URINARY TRACT INFECTION TREATMENT IN COMMUNITY PRACTICE. Clinical Assistant Professor School of Pharmacy LIU
|
|
- Douglas Rice
- 5 years ago
- Views:
Transcription
1 URINARY TRACT INFECTION TREATMENT IN COMMUNITY PRACTICE Jihan Sf Safwan, Pharm.D. Clinical Assistant Professor School of Pharmacy LIU
2 LEARNING OBJECTIVES Identify patients with uncomplicated cystitis (UC) presenting to the communitypharmacy Select optimal treatment based on in vitro resistance prevalence and the ecological adverse effects of antimicrobial therapy (collateral damage) 2
3 GUIDELINE International Clinical PracticeGuidelines for the Treatment of Acute Uncomplicated Cystitis and Pyelonephritis in Women 3 Infectious Diseases Society of America European Society for Microbiology and Infectious Diseases
4 DEFINITION Urinary Tract Infection (UTI) Inflammatory response of the urothelium after a bacterial invasion accompanied with bacteriuriaand i pyuria Presence of at least 100,000 colony forming units (cfu)/ ml in a pure culture of voided clean catch urine 4
5 CLASSIFICATION Upper Lower Uncomplicated Pyelonephritis Intra renal abscess Perinephric abscess Cystitis Urethritis Prostatitis Infection in a structurally and neurologically normal urinary tract Uncomplicated Cystitis Complicated Infection in a urinary tract with functional or structural abnormalities (eg. Indwelling catheter or renal calculi) 5
6 EPIDEMIOLOGY One of the most common indications for prescribing antibiotics at the communitypharmacy Country Lebanon Extrapolated Population estimated Gender prevalence used Females : Males 105, million 30:1 (Anatomy and reproductive 2.37 % physiology) 40% of all females have at least one episode of a UTI at some time in their lives Major cause for the development of resistant bacteria 6
7 EPIDEMIOLOGY Overview of UTI by age and sex 7
8 CLINICAL SCENARIO 1 Which of the following microorganisms is the main cause ofuncomplicated cystitis? a. Escherichia hi coli b. Pseudomonas aeroginosa c. Streptococcus pneumoniae d. Candida albicans 8
9 BACTERIOLOGY Bacteria Escherichia coli (E. coli) Klebsiella pneumoniae Percentage % 8.27 % Pseudomonas aeroginosa 3.98% Enterococcus Candida albicans species 3.58% 2.37% Proteus species 6.27% Streptococcus agalactiae 1.91% Proteus species 6.27 % Pseudomonas aeroginosa 3.98 % Klebsiella pneumoniae 8.27% Enterococcus species 3.58 % E. coli 60.64% Candida albicans 2.37 % Streptococcus agalactiae 1.91 % 9 Ziad Daoud,Claude Afif Escherichia coli Isolated from Urinary tract infection of Labanese patients between 2000 and 2009: epidemiology and profiles of resistance Chemotherapy Research and Practice vol 2011 Article IO , 6 page Doi /2011/
10 BACTERIOLOGY 10 Prevalence of ESBL E. coli and K. pneumoniae, and MRSA over the past years G.F. ARAJ et al. Antimicrobial bacterial resistance over a decade. Lebanese Medical Journal 2012 Volume 60 (3)
11 BACTERIOLOGY Antimicrobial susceptibility of E. coli vs years 11 G.F. ARAJ et al. Antimicrobial bacterial resistance over a decade. Lebanese Medical Journal 2012 Volume 60 (3)
12 PATHOPHYSIOLOGY Colonization of the vaginal introitus by uropathogens from the fecal flora Followed by ascension via the urethra into the bladder UNCOMPLICATED 12 UNCOMPLICATED CYSTITIS
13 RISK FACTORS Uncomplicated Immunocompetent No co morbidities No known urologic abnormalities Non pregnant Premenopausal Sexual intercourse Female gender Decrease in fluid intake Complicated History of childhood urinary tract infections Immunocompromised Preadolescent or postmenopausal Pregnant Underlying metabolic disorder (e.g., diabetes mellitus) Urologic abnormalities (e.g., stones, stents, indwelling catheters, neurogenic bladder, polycystic kidney disease) 13
14 SIGNS AND SYMPTOMS Frequency Dysuria Urgency Micturition Suprapubic pain +/ Hematuria 14
15 DIAGNOSIS Laboratory diagnostic tools (not necessary for UC) Urinalysis (microscopy or dipstick) Urine culture If atypical presentation Nitrites and leukocyte esterase If antimicrobial resistance suspected 15
16 TREATMENT Considerations in selecting the agent for acute UC: Active againstusualorganisms Achieve high urinary concentrations Tolerable / Low toxicity Resistance rates Propensity to cause Collateral Damage Cost Drug availability 16
17 TREATMENT Women with acute UC: No fever No Flank pain Nitrofurantoin Trimethoprim Sulfamethoxazole (TMP SMX) Fosfomycin Pivmecillinam Not tin Lebanon Alternatives 17 Fluoroquinolones (FQ) or Beta Lactams
18 NITROFURANTOIN Mechanism Inactivates or alters bacterial ribosomal proteins and other macromolecules that may interfere with metabolism and cell wall synthesis Dosing 100 mg PO bid for 5 days Clinical % Minimal collateral damage Efficacy May be effective ect eagainst ESBL Nausea, vomiting, loss of appetite Take with food Urine may turn dark yellow or brown in color Disappears after discontinuation Contraindicated (CI) if Creatinine Clearance (Cr Cl) < 60 ml/min Pregnancy category B Side effects and 18 counseling ESBL: extended spectrum β lactamase producing gram negative rods; PO: Orally; bid: twice per day
19 TMP SMX Mechanism TMP Inhibits dihydrofolate reductase Blocks production of tetrahydrofolic acid from dihydrofolic acid SMX Inhibits bacterial synthesis of dihydrofolic acid by competing with para aminobenzoic acid Dosing One double strength tablet (160/800 mg) bid for 3 days Clinical Efficacy % Minimal collateral damage Nausea, vomiting, diarrhea, and lossofappetiteof Do not use if you are allergic to sulfa medications High plasma protein binding Drug Interactions Pregnancy category: D Side effects and counseling 19
20 FOSFOMYCIN Mechanism Dosing Clinical Efficacy Blocks bacterial cell wall synthesis by inactivating enolpyruvyl transferase Reduces bacterial adherence to uroepithelialcells 3 g PO once Dissolve 1 packet (3 g) in a glass of water 91% Minimal collateral damage May be effective against ESBL Good oral absorption Excreted unchanged in urine High urine concentration lasting > 24 hrs Diarrhea, nausea, stomach upset, headache, or dizziness Minimal drug interactions Pregnancy Category: B Side effects and counseling 20
21 FLUOROQUINOLONES Ciprofloxacin Levofloxacin Ofloxacin Norfloxacin Available In Lebanon Prulifloxacin BUT Notin Guideline 21
22 FLUOROQUINOLONES Collateral Damage High BBW Increased risk of tendinitis and tendon rupture Contraindication Children Pregnancy Category C Side Effects Nausea / Diarrhea / Dizziness / Headache Lightheadedness / Trouble sleeping Duration 3 days in UC Ciprofloxacin Levofloxacin Ofloxacin Immediate release 250 mg PO bid Extended release 500 mg PO qd 250 mg PO qd 200 mg PO bid 22
23 BETA LACTAMS Less effective than FQ and TMP SMX Cfdii Cefdinir Duration of treatment 7 days Cefaclor Amoxicillin Clavulanate Cefpodoxime Proxetil Amoxicillin and Ampicillin Not for empiric treatment Poor efficacy High resistance 23
24 COLLATERAL DAMAGE Ecological adverse effect of antimicrobial therapy Selection of drug resistantresistant organisms Promote colonization or infection with MDR Associated with use of: Broad spectrum cephalosporins hl AND Fluoroquinolones l 24 MDR: Multi Drug Resistant
25 COLLATERAL DAMAGE Vancomycinresistant enterococci Extended spectrum β lactamase producing Klebsiella pneumoniae Broad spectrum cephalosporins β lactam resistant Acinetobacter Clostridium difficile 25
26 COLLATERAL DAMAGE Fluoroquinolones FQ resistant gram negative bacilli (pseudomonas) Methicillinresistant S. aureus ESBL 26
27 COLLATERAL DAMAGE Preserved in vitro susceptibility of E. coli over many years to: Nitrofurantoin Fosfomycin Cause minimal collateral damage (minimal i effects on normal fecal flora) Mecillinam 27
28 NON PHARMACOLOGICAL TREATMENT Drink plenty of water and other fluids every day (8 10 glasses) Drink cranberry juice Effective toilet hygiene (Wipe front to back) Regular and complete emptying of bladder Fragrance/feminine Shower rather deodorisers Voiding and than bathe Synthetic underwear hygiene post Carbonated, caffeinated, sexual alcoholic and acidic intercourse foods and fluids Avoid irritants 28
29 CONCLUSION Health care is a multidisciplinary service Pharmacists play a major role Patients seek direct medical advice from pharmacists Follow guideline in treating UTIs & encourage nonpharmacological treatment of UTIs 29
30 CLINICAL SCENARIO 2 Tamara is a 56 y.o. woman complaining of 1 day of increased urinary frequency, dysuria and sensation of incomplete voiding. She says she does not have fever, chills, vaginal discharge, or flank pain. She states that she is on Acenocoumarol (oral anticoagulant: VitaminK Antagonist) 4 mgpo for stroke prevention. Which of the following would you dispense to treat Tamara? Nitrofurantoin 100 mg PO bid for 5 days TMP SMX double strength tablet (160/800 mg) bid for 3 days Ciprofloxacin 500 mg PO qd for 3 days None of the above since she should perform a urinalysis 30
31 CLINICAL SCENARIO 3 Nina is a 28 year old woman who presents with a 2 day history of dysuria, frequency, and urgency. She has no significant medical history. She reports that she is very noncompliant and forgets taking any medications. Which one of the following is the best empiric therapy for Nina? Nitrofurantoin t i PO 100 mg twice daily dil for 3 days Ofloxacin PO 200 mg 2 times/day for 3 days TMP SMX PO double strength th2 times/day for 3 days Fosfomycin 3 g PO once 31
32 32
UTI Dr S Mathijs Department of Pharmacology
UTI Dr S Mathijs Department of Pharmacology Introduction Responsible for > 7 million consultations annually 15% of all antibiotic prescriptions 40% of all hospital acquired infections Significant burden
More information1. 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 informationGuidelines 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 informationUpdate 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 information11/10/2016. 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 informationUrinary Tract Infection Workshop
Urinary Tract Infection Workshop Diagnosis, sampling, antibiotic selection, recurrence, prophylaxis Nick Francis, Robin Howe, Harry Ahmed Outline Diagnosis and sampling Nick 10 min Choice of antibiotic
More information3/23/2017. Kathryn G. Smith, PharmD PGY1 Pharmacy Resident Via Christi Hospitals Wichita, Inc. Kathryn G. Smith: Nothing to disclose
Kathryn G. Smith, PharmD PGY1 Pharmacy Resident Via Christi Hospitals Wichita, Inc Kathryn G. Smith: Nothing to disclose Describe the new updates and rationale for them Relay safety concerns with use of
More informationAcute Pyelonephritis POAC Guideline
Acute Pyelonephritis POAC Guideline Refer full regional pathway http://aucklandregion.healthpathways.org.nz/33444 EXCLUSION CRITERIA: COMPLICATED PYELONEPHRITIS Discuss with relevant specialist for advice
More informationCork and Kerry SARI Newsletter; Vol. 2 (2), December 2006
Cork and SARI Newsletter; Vol. 2 (2), December 6 Item Type Newsletter Authors Murray, Deirdre;O'Connor, Nuala;Condon, Rosalind Download date 31/1/18 15:27:31 Link to Item http://hdl.handle.net/1147/67296
More informationAntibiotic 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 informationTreatment 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 informationCipro for gram positive cocci in urine
Buscar... Cipro for gram positive cocci in urine 20-6-2017 Pneumonia can be generally defined as an infection of the lung parenchyma, in which consolidation of the affected part and a filling of the alveolar
More informationA retrospective analysis of urine culture results issued by the microbiology department, Teaching Hospital, Karapitiya
A retrospective analysis of urine culture results issued by the microbiology department, Teaching Hospital, Karapitiya LU Edirisinghe 1, D Vidanagama 2 1 Senior Registrar in Medicine, 2 Consultant Microbiologist,
More informationhttp://dx.doi.org/10.1016/j.jemermed.2015.06.028 The Journal of Emergency Medicine, Vol. 49, No. 6, pp. 998 1003, 2015 Copyright Ó 2015 Elsevier Inc. Printed in the USA. All rights reserved 0736-4679/$
More informationAntimicrobial Stewardship in Continuing Care. Urinary Tract Infections Clinical Checklist
Antimicrobial Stewardship in Continuing Care Urinary Tract Infections Clinical Checklist December 2014 What is Antimicrobial Stewardship? Using the: right antimicrobial agent for a given diagnosis at the
More informationOther 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 informationIDSA GUIDELINES EXECUTIVE SUMMARY
IDSA GUIDELINES International Clinical Practice Guidelines for the Treatment of Acute Uncomplicated Cystitis and Pyelonephritis in Women: A 2010 Update by the Infectious Diseases Society of America and
More informationInteractive 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$100 $200 $300 $400 $500
Skin is In Runny Noses Got to go! Hear no evil It s in the Lungs $100 $100 $100 $100 $100 $200 $200 $200 $200 $200 $300 $300 $300 $300 $300 $400 $400 $400 $400 $400 $500 $500 $500 $500 $500 Double Jeopardy
More informationAntibiotic 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 informationHost, Syndrome, Bug, Drug: Introducing 2 Frameworks to Approach Infectious Diseases Cases with an Antimicrobial Stewardship Focus
Host, Syndrome, Bug, Drug: Introducing 2 Frameworks to Approach Infectious Diseases Cases with an Antimicrobial Stewardship Focus Montana ACP Meeting 2018 September 8, 2018 Staci Lee, MD, MEHP Billings
More informationAntimicrobial Resistance, Everyone s Fight. Charlotte Makanga Consultant Antimicrobial Pharmacist Betsi Cadwaladr University Health Board
Antimicrobial Resistance, Everyone s Fight Charlotte Makanga Consultant Antimicrobial Pharmacist Betsi Cadwaladr University Health Board Antimicrobial Resistance Antimicrobial resistance happens when microorganisms
More informationPrudent Use of Antibiotics in Long Term Care Residents with Suspected UTI
Prudent Use of Antibiotics in Long Term Care Residents with Suspected UTI Shira Doron, MD Assistant Professor of Medicine Division of Geographic Medicine and Infectious Diseases Tufts Medical Center Boston,
More informationCLINICAL 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 informationCipro for klebsiella uti
Cipro for klebsiella uti Search Can UTI be an effective treatment for Klebsiella Pneumoniae? It is safe or dangerous to use UTI while suffering from Klebsiella Pneumoniae? 87 discussions on Treato. instock
More informationAntibiotics in the trenches: An ER Doc s Perspective
Antibiotics in the trenches: An ER Doc s Perspective Peter Currie, MD Medical Director for Quality Emergency Physicians Professional Association (EPPA) Agenda Emergency Medicine Specific Disease Processes
More informationPerichondritis: 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 informationfolate-derived cofactors purines pyrimidines Sulfonamides sulfa drugs Trimethoprim infecting bacterium to perform DNA synthesis cotrimoxazole
Folate Antagonists Enzymes requiring folate-derived cofactors are essential for the synthesis of purines and pyrimidines (precursors of RNA and DNA) and other compounds necessary for cellular growth and
More informationPharmacology 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 informationrates adjusted for age, sex, infection subclass, and type of antibiotic treatment used) by British Medical Journal Publishing Group
Antibiotic treatment failure in four common infections in UK primary care 1991-2012: longitudinal analysis Craig J Currie BMJ 2014;349:g5493 23 September 2014 More than one in 10 initial antibiotic monotherapies
More informationDr. C. MANIKANDAN, Director,
STUDY OF PREVALENCE AND ANTIMICROBIAL SUSCEPTIBILITIES OF BACTERIA AND FUNGI ISOLATED FROM PATIENTS WITH URINARY TRACT INFECTIONS IN PATTUKKOTTAI, TAMIL NADU, INDIA Dr. C. MANIKANDAN, Director, Gangasaras
More informationInfectious 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 informationAntimicrobial Stewardship in the Long Term Care and Outpatient Settings. Carlos Reyes Sacin, MD, AAHIVS
Antimicrobial Stewardship in the Long Term Care and Outpatient Settings Carlos Reyes Sacin, MD, AAHIVS Disclosure Speaker and consultant in HIV medicine for Gilead and Jansen Pharmaceuticals Objectives
More informationVolume 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 informationAntibiotic stewardship in long term care
Antibiotic stewardship in long term care Shira Doron, MD Associate Professor of Medicine Division of Geographic Medicine and Infectious Diseases Tufts Medical Center Boston, MA Consultant to Massachusetts
More informationVolume. December Infection. Notes. length of. cases as 90% 1 week. tonsillitis. First Line. sore throat / daily for 5 days. quinsy >4000.
Volume 8; Number 22 LINCOLNSHIRE GUIDELINES FOR THE TREATMENT OF COMMONLYY OCCURRING INFECTIONS IN PRIMARY CARE: WINTER 2014/15 In this issue of the PACE Bulletin we present an update of our Guidelines
More informationAn Approach to Appropriate Antibiotic Prescribing in Outpatient and LTC Settings?
An Approach to Appropriate Antibiotic Prescribing in Outpatient and LTC Settings? Dr. Andrew Morris Antimicrobial Stewardship ProgramMt. Sinai Hospital University Health Network amorris@mtsinai.on.ca andrew.morris@uhn.ca
More informationNorthwestern 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 informationKey words: Urinary tract infection, Antibiotic resistance, E.coli.
Original article MICROBIOLOGICAL STUDY OF URINE ISOLATES IN OUT PATIENTS AND ITS RESISTANCE PATTERN AT A TERTIARY CARE HOSPITAL IN KANPUR. R.Sujatha 1,Deepak S 2, Nidhi P 3, Vaishali S 2, Dilshad K 2 1.
More informationWhat 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 informationCan levaquin treat group b strep
Can levaquin treat group b strep The Borg System is 100 % Can levaquin treat group b strep IBS - Symptoms, Diet and Treatment. IBS, is the common slang term or abbreviation for Irritable Bowel Syndrome
More informationANTIBIOTIC USE GUIDELINES FOR URINARY TRACT AND RESPIRATORY DISEASE
ANTIBIOTIC USE GUIDELINES FOR URINARY TRACT AND RESPIRATORY DISEASE Jane Sykes, BVSc(Hons), PhD, DACVIM (SAIM) School of Veterinary Medicine Dept. of Medicine & Epidemiology University of California Davis,
More information9/30/2016. Dr. Janell Mayer, Pharm.D., CGP, BCPS Dr. Lindsey Votaw, Pharm.D., CGP, BCPS
Dr. Janell Mayer, Pharm.D., CGP, BCPS Dr. Lindsey Votaw, Pharm.D., CGP, BCPS 1 2 Untoward Effects of Antibiotics Antibiotic resistance Adverse drug events (ADEs) Hypersensitivity/allergy Drug side effects
More informationETX0282, a Novel Oral Agent Against Multidrug-Resistant Enterobacteriaceae
ETX0282, a Novel Oral Agent Against Multidrug-Resistant Enterobacteriaceae Thomas Durand-Réville 02 June 2017 - ASM Microbe 2017 (Session #113) Disclosures Thomas Durand-Réville: Full-time Employee; Self;
More informationAntimicrobial 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 informationSimplicef is Used to Treat Animals with Skin Infections
Simplicef is Used to Treat Animals with Skin Infections PRODUCT INFO Simplicef tablets are a semi-synthetic cephalosporin antibiotic cefpodoxime proxetil used to cure infections caused by the susceptible
More informationAntibiotics for uncomplicated urinary tract infection in women
Drug review UTI Antibiotics for uncomplicated urinary tract infection in women Sarah Thompson BSc, MB ChB, Sarah Yacomeni BSc, MB ChB and Robert Townsend MSc, MRCPath, DTM&H Most well women with uncomplicated
More informationMicrobiology ( Bacteriology) sheet # 7
Microbiology ( Bacteriology) sheet # 7 Revision of last lecture : Each type of antimicrobial drug normally targets a specific structure or component of the bacterial cell eg:( cell wall, cell membrane,
More informationAmoxicillin Introduction: Mechanism of action: Pharmacology: Indications: Dosage: 12 Weeks ( 3 Months):
Amoxicillin Introduction: A semisynthetic antibiotic, an analog of ampicillin, with a broad spectrum of bactericidal activity against many gram-positive and gram-negative microganisms. Mechanism of action:
More informationAppropriate 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 informationInitial 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 informationAdvanced 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 informationChildrens 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 informationRecommended antibiotics for uncomplicated UTI in women
Drug review UTI Recommended antibiotics for uncomplicated UTI in women SPL Sarah Thompson BSc, MB ChB and Robert Townsend MSc, MRCPath, DTM&H Short courses of oral antibiotics in uncomplicated UTI remain
More informationDisclosures. 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 informationBurton's Microbiology for the Health Sciences. Chapter 9. Controlling Microbial Growth in Vivo Using Antimicrobial Agents
Burton's Microbiology for the Health Sciences Chapter 9. Controlling Microbial Growth in Vivo Using Antimicrobial Agents Chapter 9 Outline Introduction Characteristics of an Ideal Antimicrobial Agent How
More information10/13/14. 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 informationJMSCR Vol 05 Issue 07 Page July 2017
www.jmscr.igmpublication.org Impact Factor 5.84 Index Copernicus Value: 83.27 ISSN (e)-2347-176x ISSN (p) 2455-0450 DOI: https://dx.doi.org/10.18535/jmscr/v5i7.202 Original Research Article Profile of
More informationCLINICAL USE OF AMINOGLYCOSIDES AND FLUOROQUINOLONES THE AMINOGLYCOSIDES:
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 informationProtein 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 informationApproach 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 informationAppropriate 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 informationVolume 2; Number 16 October 2008
Volume 2; Number 16 October 2008 What s new this month NHS Lincolnshire have launched a public information campaign designed to raise public awareness of the risks associated with the inappropriate use
More informationCommunity Antibiotic Stewardship Hot Topic: Urinary Tract Infections in Post-Acute Patients and Long-Term Care Residents
Community Antibiotic Stewardship Hot Topic: Urinary Tract Infections in Post-Acute Patients and Long-Term Care Residents Great Plains QIN Support 2 How to Get Involved 3 We Have Gone Social Like Us and
More informationScottish Medicines Consortium
Scottish Medicines Consortium tigecycline 50mg vial of powder for intravenous infusion (Tygacil ) (277/06) Wyeth 9 June 2006 The Scottish Medicines Consortium (SMC) has completed its assessment of the
More informationMulti-Drug Resistant Organisms (MDRO)
Multi-Drug Resistant Organisms (MDRO) 2016 What are MDROs? Multi-drug resistant organisms, or MDROs, are bacteria resistant to current antibiotic therapy and therefore difficult to treat. MDROs can cause
More informationSafe Patient Care Keeping our Residents Safe Use Standard Precautions for ALL Residents at ALL times
Safe Patient Care Keeping our Residents Safe 2016 Use Standard Precautions for ALL Residents at ALL times #safepatientcare Do bugs need drugs? Dr Deirdre O Brien Consultant Microbiologist Mercy University
More information4 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 informationThe 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 informationTECHNOLOGY OVERVIEW: PHARMACEUTICALS
TECHNOLOGY OVERVIEW: PHARMACEUTICALS ISSUE 10.0 DECEMBER 1997 CLINICAL AND ECONOMIC CONSIDERATIONS IN THE USE OF FLUOROQUINOLONES based primarily on the Technical Report: An Analysis of the Use of Fluoroquinolones
More informationIntroduction to Chemotherapeutic Agents. Munir Gharaibeh MD, PhD, MHPE School of Medicine, The university of Jordan November 2018
Introduction to Chemotherapeutic Agents Munir Gharaibeh MD, PhD, MHPE School of Medicine, The university of Jordan November 2018 Antimicrobial Agents Substances that kill bacteria without harming the host.
More informationCLINICAL 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 informationObjectives. Antibiotic Prophylaxis in Urologic Procedures: A Review of the CUA Guidelines & Local Epidemiology of Drug Resistance
Antibiotic Prophylaxis in Urologic Procedures: A Review of the CUA Guidelines & Local Epidemiology of Drug Resistance David Hogarth UBC Urology PGY-1 May 24, 2017 Objectives 1. To review the current CUA
More informationGENERAL 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 informationA Study on Urinary Tract Infection Pathogen Profile and Their In Vitro Susceptibility to Antimicrobial Agents
Original Article Print ISSN: 2321-6379 Online ISSN: 2321-595X DOI: 10.17354/ijss/2017/65 A Study on Urinary Tract Infection Pathogen Profile and Their In Vitro Susceptibility to Antimicrobial Agents M
More information** 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 informationGroup b strep and macrodantin
Group b strep and macrodantin The Borg System is 100 % Group b strep and macrodantin 12-10-2017 Group B Streptococcus, also known as Streptococcus agalactiae, was once considered a pathogen of only domestic
More informationTreatment of Urinary Tract Infection
Treatment of Urinary Tract Infection Editing File Recognize different groups of antibiotics used in UTIs. Describe their mechanism of action, pharmacokinetics properties and adverse effects. Describe the
More informationCommunity-Associated C. difficile Infection: Think Outside the Hospital. Maria Bye, MPH Epidemiologist May 1, 2018
Community-Associated C. difficile Infection: Think Outside the Hospital Maria Bye, MPH Epidemiologist Maria.Bye@state.mn.us 651-201-4085 May 1, 2018 Clostridium difficile Clostridium difficile Clostridium
More informationAntibiotic. 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 informationnumber Done by Corrected by Doctor
number 32 Done by Nazek Hyasat Corrected by Doctor مالك الزحلف In this sheet we will talk about two cute drugs and a group of drugs, wish you a pleasant study... First of all, we will talk about clindamycin,which
More informationNew Zealand Consumer Medicine Information
New Zealand Consumer Medicine Information FLUCLOXACILLIN Flucloxacillin (as the sodium salt) 250 mg and 500 mg capsules Flucloxacillin (as the sodium salt) 125 mg/5 ml and 250 mg/5 ml powder for oral solution
More informationCephalosporins, 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 informationAntimicrobial 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 informationPrinciples 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 informationChapter 46. Sulfonamides, Trimethoprim, & Quinolones
Chapter 46 Sulfonamides, Trimethoprim, & Quinolones Classification of synthetic antimicrobial agents Ⅰ. Antifolate drugs: a. Sulfonamides b. Trimethoprim Ⅱ. DNA gyrase inhibitors: Fluoroquinolones Ⅰ. Antifolate
More informationSuggestions 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 informationSimilar 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 informationWomen 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 informationMicrobiology : antimicrobial drugs. Sheet 11. Ali abualhija
Microbiology : antimicrobial drugs Sheet 11 Ali abualhija return to our topic antimicrobial drugs, we have finished major group of antimicrobial drugs which associated with inhibition of protein synthesis
More informationAntibiotic Susceptibility Patterns of Community-Acquired Urinary Tract Infection Isolates from Female Patients on the US (Texas)- Mexico Border
Antibiotic Susceptibility Patterns of Community-Acquired Urinary Tract Infection Isolates from Female Patients on the US (Texas)- Mexico Border Yvonne Vasquez, MPH W. Lee Hand, MD Department of Research
More informationPrepared: August Review: July Common Infections. A Medicines Optimisation Antibiotic Prescribing Guide.
Prepared: August 2013 Review: July 2014 Common Infections. A Medicines Optimisation Antibiotic Prescribing Guide. Contents Page: Page No Why do we want to review antibiotics? 2 What do NICE say? 3 Acute
More informationPrescribing 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 informationSUMMARY OF PRODUCT CHARACTERISTICS. Cephacare flavour 50 mg tablets for cats and dogs. Excipients: For a full list of excipients, see section 6.1.
SUMMARY OF PRODUCT CHARACTERISTICS 1. NAME OF THE VETERINARY MEDICINAL PRODUCT Cephacare flavour 50 mg tablets for cats and dogs 2. QUALITATIVE AND QUANTITATIVE COMPOSITION Each tablet contains: Active
More informationTHE SENSITIVITY OF PATHOGENS OF COMMUNITY-ACQUIRED URINARY TRACT INFECTIONS IN KARAGANDA Ye. A. Zakharova 1, Chesca Antonella 2, I. S.
THE SENSITIVITY OF PATHOGENS OF COMMUNITY-ACQUIRED URINARY TRACT INFECTIONS IN KARAGANDA Ye. A. Zakharova 1, Chesca Antonella 2, I. S. Azizov 1 1 THE SHARED LABORATORY OF SCIENCE RESERCH CENTER, KARAGANDA
More informationPRACTIC 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 informationMercy 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 informationInfection Control & Prevention
Infection Control & Prevention Objectives: Define the term multi-drug resistant organism (MDRO). Recognize risk factors for developing MDROs. Describe the clinical manifestations and medical treatment
More information2012 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 informationESBL Positive E. coli and K. pneumoneae are Emerging as Major Pathogens for Urinary Tract Infection
ESBL Positive E. coli and K. pneumoneae are Emerging as Major Pathogens for Urinary Tract Infection Muhammad Abdur Rahim*, Palash Mitra*. Tabassum Samad*. Tufayel Ahmed Chowdhury*. Mehruba Alam Ananna*.
More information