Rational management of community acquired infections

Size: px
Start display at page:

Download "Rational management of community acquired infections"

Transcription

1 Rational management of community acquired infections Dr Tanu Singhal MD, MSc Consultant Pediatrics and Infectious Disease Kokilaben Dhirubhai Ambani Hospital, Mumbai

2 Why is rational management needed? To improve outcomes To reduce antimicrobial resistance To reduce costs To reduce adverse drug effects

3 Bad bugs, no new drugs! 3

4 General principles for antibiotic therapy Choose empirical therapy based on Likely pathogen Likely antimicrobial resistance Prior antibiotic exposure Severity of illness Host co morbidities Site of infection Modify when cultures available to most narrow spectrum and appropriate Abx (definitive therapy) Give right dose, duration and route

5 Upper respiratory tract infections Most are viral, some influenza Symptomatic therapy with paracetamol, nasal decongestents, home remedies and anti tussives Antibiotics don t prevent super infection Bacterial URTI: streptococcal pharyngitis, acute otitis media, sinusitis Bacterial URTI need antibiotics Amoxicillin/ coamoxiclav Cefixime/quinolones not useful and cefpodoxime/ cefdinir not needed Explain patient about complications Breathing difficulty Ear pain

6 Lower respiratory tract infections Most due to pneumococcus, mycoplasma, viruses OPD: coamoxiclav/ macrolide/ doxycycline WARD: ceftriaxone/coamoxiclav with macrolide OR levofloxacin monotherapy ICU: ceftriaxone and levofloxacin Caution while using quinolones since sometimes TB can present as CAP Comorbidities will need gram neg cover MRSA cover in case of necrotizing pneumonia Add oseltamivir in case of outbreak

7 Treatment of diarrhea In children is mostly viral and does not need antibiotics E. histolytica contributes to less than 3% Indications for antibiotics is visible blood in stool Quinolones/ cefixime/azithromycin No role of amikacin, oral colistin and fixed drug combinations

8 Enteric ( Typhoid/ Paratyphoid fever) Remember to send blood cultures High rates of quinolone resistance in Salmonella Outpatients 20 mg/kg/day ( 1200 mg/day max) for 2 weeks Azithromycin 1 gm daily for 7-10 days Cotrimoxazole Inpatients Ceftriaxone No benefit of combo therapy, quinolones, amikacin and BL-BLI s Defervescence takes time 5-7 days In case of relapse treat with drugs with good intracellular penetration- azithromycin

9 Skin and soft tissue infections Common pathogens- strep and staph Rising incidence of community acquired MRSA Localized Fucidic acid, mupirocin Generalized Cephalexin, cefadroxil, coamoxiclav more broad spectrum No role of cefixime, ciprofloxacin For inpatients- IV cefazolin, cloxacillin, cefuroxime MRSA cover if sick patient/ documented MRSA

10 Treatment of UTI Diagnostic challenges Rising incidence of ESBL in community pathogens 1 st line therapy outpatients, stable inpatients, no history of resistance/ recurrent infections Ciprofloxacin Cotrimoxazole Amoxiclav/Cefixime/ Ceftriaxone/Cephalexin Nitrofurantoin only for cystitis 2 nd line therapy Sick patients/history of resistance/ non responders Aminoglycosides BL-BLI combinations/carbapenems

11 Acute bacterial meningitis S. pneumoniae, meningococcus, Hemophilus Listeria in elderly and immunocompromised Therapy of choice: Ceftriaxone 4 gm daily Current resistance status in S. pneumoniae does not warrant addition of vancomycin No benefit of adding amikacin and using BL- BLI combinations Duration of therapy days

12 Bone and joint infections Staph aureus commonest pathogen ( more MSSA than MRSA) Other pathogens in extremes of age Important to send cultures ( blood/ bone/ joint fluid) prior to antibiotics IV cefazolin/ cloxacillin usually appropriate Switch to oral once clinical resolution and normalization of acute inflammatory reactants Duration 3-6 weeks

13 Intrabdominal infections Common organisms- E coli, anaerobes Primary peritonitis: Ceftriaxone/ BL-BLI for 5-7 days Secondary peritonitis Ceftriaxone with metronidazole BL-BLI monotherapy ( pip taz/ cef sulbactam) No need to add metronidazole if giving BL-BLI s Biliary infections: use agents with good biliary penetration ( Pip taz, quinolones) Pancreatitis: No role for prophylactic antibiotics

14 Malaria Vivax malaria Chloroquine is the drug of choice 10 0,24 hrs and 5 mg/kg at 48 hours Primaquine 0.3 mg/kg for 14 days for radical therapy ACT: dihydroartemisinin and piperaquine better than artemether lumefantrine Falciparum malaria Artemether lumefantrine with fatty meal Single dose of primaquine 0.25 mg/kg Severe malaria IV artesunate and then ACT

15 Severe sepsis/ Septic shock No clinical focus Suspicion of tropical infections (dengue/ malaria/ lepto,rickettsia Ceftriaxone and doxy and artesunate Suspect bacterial sepsis (pneumococcus/ gram neg) Ceftriaxone and amikacin Pip taz and amikacin Meropenem/ Imipenem

16 Dosing and Duration of antibiotics Dose Pay due attention to weight Loading dose is useful for many abx First dose is always the full dose irrespective of renal function Remember to modify doses for hepatic and renal dysfunction and upgrade when needed Duration and Route Trend to shift to oral quickly and also shorten duration No oral switchover in infective endocarditis, meningitis

17 Summary Decide whether antibiotics are indeed needed Remember viral infections are not benefited by antibiotics Decide empirical choices appropriately Remember to modify once culture results are available Pay due attention to drug quality, dose, route and duration

Perichondritis: Source: UpToDate Ciprofloxacin 10 mg/kg/dose PO (max 500 mg/dose) BID Inpatient: Ceftazidime 50 mg/kg/dose q8 hours IV

Perichondritis: Source: UpToDate Ciprofloxacin 10 mg/kg/dose PO (max 500 mg/dose) BID Inpatient: Ceftazidime 50 mg/kg/dose q8 hours IV Empiric Antibiotics for Pediatric Infections Seen in ED NOTE: Choice of empiric antibiotic therapy must take into account local pathogen frequency and resistance patterns, individual patient characteristics,

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

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

Antibiotic Usage Guidelines in Hospital

Antibiotic Usage Guidelines in Hospital SUPPLEMENT TO JAPI december VOL. 58 51 Antibiotic Usage Guidelines in Hospital Camilla Rodrigues * Use of surveillance data information of Hospital antibiotic policy guidelines from Hinduja Hospital. The

More information

Appropriate Management of Common Pediatric Infections. Blaise L. Congeni M.D. Akron Children s Hospital Division of Pediatric Infectious Diseases

Appropriate Management of Common Pediatric Infections. Blaise L. Congeni M.D. Akron Children s Hospital Division of Pediatric Infectious Diseases Appropriate Management of Common Pediatric Infections Blaise L. Congeni M.D. Akron Children s Hospital Division of Pediatric Infectious Diseases It s all about the microorganism The common pathogens Viruses

More information

Prescribing Guidelines for Outpatient Antimicrobials in Otherwise Healthy Children

Prescribing Guidelines for Outpatient Antimicrobials in Otherwise Healthy Children Prescribing Guidelines for Outpatient Antimicrobials in Otherwise Healthy Children Prescribing Antimicrobials for Common Illnesses When treating common illnesses such as ear infections and strep throat,

More information

11/10/2016. Skin and Soft Tissue Infections. Disclosures. Educational Need/Practice Gap. Objectives. Case #1

11/10/2016. Skin and Soft Tissue Infections. Disclosures. Educational Need/Practice Gap. Objectives. Case #1 Disclosures Selecting Antimicrobials for Common Infections in Children FMR-Contemporary Pediatrics 11/2016 Sean McTigue, MD Assistant Professor of Pediatrics, Pediatric Infectious Diseases Medical Director

More information

10/13/14. Low: not well absorbed. Good: [blood and tissue] < than if given IV. High: > 90% absorption orally

10/13/14. Low: not well absorbed. Good: [blood and tissue] < than if given IV. High: > 90% absorption orally Low: not well absorbed PO agent not for serious infection nitrofurantoin Good: [blood and tissue] < than if given IV [Therapeutic] in excess of [effective] eg. cephalexin High: > 90% absorption orally

More information

Interactive session: adapting to antibiogram. Thong Phe Heng Vengchhun Felix Leclerc Erika Vlieghe

Interactive session: adapting to antibiogram. Thong Phe Heng Vengchhun Felix Leclerc Erika Vlieghe Interactive session: adapting to antibiogram Thong Phe Heng Vengchhun Felix Leclerc Erika Vlieghe Case 1 63 y old woman Dx: urosepsis? After 2 d: intermediate result: Gram-negative bacilli Empiric antibiotic

More information

21 st Expert Committee on Selection and Use of Essential Medicines Peer Review Report Antibiotics Review

21 st Expert Committee on Selection and Use of Essential Medicines Peer Review Report Antibiotics Review (1) Have all important studies/evidence of which you are aware been included in the application? Yes No Please provide brief comments on any relevant studies that have not been included: (2) For each of

More information

GENERAL NOTES: 2016 site of infection type of organism location of the patient

GENERAL NOTES: 2016 site of infection type of organism location of the patient GENERAL NOTES: This is a summary of the antibiotic sensitivity profile of clinical isolates recovered at AIIMS Bhopal Hospital during the year 2016. However, for organisms in which < 30 isolates were recovered

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

Let me clear my throat: empiric antibiotics in

Let me clear my throat: empiric antibiotics in Let me clear my throat: empiric antibiotics in respiratory tract infections Alexander John Langley, MD MS MPH Goals of this talk Overuse of antibiotics is a major issue, as a result many specialist medical

More information

INFECTIONS IN CHILDREN-ANTIMICROBIAL MANAGEMENT

INFECTIONS IN CHILDREN-ANTIMICROBIAL MANAGEMENT INFECTIONS IN CHILDREN-ANTIMICROBIAL MANAGEMENT Name & Title Of Authors: Dr M Milupi, Consultant Microbiologist Dr N Rao,Consultant Paediatrician Dr V Desai Consultant Paediatrician Date Revised: DEC 2015

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

Suggested treatment. Inj Crystalline Penicillin 50,000U/Kg i.v. 4-6hrly (if child cannot swallow) 40mg/Kg/dose BID x 10days

Suggested treatment. Inj Crystalline Penicillin 50,000U/Kg i.v. 4-6hrly (if child cannot swallow) 40mg/Kg/dose BID x 10days GUIDELINES FOR TREATMENT OF INFECTIONS IN CHILDREN A. RESPIRATORY TRACT INFECTIONS UPPER RESPIRATORY TRACT INFECTIONS Infection/Condition/likely organism Suggested treatment Preferred Alternative Acute

More information

Principles of Infectious Disease. Dr. Ezra Levy CSUHS PA Program

Principles of Infectious Disease. Dr. Ezra Levy CSUHS PA Program Principles of Infectious Disease Dr. Ezra Levy CSUHS PA Program I. Microbiology (1) morphology (e.g., cocci, bacilli) (2) growth characteristics (e.g., aerobic vs anaerobic) (3) other qualities (e.g.,

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

Infection Comments First Line Agents Penicillin Allergy History of multiresistant. line treatment: persist for >7 days they may be

Infection Comments First Line Agents Penicillin Allergy History of multiresistant. line treatment: persist for >7 days they may be Gastrointestinal Infections Infection Comments First Line Agents Penicillin Allergy History of multiresistant Campylobacter Antibiotics not recommended. Erythromycin 250mg PO 6 Alternative to first N/A

More information

GUIDELINES FOR THE MANAGEMENT OF COMMUNITY-ACQUIRED PNEUMONIA IN ADULTS

GUIDELINES FOR THE MANAGEMENT OF COMMUNITY-ACQUIRED PNEUMONIA IN ADULTS Version 3.1 GUIDELINES FOR THE MANAGEMENT OF COMMUNITY-ACQUIRED PNEUMONIA IN ADULTS Date ratified June 2008 Updated March 2009 Review date June 2010 Ratified by Authors Consultation Evidence base Changes

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

Treatment of Respiratory Tract Infections Prof. Mohammad Alhumayyd Dr. Aliah Alshanwani

Treatment of Respiratory Tract Infections Prof. Mohammad Alhumayyd Dr. Aliah Alshanwani Treatment of Respiratory Tract Infections Prof. Mohammad Alhumayyd Dr. Aliah Alshanwani 30-1-2018 1 Objectives of the lecture At the end of lecture, the students should be able to understand the following:

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

Suggestions for appropriate agents to include in routine antimicrobial susceptibility testing

Suggestions for appropriate agents to include in routine antimicrobial susceptibility testing Suggestions for appropriate agents to include in routine antimicrobial susceptibility testing These suggestions are intended to indicate minimum sets of agents to test routinely in a diagnostic laboratory

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

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

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

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

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

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

PIPERACILLIN- TAZOBACTAM INJECTION - SUPPLY PROBLEMS

PIPERACILLIN- TAZOBACTAM INJECTION - SUPPLY PROBLEMS PIPERACILLIN- TAZOBACTAM INJECTION - SUPPLY PROBLEMS The current supply of piperacillin- tazobactam should be reserved f Microbiology / Infectious Diseases approval and f neutropenic sepsis, severe sepsis

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

Disclosures. Nothing Medically I own FiPhysician LLC, a financial planning and investment company (FiPhysician.com)

Disclosures. Nothing Medically I own FiPhysician LLC, a financial planning and investment company (FiPhysician.com) "How to work around (with) administration to build an Antimicrobial Stewardship Program AND how to get dumb (oops reluctant) doctors to do the right thing" David Graham, MD Disclosures Nothing Medically

More information

Guidelines for Antimicrobial treatment for treatment of confirmed infections adults

Guidelines for Antimicrobial treatment for treatment of confirmed infections adults Guidelines for Antimicrobial treatment for treatment of confirmed infections adults This guideline gives recommendations for treatment of confirmed infections in adults for children please see the Paediatric

More information

1. The preferred treatment option for an initial UTI episode in a 22-year-old female patient

1. The preferred treatment option for an initial UTI episode in a 22-year-old female patient 1 Chapter 79, Self-Assessment Questions 1. The preferred treatment option for an initial UTI episode in a 22-year-old female patient with normal renal function is: A. Trimethoprim-sulfamethoxazole B. Cefuroxime

More information

INFECTIONS IN CHILDREN-ANTIMICROBIAL MANAGEMENT

INFECTIONS IN CHILDREN-ANTIMICROBIAL MANAGEMENT INFECTIONS IN CHILDREN-ANTIMICROBIAL MANAGEMENT Name & Title Of Authors: Dr M Milupi, Consultant Microbiologist Dr N Rao,Consultant Paediatrician Dr V Desai Consultant Paediatrician Date Revised: APRIL

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

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

CLINICAL USE OF BETA-LACTAMS

CLINICAL USE OF BETA-LACTAMS CLINICAL USE OF BETA-LACTAMS Douglas Black, Pharm.D. Associate Professor School of Pharmacy University of Washington dblack@u.washington.edu WHY IS INFECTIOUS DISEASE PHARMACOTHERAPY SO CONFUSING? Microbial

More information

Meropenem for all? Midge Asogan ICU Fellow (also ID AT)

Meropenem for all? Midge Asogan ICU Fellow (also ID AT) Meropenem for all? Midge Asogan ICU Fellow (also ID AT) Infections Common reason for presentation to ICU Community acquired - vs nosocomial - new infection acquired within hospital environment Treatment

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

Choosing the Best Antibiotic in Problem Outpatient Infectious Disease Cases

Choosing the Best Antibiotic in Problem Outpatient Infectious Disease Cases Choosing the Best Antibiotic in Problem Outpatient Infectious Disease Cases Dr. Earl Rubin Associate Professor Department of Pediatrics Division of Infectious Diseases Montreal Children s Hospital Disclosures

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

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

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

PHAMACOLOGY 2 nd EXAM QUESTIONS 2012/2013

PHAMACOLOGY 2 nd EXAM QUESTIONS 2012/2013 PHAMACOLOGY 2 nd EXAM QUESTIONS 2012/2013 1.from the pharmacological point of view, which of the following intervention is correct? a) treating postpartum non-obstructive urinary retention by intramuscular

More information

Infectious Disease 101: Helping the Consultant Pharmacist with Stewardship Principles

Infectious Disease 101: Helping the Consultant Pharmacist with Stewardship Principles Infectious Disease 101: Helping the Consultant Pharmacist with Stewardship Principles Conflicts of Interest None at this time May be discussing off-label indications KALIN M. CLIFFORD, PHARM.D., BCPS,

More information

Appropriate Antibiotic Prescribing: Making Good Choices for Bad Bugs. Disclosure 4/22/17

Appropriate Antibiotic Prescribing: Making Good Choices for Bad Bugs. Disclosure 4/22/17 Appropriate Antibiotic Prescribing: Making Good Choices for Bad Bugs Elizabeth O. Hand, Pharm.D., BCPS Pediatric Infectious Disease Pharmacist University Health System Clinical Assistant Professor The

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

number Done by Corrected by Doctor

number Done by Corrected by Doctor number 28 Done by Dina Yaseen Corrected by حسام أبو عوض Doctor مالك الزحلف Cephalosporins -Cephalosporins are β-lactam antibiotics isolated from a strain of Streptomyces. -They are bactericidal and work

More information

ANALYSIS OF ANTIMICROBIAL PRESCRIPTIONS IN PEDIATRIC PATIENTS IN A TEACHING HOSPITAL

ANALYSIS OF ANTIMICROBIAL PRESCRIPTIONS IN PEDIATRIC PATIENTS IN A TEACHING HOSPITAL Academic Sciences Asian Journal of Pharmaceutical and Clinical Research Vol, Suppl, 0 ISSN - 074-44 Research Article ANALYSIS OF ANTIMICROBIAL PRESCRIPTIONS IN PEDIATRIC PATIENTS IN A TEACHING HOSPITAL

More information

Septicaemia Definitions 1

Septicaemia Definitions 1 Septicaemia Definitions 1 Term Definition Bacteraemia Systemic Inflammatory response (SIRS) Sepsis Bacteria that can be cultured from the blood stream The systemic response to a wide range of stresses.

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

Help with moving disc diffusion methods from BSAC to EUCAST. Media BSAC EUCAST

Help with moving disc diffusion methods from BSAC to EUCAST. Media BSAC EUCAST Help with moving disc diffusion methods from BSAC to EUCAST This document sets out the main differences between the BSAC and EUCAST disc diffusion methods with specific emphasis on preparation prior to

More information

Clinical Practice Standard

Clinical Practice Standard Clinical Practice Standard 1-20-6-1-010 TITLE: INTRAVENOUS TO ORAL CONVERSION FOR ANTIMICROBIALS A printed copy of this document may not reflect the current, electronic version on OurNH. APPLICABILITY:

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

National Clinical Guideline Centre Pneumonia Diagnosis and management of community- and hospital-acquired pneumonia in adults

National Clinical Guideline Centre Pneumonia Diagnosis and management of community- and hospital-acquired pneumonia in adults National Clinical Guideline Centre Antibiotic classifications Pneumonia Diagnosis and management of community- and hospital-acquired pneumonia in adults Clinical guideline 191 Appendix N 3 December 2014

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

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

ECHO: Management of URIs. Charles Krasner, M.D. Sierra NV Veterans Affairs Hospital University of NV, Reno School of Medicine October 16, 2018

ECHO: Management of URIs. Charles Krasner, M.D. Sierra NV Veterans Affairs Hospital University of NV, Reno School of Medicine October 16, 2018 ECHO: Management of URIs Charles Krasner, M.D. Sierra NV Veterans Affairs Hospital University of NV, Reno School of Medicine October 16, 2018 Infectious causes of URIs change over time Most ARIs are viral

More information

Volume 1; Number 7 November 2007

Volume 1; Number 7 November 2007 Volume 1; Number 7 November 2007 CONTENTS Page 1 Page 3 Guidance on the Use of Antibacterial Drugs in Lincolnshire Primary Care: Winter 2007/8 NICE Clinical Guideline 54: Urinary Tract Infection in Children

More information

Antibiotics & Common Infections: Stewardship, Effectiveness, Safety & Clinical Pearls. Welcome We will begin shortly.

Antibiotics & Common Infections: Stewardship, Effectiveness, Safety & Clinical Pearls. Welcome We will begin shortly. Antibiotics & Common Infections: Stewardship, Effectiveness, Safety & Clinical Pearls Welcome We will begin shortly. The Canadian Pharmacists Association is pleased to be collaborating with the following

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

Antimicrobial Stewardship in Ambulatory Care

Antimicrobial Stewardship in Ambulatory Care Antimicrobial Stewardship in Ambulatory Care Nila Suntharam, M.D. May 5, 2017 Dr. Suntharam indicated no potential conflict of interest to this presentation. She does not intend to discuss any unapproved/investigative

More information

Cephalosporins, Quinolones and Co-amoxiclav Prescribing Audit

Cephalosporins, Quinolones and Co-amoxiclav Prescribing Audit Cephalosporins, Quinolones and Co-amoxiclav Prescribing Audit Executive Summary Background Antibiotic resistance poses a significant threat to public health, as antibiotics underpin routine medical practice.

More information

Updated recommended treatment regimens for gonococcal infections and associated conditions United States, April 2007

Updated recommended treatment regimens for gonococcal infections and associated conditions United States, April 2007 Updated recommended treatment regimens for gonococcal infections and associated conditions United States, April 2007 1 Ongoing data from CDC 's Gonococcal Isolate Surveillance Project (GISP), including

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

Guidelines for the Empirical Treatment of Sepsis in Adults (excluding Neutropenic Sepsis)

Guidelines for the Empirical Treatment of Sepsis in Adults (excluding Neutropenic Sepsis) Guidelines for the Empirical Treatment of Sepsis in Adults (excluding Neutropenic Sepsis) Full Title of Guideline: Author (include email and role): Division & Speciality: Scope (Target audience, state

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

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

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

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

Supplementary Online Content

Supplementary Online Content Supplementary Online Content Gerber JS, Prasad PA, Fiks AG, et al. Effect of an outpatient antimicrobial stewardship intervention on broad-spectrum antibiotic prescribing by primary care pediatricians:

More information

Measure Information Form

Measure Information Form Release Notes: Measure Information Form Version 3.0b **NQF-ENDORSED VOLUNTARY CONSENSUS STANDARDS FOR HOSPITAL CARE** Measure Set: Pneumonia (PN) Performance Measure Identifier: Measure Information Form

More information

DNA Gyrase Inhibitors, Sulfa drugs and VRE

DNA Gyrase Inhibitors, Sulfa drugs and VRE Quick Review: Side Effects Tetracyclines: Phototoxicity and it may precipite in bones and joints. This is why I don t give tetracycline to children. Macrolides: Safe drugs; Virtually no side effects. This

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

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

2018 OPTIONS FOR INDIVIDUAL MEASURES: REGISTRY ONLY. MEASURE TYPE: Process

2018 OPTIONS FOR INDIVIDUAL MEASURES: REGISTRY ONLY. MEASURE TYPE: Process Quality ID #65 (NQF 0069): Appropriate Treatment for Children with Upper Respiratory Infection (URI) National Quality Strategy Domain: Efficiency and Cost Reduction 2018 OPTIONS FOR INDIVIDUAL MEASURES:

More information

Update on Fluoroquinolones. Charles Krasner, M.D. June 16, 2016 Antibiotic Stewardship Program -ECHO

Update on Fluoroquinolones. Charles Krasner, M.D. June 16, 2016 Antibiotic Stewardship Program -ECHO Update on Fluoroquinolones Charles Krasner, M.D. June 16, 2016 Antibiotic Stewardship Program -ECHO Potential fluoroquinolone side-effects Increased risk, greater than with most other antibiotics, for

More information

Rational use of antibiotic in upper respiratory tract infection (URI) and community acquired pneumonia รศ.จามร ธ รตก ลพ ศาล 23 พฤษภาคม 2550

Rational use of antibiotic in upper respiratory tract infection (URI) and community acquired pneumonia รศ.จามร ธ รตก ลพ ศาล 23 พฤษภาคม 2550 Rational use of antibiotic in upper respiratory tract infection (URI) and community acquired pneumonia รศ.จามร ธ รตก ลพ ศาล 23 พฤษภาคม 2550 Sinusitis Upper respiratory tract infections (URI) Common cold

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

Antimicrobial Update Stewardship in Primary Care. Clare Colligan Antimicrobial Pharmacist NHS Forth Valley

Antimicrobial Update Stewardship in Primary Care. Clare Colligan Antimicrobial Pharmacist NHS Forth Valley Antimicrobial Update Stewardship in Primary Care Clare Colligan Antimicrobial Pharmacist NHS Forth Valley Setting the Scene! Consequences of Antibiotic Use? Resistance For an individual patient with

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

Guidelines for Treatment of Urinary Tract Infections

Guidelines for Treatment of Urinary Tract Infections Guidelines for Treatment of Urinary Tract Infections Overview This document details the Michigan Hospital Medicine Safety (HMS) Consortium preferred antibiotic choices for treatment of uncomplicated and

More information

St. Joseph s General Hospital Vegreville. and. Mary Immaculate Care Centre. Antimicrobial Stewardship Report

St. Joseph s General Hospital Vegreville. and. Mary Immaculate Care Centre. Antimicrobial Stewardship Report St. Joseph s General Hospital Vegreville and Mary Immaculate Care Centre Antimicrobial Stewardship Report January to June 217 Introduction Antibiotics are among the most commonly prescribed medications

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

Women s Antimicrobial Guidelines Summary

Women s Antimicrobial Guidelines Summary Women s Antimicrobial Guidelines Summary 1. Introduction and Who Guideline applies to This guideline has been developed to deliver safe and appropriate empirical use of antibiotics for patients at University

More information

Antimicrobial prescribing pattern in acute tonsillitis: A hospital based study in Ajman, UAE

Antimicrobial prescribing pattern in acute tonsillitis: A hospital based study in Ajman, UAE Antimicrobial prescribing pattern in acute tonsillitis: A hospital based study in Ajman, UAE Lisha Jenny John 1*, Meenu Cherian 2, Jayadevan Sreedharan 3, Tambi Cherian 2 1 Department of Pharmacology,

More information

Compliance of manufacturers of AST materials and devices with EUCAST guidelines

Compliance of manufacturers of AST materials and devices with EUCAST guidelines Compliance of manufacturers of AST materials and devices with EUCAST guidelines Data are based on questionnaires to manufacturers of materials and devices for antimicrobial susceptibility testing. The

More information

POINT PREVALENCE SURVEY A tool for antibiotic stewardship in hospitals. Koen Magerman Working group Hospital Medicine

POINT PREVALENCE SURVEY A tool for antibiotic stewardship in hospitals. Koen Magerman Working group Hospital Medicine POINT PREVALENCE SURVEY A tool for antibiotic stewardship in hospitals Koen Magerman Working group Hospital Medicine Background Strategic plan By means of a point prevalence survey and internal audits

More information

MEDICAL SPECIALITIES A.CARDIOVASCULAR INFECTIONS

MEDICAL SPECIALITIES A.CARDIOVASCULAR INFECTIONS MEDICAL SPECIALITIES A.CARDIOVASCULAR INFECTIONS Infection/Condition/lik ely organism Infective endocarditis native valve/due to Penicillin- Susceptible Streptococcus Viridans/S.bovis Suggested treatment

More information

Pinni Meedha Mojutho Ammanu Dengina Koduku Part 1 Kama Kathalu

Pinni Meedha Mojutho Ammanu Dengina Koduku Part 1 Kama Kathalu Search for: Search Search Does levaquin cover anaerobes Pinni Meedha Mojutho Ammanu Dengina Koduku Part 1 Kama Kathalu Levofloxacin, sold under the trade names Levaquin among others, is an antibiotic.

More information

Objectives. Review basic categories of intra-abdominal infection and their respective treatments. Community acquired intra-abdominal infection

Objectives. Review basic categories of intra-abdominal infection and their respective treatments. Community acquired intra-abdominal infection Objectives Review basic categories of intra-abdominal infection and their respective treatments Community acquired intra-abdominal infection Mild/Moderate Severe Acute biliary tract infections Nosocomial

More information

Objectives. Basic Microbiology. Patient related. Environment related. Organism related 10/12/2017

Objectives. Basic Microbiology. Patient related. Environment related. Organism related 10/12/2017 Basic Microbiology Vaneet Arora, MD MPH D(ABMM) FCCM Associate Director of Clinical Microbiology, UK HealthCare Assistant Professor, Department of Pathology and Laboratory Medicine University of Kentucky

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

Cefazolin vs. Antistaphyloccal Penicillins: The Great Debate

Cefazolin vs. Antistaphyloccal Penicillins: The Great Debate Cefazolin vs. Antistaphyloccal Penicillins: The Great Debate Annie Heble, PharmD PGY2 Pediatric Pharmacy Resident Children s Hospital Colorado Microbiology Rounds March 22, 2017 Image Source: Buck cartoons

More information

جداول میکروارگانیسم های بیماریزای اولویت دار و آنتی بیوتیک های تعیین شده برای آزمایش تعیین حساسیت ضد میکروبی در برنامه مهار مقاومت میکروبی

جداول میکروارگانیسم های بیماریزای اولویت دار و آنتی بیوتیک های تعیین شده برای آزمایش تعیین حساسیت ضد میکروبی در برنامه مهار مقاومت میکروبی جداول میکروارگانیسم های بیماریزای اولویت دار و آنتی بیوتیک های تعیین شده برای آزمایش تعیین حساسیت ضد میکروبی در برنامه مهار مقاومت میکروبی ویرایش دوم بر اساس ed., 2017 CLSI M100 27 th تابستان ۶۹۳۱ تهیه

More information

DRAFT DRAFT. Paediatric Antibiotic Prescribing Guideline. May

DRAFT DRAFT. Paediatric Antibiotic Prescribing Guideline. May Paediatric Antibiotic Prescribing Guideline www.oxfdahsn.g/children Magdalen Centre Nth, 1 Robert Robinson Avenue, Oxfd Science Park, OX4 4GA, United Kingdom t: +44(0) 1865 784944 e: info@oxfdahsn.g Follow

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