Beruflich Dokumente
Kultur Dokumente
Jan Bazner-Chandler
MSN, CNS, RN, CPNP
Bacteria
Bacteria
Gram positive
Staphylococcus aureus
Streptocci
Enterococci
Gram negative
Empiric Therapy
Prophylactic Antibiotic
Therapy
Superinfection
Examples of Superinfections
Laboratory Tests
Cultures
Throat
Wound
Urine
Sputum
Blood
Clinical Pearl
Antimicrobials
Two Classifications
Deep wounds
Characterized by abscess formation, foul-smelling
pus and tissue destruction
Community-Acquired
Infection
Nosocomial Infections
Pseudomonas
Proteus
Bacterial Resistance
Opportunistic Host
Infants
Geriatric population
Cancer
HIV positive low T-cell count
Burns
Skin breakdown
Client with total knee or hip replacement
Allergies
Previous drug reactions
Baseline renal and liver function
Review culture reports for appropriate
antibacterial drug choice
Patient response to antibiotics therapy
Antibiotics
Sulfonamides
Penicillins
Cephalosporins
Macrolides
Fluoroquinolones
Aminoglycosides
Tetracyclines
Sulfonamides
Indications
Contraindications
Adverse Effects
B-Lactam Antibiotics
penicillins
cephalosporins
carbapenes
monobactams
Penicillin
Penicillin
First generation IM or IV
Newer penicillins have been developed that
increase gastric acid stability of penicillin
Good drug since it enters most bodily fluids:
joint, pleural, and pericardial.
Not effective against intraocular (eye) or
cerebral spinal fluid infection (CSF)
Penicillin
Susceptible Bacteria
Gram-positive organisms
Streptococcus
Enterococcus
Staphylococcus
Adverse Reactions
Hives
Anaphylaxis
Unasyn
Augmentin
Timentin
Zosyn
Ampicillin Synthetic
Penicillin
Ampicillin
Nursing Implications
Same as penicillin
Ask client about oral contraceptive use drug
may cause transient decrease in
effectiveness
Advise to use additional BC barrier
protection during antibiotic therapy
Amoxicillin
Amoxicillin
Cephalosporins
Cephalosporin
Meningitis
First Generation
Cephalosporins
Impetigo
First Generation
Cephalosporins
Keflex
Client teaching
Keflex Dosing
Cefazolin or Ancef
Ancef Dosing
IV
Used for UTI, bone and skin infections,
endocarditis
Not suitable for treatment of meningitis
Perioperative prophylaxis
Second-Generation
Cephalosporins
Carbapenems
imipenem-cilastatin (Primaxin)
meropenen (Merrem): only drug in this class used
in the treatment of bacterial meningitis.
Macrolides
azithromycin * Zithromax
Clarithromcin * Biaxin
dirithromycin
erythromycin
Macrolides
Macrolides
Ketaloids
Tetracyclines
Tetracyclines
IM or IV administration
Have more toxic side effects
Blood levels may need to be monitored to
determine therapeutic versus toxic levels of
mediation in the blood.
Aminoglycosides
Concentration Dependent
Adverse Effects
Aminoglycosides
Aminoglycosides
gentamicin (Garamycin)
tobramycin (Nobcin, TOBI)
neomycin (Neo-Fradin)
Floroquinolones
ciproflxcin (Cipro)
clindamycin (Cleocin)
MRSA Infections
MRSA
Vancomycin
Adverse Effect
Anti-viral Drugs
Herpes Zoster
Cold Sore
Herpes Drugs
Generic: acyclovir
Trade: Zovirax
Action: interferes with DNA synthesis.
Therapeutic effects: Inhibition of viral
replication, decreased viral shedding and
reduced time for healing of lesions.
acyclovir