Chapter 17 Anti-Infective Drugs

2 Treatment by Anti-Infectives Need to identify causative organism Determine sensitivity Culture and sensitivity –24-48 hours Broad spectrum antibiotics

3 Back in the Game Sports Medicine is a clinic dedicated to the treatment of physical injuries to the body. Caring for an injured body involves more than making the diagnosis; it's about understanding and treating the cause to prevent future injuries. The clinic addresses variety of injuries to the body whether it be from a car accident to over-use trauma. When injuries occur, it is no longer enough for people to "take it easy for awhile" or "work through it."Back in the Game PHYSICIAL THERAPY We believe that the true goal of physical therapy involves restoration of function through neuromuscular re-education and specialized manual techniques. These techniques restore movement, balance and quality of life. At Back in the Game, we go a step further and instruct people how to keep their bodies stronger and healthier. We do this by teaching proper body mechanics and developing personalized exercises that will help prevent re-injury.PHYSICIAL THERAPY At Back In The Game, it's all about you. You're the reason we're here. The entire visit is centered around giving you an experience uncommon in today's impersonal medical world. We recognize that you are a unique human being with specific needs which require talented people who truly care and we strive to deliver this care in a professional, yet comfortable environment. Dr. Lambert, a state licensed Chiropractic Physician, who has training in sports medicine, heads Back In The Game. Edited by Dr. Ryan Lambert-Bellacov, chiropractor for Back in the Game in West Linn, OR

Resistance What is resistance? Misuse of antibiotics Nosocomial infections MRSA (Methicillin-Resistant Staphylococcus Aureus) VRE (Vancomycin-Resistant Enterococcus) Edited by Dr. Ryan Lambert-Bellacov, chiropractor for Back in the Game in West Linn, OR

Strategies to Prevent Resistance Appropriate use of antibiotics Accurate diagnosis Targeted treatment of bacterial infections Preventive measures Edited by Dr. Ryan Lambert-Bellacov, chiropractor for Back in the Game in West Linn, OR

Selection of Anti-Infective Drugs Status of hepatic and/or renal function Age of patient Pregnancy or lactation Likelihood of organisms developing resistance Know allergies Edited by Dr. Ryan Lambert-Bellacov, chiropractor for Back in the Game in West Linn, OR

Adverse Reactions Hypersensitivity Anaphylaxis Direct toxicity Indirection toxicity Edited by Dr. Ryan Lambert-Bellacov, chiropractor for Back in the Game in West Linn, OR

8 Aminoglycosides Gram-negative and gram-positive bacteria Toxicity Peak and trough levels Serious side effects Contraindications Interactions Patient education

9 Cephalosporins Semisynthetic Broad-spectrum First, second, third, or fourth generation Side effects Contraindication or extreme caution

Copyright © 2007 by Thomson Delmar Learning. ALL RIGHTS RESERVED.10 Cephalosporins Interactions Patient education

11 Macrolides Used when there is allergy to penicillin Less toxicity Side effects Contraindications Interactions Patient education Edited by Dr. Ryan Lambert-Bellacov, chiropractor for Back in the Game in West Linn, OR

12 Penicillins Produced from fungus Uses Semisynthetic penicillins Serious side effects Contraindications or extreme cautions

13 Penicillins Interactions Patient education

14 Quinolones When used Increased resistance Side effects Contraindications or caution Interactions Patient education

15 Tetracyclines Broad-spectrum When used Side effects Contraindications Interactions Patient education Edited by Dr. Ryan Lambert-Bellacov, chiropractor for Back in the Game in West Linn, OR

16 Antifungals Amphotericin B Fluconazole Griseofulvin Nystatin Patient education Edited by Dr. Ryan Lambert-Bellacov, chiropractor for Back in the Game in West Linn, OR

17 Antituberculosis Agents Treat asymptomatic infection Treat active clinical tuberculosis CDC recommendations Side effects Contraindications or caution Interactions Patient education Edited by Dr. Ryan Lambert-Bellacov, chiropractor for Back in the Game in West Linn, OR

18 Other Anti-Infectives Clindamycin Metronidazole Vancomycin Edited by Dr. Ryan Lambert-Bellacov, chiropractor for Back in the Game in West Linn, OR

19 Antivirals Acyclovir Amantadine Neuraminidase inhibitors Ribavirin Edited by Dr. Ryan Lambert-Bellacov, chiropractor for Back in the Game in West Linn, OR

20 HIV/AIDS Treatment Incurable with current medications Suppression of viral load Restore and/or preserve immunologic function Improve quality of life Reduce HIV-related morbidity and mortality Edited by Dr. Ryan Lambert-Bellacov, chiropractor for Back in the Game in West Linn, OR

21 HIV/AIDS Medications Anti-retroviral protease inhibitors Nucleoside reverse transcriptase inhibitors Non-nucleoside reverse transcriptase inhibitors Treatment of opportunistic infections Edited by Dr. Ryan Lambert-Bellacov, chiropractor for Back in the Game in West Linn, OR

22 Sulfonamides Among oldest anti-infectives Increasing resistance Used in combination with other drugs Side effects Contraindications Interactions Patient education Edited by Dr. Ryan Lambert-Bellacov, chiropractor for Back in the Game in West Linn, OR

23 Urinary Anti-Infectives Usually bacteriostatic instead of bactericidal Nitrofurantoin (Furadantin & Macrodantin) Side effects Contraindication or caution

24 Urinary Anti-Infectives Interactions Patient education

Back in the Game Sports Medicine is a clinic dedicated to the treatment of physical injuries to the body. Caring for an injured body involves more than making the diagnosis; it's about understanding and treating the cause to prevent future injuries. The clinic addresses variety of injuries to the body whether it be from a car accident to over-use trauma. When injuries occur, it is no longer enough for people to "take it easy for awhile" or "work through it."Back in the Game PHYSICIAL THERAPY We believe that the true goal of physical therapy involves restoration of function through neuromuscular re-education and specialized manual techniques. These techniques restore movement, balance and quality of life. At Back in the Game, we go a step further and instruct people how to keep their bodies stronger and healthier. We do this by teaching proper body mechanics and developing personalized exercises that will help prevent re-injury.PHYSICIAL THERAPY At Back In The Game, it's all about you. You're the reason we're here. The entire visit is centered around giving you an experience uncommon in today's impersonal medical world. We recognize that you are a unique human being with specific needs which require talented people who truly care and we strive to deliver this care in a professional, yet comfortable environment. Dr. Lambert, a state licensed Chiropractic Physician, who has training in sports medicine, heads Back In The Game.