole Favorable pharmacokinetic and safety profile Emergence of resistant C. albicans and less susceptible/ resistant species (C. glabrata or C. krusei) Dose reduction in renal dysfunction Crcl <50ml/min; administer 50% of dose Hemodialysis: 50% of the dose is removed by hemodialysis, administer dose after each dialysis treatment Drug Interactions Strong inhibitor: CYP2C9; 2C19 Moderate inhibitor: CYP3A4 Weak inhibitor: CYP1A2

36 Caspofungin Echinocandin: semisynthetic antifungal lipopeptides Many Candida species are susceptible: C. albicans, C. glabrata, C. tropicalis, C. parapsilosis, Candida famata, Candida rugosa, and Candida stellatoidea Dosage: 70mg on day 1 then 50 mg/day Moderate hepatic insufficiency 70 mg on day 1 then 35 mg/day Not a CYP450 substrate (limited DDIs)

37 Major Interactions Warfarin - likely all antimicrobials metronidazole, SMX/TMP result in INR rifampin, nafcillin result in INR Immunosuppresants azole antifungals Azoles inhibit CYP 3A4 metabolism of tacrolimus Divalent cations oral fluoroquinolones Ca++, Mg++, Fe++, Al++ bind and oral FQ absorption Induce drug metabolism rifampin, nafcillin

Introduction to Pharmacokinetics and Pharmacodynamics

Introduction to Pharmacokinetics and Pharmacodynamics Introduction to Pharmacokinetics and Pharmacodynamics Diane M. Cappelletty, Pharm.D. Assistant Professor of Pharmacy Practice Wayne State University August, 2001 Vocabulary Clearance Renal elimination:

More information

Mercy Medical Center Des Moines, Iowa Department of Pathology. Microbiology Department Antibiotic Susceptibility January December 2016

Mercy Medical Center Des Moines, Iowa Department of Pathology. Microbiology Department Antibiotic Susceptibility January December 2016 Mercy Medical Center Des Moines, Iowa Department of Pathology Microbiology Department Antibiotic Susceptibility January December 2016 These statistics are intended solely as a GUIDE to choosing appropriate

More information

Other Beta - lactam Antibiotics

Other Beta - lactam Antibiotics Other Beta - lactam Antibiotics Assistant Professor Dr. Naza M. Ali Lec 5 8 Nov 2017 Lecture outlines Other beta lactam antibiotics Other inhibitors of cell wall synthesis Other beta-lactam Antibiotics

More information

Northwestern Medicine Central DuPage Hospital Antimicrobial Criteria Updated 11/16/16

Northwestern Medicine Central DuPage Hospital Antimicrobial Criteria Updated 11/16/16 Northwestern Medicine Central DuPage Hospital Antimicrobial Criteria Updated 11/16/16 These criteria are based on national and local susceptibility data as well as Infectious Disease Society of America

More information

Appropriate Antimicrobial Therapy for Treatment of

Appropriate Antimicrobial Therapy for Treatment of Appropriate Antimicrobial Therapy for Treatment of Staphylococcus aureus infections ( MRSA ) By : A. Bojdi MD Assistant Professor Inf. Dis. Dep. Imam Reza Hosp. MUMS Antibiotics Still Miracle Drugs Paul

More information

Pharmacokinetic & Pharmadynamic of Once Daily Aminoglycosides (ODA) and their Monitoring. Janis Chan Pharmacist, UCH 2008

Pharmacokinetic & Pharmadynamic of Once Daily Aminoglycosides (ODA) and their Monitoring. Janis Chan Pharmacist, UCH 2008 Pharmacokinetic & Pharmadynamic of Once Daily Aminoglycosides (ODA) and their Monitoring Janis Chan Pharmacist, UCH 25-4-2008 2008 Aminoglycosides (AG) 1. Gentamicin 2. Amikacin 3. Streptomycin 4. Neomycin

More information

Antimicrobial Therapy

Antimicrobial Therapy Antimicrobial Therapy David H. Spach, MD Professor of Medicine Division of Infectious Diseases University of Washington, Seattle Disclosure: Dr. Spach has no significant financial interest in any of the

More information

Table 1. Commonly encountered or important organisms and their usual antimicrobial susceptibilities.

Table 1. Commonly encountered or important organisms and their usual antimicrobial susceptibilities. Table 1. Commonly encountered or important organisms and their usual antimicrobial susceptibilities. Gram-positive cocci: Staphylococcus aureus: *Resistance to penicillin is almost universal. Resistance

More information

Childrens Hospital Antibiogram for 2012 (Based on data from 2011)

Childrens Hospital Antibiogram for 2012 (Based on data from 2011) Childrens Hospital Antibiogram for 2012 (Based on data from 2011) Prepared by: Department of Clinical Microbiology, Health Sciences Centre For further information contact: Andrew Walkty, MD, FRCPC Medical

More information

Antimicrobial Pharmacodynamics

Antimicrobial Pharmacodynamics Antimicrobial Pharmacodynamics November 28, 2007 George P. Allen, Pharm.D. Assistant Professor, Pharmacy Practice OSU College of Pharmacy at OHSU Objectives Become familiar with PD parameters what they

More information

* gender factor (male=1, female=0.85)

* gender factor (male=1, female=0.85) Usual Doses of Antimicrobials Typically Not Requiring Renal Adjustment Azithromycin 250 500 mg Q24 *Amphotericin B 1 3-5 mg/kg Q24 Clindamycin 600 900 mg Q8 Liposomal (Ambisome ) Doxycycline 100 mg Q12

More information

Similar to Penicillins: -Chemically. -Mechanism of action. -Toxicity.

Similar to Penicillins: -Chemically. -Mechanism of action. -Toxicity. Similar to Penicillins: -Chemically. -Mechanism of action. -Toxicity. Cephalosporins are divided into Generations: -First generation have better activity against gram positive organisms. -Later compounds

More information

Protein Synthesis Inhibitors

Protein Synthesis Inhibitors Protein Synthesis Inhibitors Assistant Professor Dr. Naza M. Ali 11 Nov 2018 Lec 7 Aminoglycosides Are structurally related two amino sugars attached by glycosidic linkages. They are bactericidal Inhibitors

More information

Duke University Hospital Guideline for Empiric Inpatient Treatment of Cancer- Related Neutropenic Fever in Adult Patients

Duke University Hospital Guideline for Empiric Inpatient Treatment of Cancer- Related Neutropenic Fever in Adult Patients Duke University Hospital Guideline for Empiric Inpatient Treatment of Cancer- Related Neutropenic Fever in Adult Patients PURPOSE Fever among neutropenic patients is common and a significant cause of morbidity

More information

INFECTIOUS DISEASES DIAGNOSTIC LABORATORY NEWSLETTER

INFECTIOUS DISEASES DIAGNOSTIC LABORATORY NEWSLETTER INFECTIOUS DISEASES DIAGNOSTIC LABORATORY NEWSLETTER University of Minnesota Health University of Minnesota Medical Center University of Minnesota Masonic Children s Hospital May 2017 Printed herein are

More information

Pharmacology Week 6 ANTIMICROBIAL AGENTS

Pharmacology Week 6 ANTIMICROBIAL AGENTS Pharmacology Week 6 ANTIMICROBIAL AGENTS Mechanisms of antimicrobial action Mechanisms of antimicrobial action Bacteriostatic - Slow or stop bacterial growth, needs an immune system to finish off the microbe

More information

4 th and 5 th generation cephalosporins. Naderi HR Associate professor of Infectious Diseases

4 th and 5 th generation cephalosporins. Naderi HR Associate professor of Infectious Diseases 4 th and 5 th generation cephalosporins Naderi HR Associate professor of Infectious Diseases Classification Forth generation: Cefclidine, cefepime (Maxipime),cefluprenam, cefoselis,cefozopran, cefpirome

More information

Appropriate antimicrobial therapy in HAP: What does this mean?

Appropriate antimicrobial therapy in HAP: What does this mean? Appropriate antimicrobial therapy in HAP: What does this mean? Jaehee Lee, M.D. Kyungpook National University Hospital, Korea KNUH since 1907 Presentation outline Empiric antimicrobial choice: right spectrum,

More information

Approach to pediatric Antibiotics

Approach to pediatric Antibiotics Approach to pediatric Antibiotics Gassem Gohal FAAP FRCPC Assistant professor of Pediatrics objectives To be familiar with common pediatric antibiotics o Classification o Action o Adverse effect To discus

More information

The β- Lactam Antibiotics. Munir Gharaibeh MD, PhD, MHPE School of Medicine, The University of Jordan November 2018

The β- Lactam Antibiotics. Munir Gharaibeh MD, PhD, MHPE School of Medicine, The University of Jordan November 2018 The β- Lactam Antibiotics Munir Gharaibeh MD, PhD, MHPE School of Medicine, The University of Jordan November 2018 Penicillins. Cephalosporins. Carbapenems. Monobactams. The β- Lactam Antibiotics 2 3 How

More information

Medicinal Chemistry 561P. 2 st hour Examination. May 6, 2013 NAME: KEY. Good Luck!

Medicinal Chemistry 561P. 2 st hour Examination. May 6, 2013 NAME: KEY. Good Luck! Medicinal Chemistry 561P 2 st hour Examination May 6, 2013 NAME: KEY Good Luck! 2 MDCH 561P Exam 2 May 6, 2013 Name: KEY Grade: Fill in your scantron with the best choice for the questions below: 1. Which

More information

CONTAGIOUS COMMENTS Department of Epidemiology

CONTAGIOUS COMMENTS Department of Epidemiology VOLUME XXIX NUMBER 3 November 2014 CONTAGIOUS COMMENTS Department of Epidemiology Bugs and Drugs Elaine Dowell SM MLS (ASCP), Marti Roe SM MLS (ASCP), Sarah Parker MD, Jason Child PharmD, and Samuel R.

More information

The Inpatient Management of Febrile Neutropenia

The Inpatient Management of Febrile Neutropenia UCSF Medical Center Adult Blood and Marrow Transplant Program 400 Parnassus Avenue, San Francisco, CA 94143 SOP # CL 120.05 The Inpatient Management of Febrile Neutropenia BACKGROUND: Neutropenia results

More information

Cell Wall Weakeners. Antimicrobials: Drugs that Weaken the Cell Wall. Bacterial Cell Wall. Bacterial Resistance to PCNs. PCN Classification

Cell Wall Weakeners. Antimicrobials: Drugs that Weaken the Cell Wall. Bacterial Cell Wall. Bacterial Resistance to PCNs. PCN Classification Cell Wall Weakeners Antimicrobials: Drugs that Weaken the Cell Wall Beta Lactams Penicillins Cephalosporins Carbapenems Aztreonam Vancomycin Teicoplanin Bacterial Cell Wall Bacterial cytoplasm is hypertonic

More information

2009 ANTIBIOGRAM. University of Alberta Hospital and the Stollery Childrens Hospital

2009 ANTIBIOGRAM. University of Alberta Hospital and the Stollery Childrens Hospital 2009 ANTIBIOGRAM University of Alberta Hospital and the Stollery Childrens Hospital Division of Medical Microbiology Department of Laboratory Medicine and Pathology 2 Table of Contents Page Introduction.....

More information

Curricular Components for Infectious Diseases EPA

Curricular Components for Infectious Diseases EPA Curricular Components for Infectious Diseases EPA 1. EPA Title Promoting antimicrobial stewardship based on microbiological principles 2. Description of the A key role for subspecialists is to utilize

More information

Central Nervous System Infections

Central Nervous System Infections Central Nervous System Infections Meningitis Treatment Bacterial meningitis is a MEDICAL EMERGENCY. ANTIBIOTICS SHOULD BE STARTED AS SOON AS THE POSSIBILITY OF BACTERIAL MENINGITIS BECOMES EVIDENT, IDEALLY

More information

2010 ANTIBIOGRAM. University of Alberta Hospital and the Stollery Children s Hospital

2010 ANTIBIOGRAM. University of Alberta Hospital and the Stollery Children s Hospital 2010 ANTIBIOGRAM University of Alberta Hospital and the Stollery Children s Hospital Medical Microbiology Department of Laboratory Medicine and Pathology Table of Contents Page Introduction..... 2 Antibiogram

More information

CF WELL Pharmacology: Microbiology & Antibiotics

CF WELL Pharmacology: Microbiology & Antibiotics CF WELL Pharmacology: Microbiology & Antibiotics Bradley E. McCrory, PharmD, BCPS Clinical Pharmacy Specialist Pulmonary Medicine Cincinnati Children s Hospital Medical Center January 26, 2017 Disclosure

More information

Disclosures. Principles of Antimicrobial Therapy. Obtaining an Accurate Diagnosis Obtain specimens PRIOR to initiating antimicrobials

Disclosures. Principles of Antimicrobial Therapy. Obtaining an Accurate Diagnosis Obtain specimens PRIOR to initiating antimicrobials Disclosures Principles of Antimicrobial Therapy None Lori A. Cox MSN, ACNP-BC, ACNPC, FCCM Penn State Hershey Medical Center Neuroscience Critical Care Unit Obtaining an Accurate Diagnosis Determine site

More information

4/3/2017 CLINICAL PEARLS: UPDATES IN THE MANAGEMENT OF NOSOCOMIAL PNEUMONIA DISCLOSURE LEARNING OBJECTIVES

4/3/2017 CLINICAL PEARLS: UPDATES IN THE MANAGEMENT OF NOSOCOMIAL PNEUMONIA DISCLOSURE LEARNING OBJECTIVES CLINICAL PEARLS: UPDATES IN THE MANAGEMENT OF NOSOCOMIAL PNEUMONIA BILLIE BARTEL, PHARMD, BCCCP APRIL 7 TH, 2017 DISCLOSURE I have had no financial relationship over the past 12 months with any commercial

More information

Challenges Emerging resistance Fewer new drugs MRSA and other resistant pathogens are major problems

Challenges Emerging resistance Fewer new drugs MRSA and other resistant pathogens are major problems Micro 301 Antimicrobial Drugs 11/7/12 Significance of antimicrobial drugs Challenges Emerging resistance Fewer new drugs MRSA and other resistant pathogens are major problems Definitions Antibiotic Selective

More information

Antibiotic Updates: Part I

Antibiotic Updates: Part I Antibiotic Updates: Part I Fredrick M. Abrahamian, DO, FACEP, FIDSA Health Sciences Clinical Professor of Emergency Medicine David Geffen School of Medicine at UCLA Los Angeles, California Financial Disclosures

More information

PRACTIC GUIDELINES for APPROPRIATE ANTIBIOTICS USE

PRACTIC GUIDELINES for APPROPRIATE ANTIBIOTICS USE PRACTIC GUIDELINES for APPROPRIATE ANTIBIOTICS USE Global Alliance for Infection in Surgery World Society of Emergency Surgery (WSES) and not only!! Aims - 1 Rationalize the risk of antibiotics overuse

More information

Antimicrobial Stewardship Program

Antimicrobial Stewardship Program Antimicrobial Stewardship Program David R. Woodard, MSc, FSHEA, CIC CDC: Antibiotic Resistance Threats in the United States, 2013 http://www.cdc.gov/drugresistance/threat-report-2013/pdf/ CDC Threat Levels

More information

Concise Antibiogram Toolkit Background

Concise Antibiogram Toolkit Background Background This toolkit is designed to guide nursing homes in creating their own antibiograms, an important tool for guiding empiric antimicrobial therapy. Information about antibiograms and instructions

More information

Standing Orders for the Treatment of Outpatient Peritonitis

Standing Orders for the Treatment of Outpatient Peritonitis Standing Orders for the Treatment of Outpatient Peritonitis 1. Definition of Peritonitis: a. Cloudy effluent. b. WBC > 100 cells/mm3 with >50% polymorphonuclear (PMN) cells with minimum 2 hour dwell. c.

More information

UCSF Medical Center Guidelines for Inpatient Management of Febrile Neutropenia

UCSF Medical Center Guidelines for Inpatient Management of Febrile Neutropenia Published on Infectious Diseases Management Program at UCSF (https://idmp.ucsf.edu) Home > UCSF Medical Center Guidelines for Inpatient Management of Febrile Neutropenia UCSF Medical Center Guidelines

More information

CONTAGIOUS COMMENTS Department of Epidemiology

CONTAGIOUS COMMENTS Department of Epidemiology VOLUME XXXII NUMBER 6 September 2017 CONTAGIOUS COMMENTS Department of Epidemiology Bugs and Drugs Elaine Dowell SM MLS (ASCP), Stacey Hamilton MT SM (ASCP), Samuel Dominguez MD PhD, Sarah Parker MD, and

More information

Standing Orders for the Treatment of Outpatient Peritonitis

Standing Orders for the Treatment of Outpatient Peritonitis Standing Orders for the Treatment of Outpatient Peritonitis 1. Definition of Peritonitis: a. Cloudy effluent. b. WBC > 100 cells/mm3 with >50% polymorphonuclear (PMN) cells with minimum 2 hour dwell. c.

More information

ANTIBIOTICS USED FOR RESISTACE BACTERIA. 1. Vancomicin

ANTIBIOTICS USED FOR RESISTACE BACTERIA. 1. Vancomicin ANTIBIOTICS USED FOR RESISTACE BACTERIA 1. Vancomicin Vancomycin is used to treat infections caused by bacteria. It belongs to the family of medicines called antibiotics. Vancomycin works by killing bacteria

More information

Antibiotic. Antibiotic Classes, Spectrum of Activity & Antibiotic Reporting

Antibiotic. Antibiotic Classes, Spectrum of Activity & Antibiotic Reporting Antibiotic Antibiotic Classes, Spectrum of Activity & Antibiotic Reporting Any substance of natural, synthetic or semisynthetic origin which at low concentrations kills or inhibits the growth of bacteria

More information

Beta-lactam antibiotics - Cephalosporins

Beta-lactam antibiotics - Cephalosporins Beta-lactam antibiotics - Cephalosporins Targets - PBP s Activity - Cidal - growing organisms (like the penicillins) Principles of action - Affinity for PBP s Permeability ypropertiesp Stability to bacterial

More information

Initial Management of Infections in the Era of Enhanced Antimicrobial Resistance

Initial Management of Infections in the Era of Enhanced Antimicrobial Resistance Initial Management of Infections in the Era of Enhanced Antimicrobial Resistance Robert C Welliver Sr, MD Hobbs-Recknagel Endowed Chair in Pediatrics Chief, Pediatric infectious Diseases Children s Hospital

More information

General Infectious Disease Concepts/Resources

General Infectious Disease Concepts/Resources General Infectious Disease Concepts/Resources Learning Objectives: 1. Distinguish between foundational infectious disease concepts including gram positive and negative bacteria, bacteriostatic and bactericidal

More information

2015 Antibiotic Susceptibility Report

2015 Antibiotic Susceptibility Report Citrobacter freundii Enterobacter aerogenes Enterobacter cloacae Escherichia coli Haemophilus influenzenza Klebsiella oxytoca Klebsiella pneumoniae Proteus mirabilis Pseudomonas aeruginosa Serratia marcescens

More information

Antimicrobial Stewardship 101

Antimicrobial Stewardship 101 Antimicrobial Stewardship 101 Betty P. Lee, Pharm.D. Pediatric Infectious Disease/Antimicrobial Stewardship Pharmacist Lucile Packard Children s Hospital Stanford Disclosure I have no actual or potential

More information

number Done by Corrected by Doctor Dr.Malik

number Done by Corrected by Doctor Dr.Malik number 27 Done by Fatimah Farhan Corrected by Basil Al-Bakri Doctor Dr.Malik Note: anything in red is just extra info and you will not be asked about it in the exam. In this sheet we will continue talking

More information

Effective 9/25/2018. Contact for previous versions.

Effective 9/25/2018. Contact for previous versions. Pharmacokinetic and Pharmacodynamic Dose Optimization of Antibiotics (β-lactams, aminoglycosides, and ciprofloxacin) for the Treatment of Gram-Negative Infections Adult Inpatient/Emergency Department Clinical

More information

Aberdeen Hospital. Antibiotic Susceptibility Patterns For Commonly Isolated Organisms For 2015

Aberdeen Hospital. Antibiotic Susceptibility Patterns For Commonly Isolated Organisms For 2015 Aberdeen Hospital Antibiotic Susceptibility Patterns For Commonly Isolated s For 2015 Services Laboratory Microbiology Department Aberdeen Hospital Nova Scotia Health Authority 835 East River Road New

More information

Diagnosis: Presenting signs and Symptoms include:

Diagnosis: Presenting signs and Symptoms include: PERITONITIS TREATMENT PROTOCOL CARI - Caring for Australasians with Renal Impairment - CARI Guidelines complete list ISPD Guidelines: http://www.ispd.org/lang-en/treatmentguidelines/guidelines Objective

More information

2016 Antibiotic Susceptibility Report

2016 Antibiotic Susceptibility Report Fairview Northland Medical Center and Elk River, Milaca, Princeton and Zimmerman Clinics 2016 Antibiotic Susceptibility Report GRAM-NEGATIVE ORGANISMS 2016 Gram-Negative Non-Urine The number of isolates

More information

DETERMINING CORRECT DOSING REGIMENS OF ANTIBIOTICS BASED ON THE THEIR BACTERICIDAL ACTIVITY*

DETERMINING CORRECT DOSING REGIMENS OF ANTIBIOTICS BASED ON THE THEIR BACTERICIDAL ACTIVITY* 44 DETERMINING CORRECT DOSING REGIMENS OF ANTIBIOTICS BASED ON THE THEIR BACTERICIDAL ACTIVITY* AUTHOR: Cecilia C. Maramba-Lazarte, MD, MScID University of the Philippines College of Medicine-Philippine

More information

Principles of Antimicrobial therapy

Principles of Antimicrobial therapy Principles of Antimicrobial therapy Laith Mohammed Abbas Al-Huseini M.B.Ch.B., M.Sc, M.Res, Ph.D Department of Pharmacology and Therapeutics Antimicrobial agents are chemical substances that can kill or

More information

Antibacterial therapy 1. د. حامد الزعبي Dr Hamed Al-Zoubi

Antibacterial therapy 1. د. حامد الزعبي Dr Hamed Al-Zoubi Antibacterial therapy 1 د. حامد الزعبي Dr Hamed Al-Zoubi ILOs Principles and terms Different categories of antibiotics Spectrum of activity and mechanism of action Resistancs Antibacterial therapy What

More information

Antibiotic Pharmacokinetics and Pharmacodynamics for Laboratory Professionals

Antibiotic Pharmacokinetics and Pharmacodynamics for Laboratory Professionals Antibiotic Pharmacokinetics and Pharmacodynamics for Laboratory Professionals Tom Dilworth, PharmD Aurora Health Care thomas.dilworth@aurora.org Objectives Describe the pharmacokinetics and pharmacodynamics

More information

Antimicrobials Update

Antimicrobials Update Antimicrobials Update Rosie Amini, PharmD. BCPS Antimicrobial Stewardship Program Coordinator Swedish Medical Center Disclosures: Dr. Amini has no significant financial interest in any of the products

More information

Proceedings of the 13th International Congress of the World Equine Veterinary Association WEVA

Proceedings of the 13th International Congress of the World Equine Veterinary Association WEVA www.ivis.org Proceedings of the 13th International Congress of the World Equine Veterinary Association WEVA October 3-5, 2013 Budapest, Hungary Reprinted in IVIS with the Permission of the WEVA Organizers

More information

2015 Antibiogram. Red Deer Regional Hospital. Central Zone. Alberta Health Services

2015 Antibiogram. Red Deer Regional Hospital. Central Zone. Alberta Health Services 2015 Antibiogram Red Deer Regional Hospital Central Zone Alberta Health Services Introduction. This antibiogram is a cumulative report of the antimicrobial susceptibility rates of common microbial pathogens

More information

CONTAGIOUS COMMENTS Department of Epidemiology

CONTAGIOUS COMMENTS Department of Epidemiology VOLUME XXIII NUMBER 1 July 2008 CONTAGIOUS COMMENTS Department of Epidemiology Bugs and Drugs Elaine Dowell, SM (ASCP), Marti Roe SM (ASCP), Ann-Christine Nyquist MD, MSPH Are the bugs winning? The 2007

More information

Antibiotic Resistance. Antibiotic Resistance: A Growing Concern. Antibiotic resistance is not new 3/21/2011

Antibiotic Resistance. Antibiotic Resistance: A Growing Concern. Antibiotic resistance is not new 3/21/2011 Antibiotic Resistance Antibiotic Resistance: A Growing Concern Judy Ptak RN MSN Infection Prevention Practitioner Dartmouth-Hitchcock Medical Center Lebanon, NH Occurs when a microorganism fails to respond

More information

Antibiotic Updates: Part II

Antibiotic Updates: Part II Antibiotic Updates: Part II Fredrick M. Abrahamian, DO, FACEP, FIDSA Health Sciences Clinical Professor of Emergency Medicine David Geffen School of Medicine at UCLA Los Angeles, California Financial Disclosures

More information

Principles of Anti-Microbial Therapy Assistant Professor Naza M. Ali. Lec 1

Principles of Anti-Microbial Therapy Assistant Professor Naza M. Ali. Lec 1 Principles of Anti-Microbial Therapy Assistant Professor Naza M. Ali Lec 1 28 Oct 2018 References Lippincott s IIIustrated Reviews / Pharmacology 6 th Edition Katzung and Trevor s Pharmacology / Examination

More information

Rational use of antibiotics

Rational use of antibiotics Rational use of antibiotics Uga Dumpis MD, PhD,, DTM Stradins University Hospital Riga, Latvia ugadumpis@stradini.lv BALTICCARE CONFERENCE, PSKOV, 16-18.03, 18.03, 2006 Why to use antibiotics? Prophylaxis

More information

ß-lactams. Sub-families. Penicillins. Cephalosporins. Monobactams. Carbapenems

ß-lactams. Sub-families. Penicillins. Cephalosporins. Monobactams. Carbapenems β-lactams ß-lactams Sub-families Penicillins Cephalosporins Monobactams Carbapenems ß-lactams Mode of action PBPs = Trans/Carboxy/Endo- peptidases PBP binding (Penicillin-Binding Proteins) activation of

More information

These recommendations were approved for use by the Pharmaceutical and Therapeutics Committee, RCWMCH on 1 February 2017.

These recommendations were approved for use by the Pharmaceutical and Therapeutics Committee, RCWMCH on 1 February 2017. Antibiotic regimens for suspected hospital-acquired infection (HAI) outside the Paediatric Intensive Care Unit at Red Cross War Memorial Children s Hospital (RCWMCH) Lead author: Brian Eley Contributing

More information

Introduction to Antimicrobial Therapy

Introduction to Antimicrobial Therapy Introduction to Antimicrobial Therapy Christine Kubin, Pharm.D., BCPS Clinical Pharmacist, Infectious Diseases Case #2 68 y.o. female with HTN, anxiety with chest pain symptoms 7/27/05: Cath - 3 vessel

More information

Best Antimicrobials for Staphylococcus aureus Bacteremia

Best Antimicrobials for Staphylococcus aureus Bacteremia Best Antimicrobials for Staphylococcus aureus Bacteremia I. Methicillin Susceptible Staph aureus (MSSA) A. In vitro - Anti-Staphylococcal β-lactams (Oxacillin, Nafcillin, Cefazolin) are more active B.

More information

Antimicrobial Susceptibility Patterns

Antimicrobial Susceptibility Patterns Antimicrobial Susceptibility Patterns KNH SURGERY Department Masika M.M. Department of Medical Microbiology, UoN Medicines & Therapeutics Committee, KNH Outline Methodology Overall KNH data Surgery department

More information

Staph Cases. Case #1

Staph Cases. Case #1 Staph Cases Lisa Winston University of California, San Francisco San Francisco General Hospital Case #1 A 60 y.o. man with well controlled HIV and DM presents to clinic with ten days of redness and swelling

More information

Critical impact of antimicrobial resistance

Critical impact of antimicrobial resistance New Antibiotics Kurt B. Stevenson, MD, MPH Professor of Medicine and Epidemiology Division of Infectious Diseases Department of Internal Medicine The Ohio State University College of Medicine Critical

More information

Principles of Antimicrobial Therapy

Principles of Antimicrobial Therapy Principles of Antimicrobial Therapy Key Points Early and rapid diagnosis of infection and prompt initiation of appropriate antimicrobial therapy, if warranted, are fundamental to reducing the mortality

More information

What s next in the antibiotic pipeline?

What s next in the antibiotic pipeline? What s next in the antibiotic pipeline? Jennifer Tieu, Pharm.D., BCPS Clinical Pearls OSHP Spring Meeting Mercy Hospital April 13, 2018 Objective 2 Describe the drug class and mechanism of action of antibiotics

More information

Einheit für pädiatrische Infektiologie Antibiotics - what, why, when and how?

Einheit für pädiatrische Infektiologie Antibiotics - what, why, when and how? Einheit für pädiatrische Infektiologie Antibiotics - what, why, when and how? Andrea Duppenthaler andrea.duppenthaler@insel.ch Limping patient local pain swelling tenderness warmth fever acute Osteomyelitis

More information

2012 ANTIBIOGRAM. Central Zone Former DTHR Sites. Department of Pathology and Laboratory Medicine

2012 ANTIBIOGRAM. Central Zone Former DTHR Sites. Department of Pathology and Laboratory Medicine 2012 ANTIBIOGRAM Central Zone Former DTHR Sites Department of Pathology and Laboratory Medicine Medically Relevant Pathogens Based on Gram Morphology Gram-negative Bacilli Lactose Fermenters Non-lactose

More information

Provincial Drugs & Therapeutics Committee Memorandum Version 2

Provincial Drugs & Therapeutics Committee Memorandum Version 2 Provincial Drugs & Therapeutics Committee Memorandum Version 2 16 Garfield Street 16, rue Garfield PO Box 2000, Charlottetown C.P. 2000, Charlottetown Prince Edward Island Île-du-Prince-Édouard Canada

More information

Health PEI: Provincial Antibiotic Advisory Team Empiric Antibiotic Treatment Guidelines for Sepsis Syndromes in Adults

Health PEI: Provincial Antibiotic Advisory Team Empiric Antibiotic Treatment Guidelines for Sepsis Syndromes in Adults Health PEI: Provincial Antibiotic Advisory Team Empiric Antibiotic Treatment Guidelines for Sepsis Syndromes in Adults COMMUNITY-ACQUIRED PNEUMONIA HEALTHCARE-ASSOCIATED PNEUMONIA INTRA-ABDOMINAL INFECTION

More information

مادة االدوية المرحلة الثالثة م. غدير حاتم محمد

مادة االدوية المرحلة الثالثة م. غدير حاتم محمد م. مادة االدوية المرحلة الثالثة م. غدير حاتم محمد 2017-2016 ANTIMICROBIAL DRUGS Antimicrobial drugs Lecture 1 Antimicrobial Drugs Chemotherapy: The use of drugs to treat a disease. Antimicrobial drugs:

More information

Antibiotics. Antimicrobial Drugs. Alexander Fleming 10/18/2017

Antibiotics. Antimicrobial Drugs. Alexander Fleming 10/18/2017 Antibiotics Antimicrobial Drugs Chapter 20 BIO 220 Antibiotics are compounds produced by fungi or bacteria that inhibit or kill competing microbial species Antimicrobial drugs must display selective toxicity,

More information

Advanced Practice Education Associates. Antibiotics

Advanced Practice Education Associates. Antibiotics Advanced Practice Education Associates Antibiotics Overview Difference between Gram Positive(+), Gram Negative(-) organisms Beta lactam ring, allergies Antimicrobial Spectra of Antibiotic Classes 78 Copyright

More information

Aminoglycosides. Spectrum includes many aerobic Gram-negative and some Gram-positive bacteria.

Aminoglycosides. Spectrum includes many aerobic Gram-negative and some Gram-positive bacteria. Aminoglycosides The only bactericidal protein synthesis inhibitors. They bind to the ribosomal 30S subunit. Inhibit initiation of peptide synthesis and cause misreading of the genetic code. Streptomycin

More information

Antibiotics: Selected Topics Steven Park, MD/PhD Director, Antimicrobial Stewardship Program Division of Infectious Diseases UCI Medical Center

Antibiotics: Selected Topics Steven Park, MD/PhD Director, Antimicrobial Stewardship Program Division of Infectious Diseases UCI Medical Center Antibiotics: Selected Topics Steven Park, MD/PhD Director, Antimicrobial Stewardship Program Division of Infectious Diseases UCI Medical Center Case 1 60 yo healthy female admitted for fevers and dysuria.

More information

Antibiotic Stewardship Program (ASP) CHRISTUS SETX

Antibiotic Stewardship Program (ASP) CHRISTUS SETX Antibiotic Stewardship Program (ASP) CHRISTUS SETX Program Goals I. Judicious use of antibiotics Decrease use of broad spectrum antibiotics and deescalate use based on clinical symptoms Therapeutic duplication:

More information

2016 Antibiogram. Central Zone. Alberta Health Services. including. Red Deer Regional Hospital. St. Mary s Hospital, Camrose

2016 Antibiogram. Central Zone. Alberta Health Services. including. Red Deer Regional Hospital. St. Mary s Hospital, Camrose 2016 Antibiogram Central Zone Alberta Health Services including Red Deer Regional Hospital St. Mary s Hospital, Camrose Introduction This antibiogram is a cumulative report of the antimicrobial susceptibility

More information

Bad Bugs. Pharmacist Learning Objectives. Antimicrobial Resistance. Patient Case. Pharmacy Technician Learning Objectives 4/8/2016

Bad Bugs. Pharmacist Learning Objectives. Antimicrobial Resistance. Patient Case. Pharmacy Technician Learning Objectives 4/8/2016 Pharmacist Learning Objectives Antimicrobial Resistance Julie Giddens Pharm D, BCPS Infectious Disease Clinical Pharmacist OSF Saint Francis Medical Center Peoria, IL The speaker has no conflicts to disclose

More information

Zyvox. Zyvox (linezolid) Description

Zyvox. Zyvox (linezolid) Description Federal Employee Program 1310 G Street, N.W. Washington, D.C. 20005 202.942.1000 Fax 202.942.1125 5.01.20 Subject: Zyvox Page: 1 of 7 Last Review Date: March 18, 2016 Zyvox Description Zyvox (linezolid)

More information

Antimicrobial Update. Alison MacDonald Area Antimicrobial Pharmacist NHS Highland April 2018

Antimicrobial Update. Alison MacDonald Area Antimicrobial Pharmacist NHS Highland April 2018 Antimicrobial Update Alison MacDonald Area Antimicrobial Pharmacist NHS Highland alisonc.macdonald@nhs.net April 2018 Starter Questions Setting the scene... What if antibiotics were no longer effective?

More information

CLINICAL USE OF AMINOGLYCOSIDES AND FLUOROQUINOLONES

CLINICAL USE OF AMINOGLYCOSIDES AND FLUOROQUINOLONES CLINICAL USE OF AMINOGLYCOSIDES AND FLUOROQUINOLONES Douglas Black, Pharm.D. Associate Professor School of Pharmacy University of Washington dblack@u.washington.edu THE AMINOGLYCOSIDES: 1944-1975 Drug

More information

Chapter 51. Clinical Use of Antimicrobial Agents

Chapter 51. Clinical Use of Antimicrobial Agents Chapter 51 Clinical Use of Antimicrobial Agents History of antimicrobial therapy Early 17 th century Cinchona bark was used as an important historical remedy against malaria. 1909 Paul Ehrlich sought a

More information

Telithromycin. Telithromycin (Ketek ) Spectrum. Telithromycin (Ketek ) Drug Interactions. Telithromycin (Ketek ) Kinetics. Update on Antimicrobials

Telithromycin. Telithromycin (Ketek ) Spectrum. Telithromycin (Ketek ) Drug Interactions. Telithromycin (Ketek ) Kinetics. Update on Antimicrobials Update on Antimicrobials B. Joseph Guglielmo, Pharm.D. Professor and Chair Department of Clinical Pharmacy School of Pharmacy University of California San Francisco Telithromycin Telithromycin is associated

More information

2017 Antibiogram. Central Zone. Alberta Health Services. including. Red Deer Regional Hospital. St. Mary s Hospital, Camrose

2017 Antibiogram. Central Zone. Alberta Health Services. including. Red Deer Regional Hospital. St. Mary s Hospital, Camrose 2017 Antibiogram Central Zone Alberta Health Services including Red Deer Regional Hospital St. Mary s Hospital, Camrose Introduction This antibiogram is a cumulative report of the antimicrobial susceptibility

More information

BACTERIAL SUSCEPTIBILITY REPORT: 2016 (January 2016 December 2016)

BACTERIAL SUSCEPTIBILITY REPORT: 2016 (January 2016 December 2016) BACTERIAL SUSCEPTIBILITY REPORT: 2016 (January 2016 December 2016) VA Palo Alto Health Care System April 14, 2017 Trisha Nakasone, PharmD, Pharmacy Service Russell Ryono, PharmD, Public Health Surveillance

More information

1 TRADE NAME OF THE MEDICINAL PRODUCT. Gentamicin Paediatric 20mg/2ml Solution for Injection 2 QUALITATIVE AND QUANTITATIVE COMPOSITION

1 TRADE NAME OF THE MEDICINAL PRODUCT. Gentamicin Paediatric 20mg/2ml Solution for Injection 2 QUALITATIVE AND QUANTITATIVE COMPOSITION 1 TRADE NAME OF THE MEDICINAL PRODUCT Gentamicin Paediatric 20mg/2ml Solution for Injection 2 QUALITATIVE AND QUANTITATIVE COMPOSITION Each 2ml contains 20mg of Gentamicin as Gentamicin Sulfate Excipient

More information

General Approach to Infectious Diseases

General Approach to Infectious Diseases General Approach to Infectious Diseases 2 The pharmacotherapy of infectious diseases is unique. To treat most diseases with drugs, we give drugs that have some desired pharmacologic action at some receptor

More information

Eavan G. Muldoon Consultant in Infectious Diseases, National Aspergillosis Centre, University Hospital of South Manchester.

Eavan G. Muldoon Consultant in Infectious Diseases, National Aspergillosis Centre, University Hospital of South Manchester. Eavan G. Muldoon Consultant in Infectious Diseases, National Aspergillosis Centre, University Hospital of South Manchester. Fungal infections that may be suitable for OPAT Duration of therapy Candida spp,

More information

Antimicrobial stewardship: Quick, don t just do something! Stand there!

Antimicrobial stewardship: Quick, don t just do something! Stand there! Antimicrobial stewardship: Quick, don t just do something! Stand there! Stanley I. Martin, MD, FACP, FIDSA Director, Division of Infectious Diseases Director, Antimicrobial Stewardship Program Geisinger

More information

** the doctor start the lecture with revising some information from the last one:

** the doctor start the lecture with revising some information from the last one: Page 1 of 7 ** the doctor start the lecture with revising some information from the last one: #penicillin G has a good susceptibility against gram(+ve), Neisseria (-ve) #mostly active against strep. (don

More information

Antibiotic Abyss. Discussion Points. MRSA Treatment Guidelines

Antibiotic Abyss. Discussion Points. MRSA Treatment Guidelines Antibiotic Abyss Fredrick M. Abrahamian, D.O., FACEP, FIDSA Professor of Medicine UCLA School of Medicine Director of Education Department of Emergency Medicine Olive View-UCLA Medical Center Sylmar, California

More information

Necrotizing Soft Tissue Infections: Emerging Bacterial Resistance

Necrotizing Soft Tissue Infections: Emerging Bacterial Resistance Necrotizing Soft Tissue Infections: Emerging Bacterial Resistance Eileen M. Bulger, MD Professor of Surgery Harborview Medical Center University of Washington Objectives Review definition & diagnostic

More information

Antibiotics 1. Lecture 8

Antibiotics 1. Lecture 8 Antibiotics 1 Lecture 8 Overview of antibiotics What am I treating? Viral, bacterial, fungal, mycobacterial, etc. Who am I treating? Host factors: age, genetic factors, co-morbidities (renal and liver

More information