Professional Documents
Culture Documents
ANTIBIOTIC IN
CHILDREN
BLOK 26
1945
1955
Component of
Treatment
General principles of
the treatment of infection
Basic principle of
prescribing antibiotic
Benefit value for patient
Highly suggested bacterial infeciotn
Antibiotic selection
Class, dose, route, interval, duration
PK/PD
Adverse reaction
Clinical asessment
Step 1
Clinical asassment
The likely
anatomical
locations
The most
Most
suitable choice of
pathogen
drug
Determined by accurate physical
Superficial (skin,
Invasive to the tissue or
examination
mucosa)
blood stream
intravenous
Step 2
Look for other issues
Epidemiological aspects
Valvular
heart disease,
Pre-existing
medical
problems
Prosthetic
devices: V-P
underlying malignant
shunt
disease
PMN
Factors to assist
antibiotic selection
indication
for
antimicro
bial agent
Monotherap
y or
combinaiton
Most common
organism
causing the
infection & the
local
susceptibility
pattern
Antibiotic
spectrum of
the chosen
empirical
agent
Host factor
that might
affect therapy
Adverse
reation
PK/PD that
are associated
with a
particular
antibiotic
Cost
effectivenes
s of
antibioitc
selection
Criteria in antibioitic
selection
Broad or
narrow
spectrum
Epmpiric or
definitive
IV or oral
Bacteriostat
ic or
bactericid
Moo or
combined
@ chemical structure
and
@mechanism of action
Bacterial Basics
Bacteria aspects antibiotic
target
Bacterial Biosynthet
DNA
cell
ic
replication
envelope processes
14
Antibiotic classes
Broad spectrum
Unknown etilogy
Emprirical
Potential serious
bacterial infection
Multiple antibioitc
Mono vs Combination
Mono or combination
Antibiotic combination
Sinergy or additive
Common antibiotic
combination
Double lactam
-lactam &
aminoglycosi
de
-lactam &
quinolon
Antibiotic
administration
Preffered
easy and
cost-effective
Oral
i.v
When do we
give iv?
Advantage
Reach desirable
soon
Oral (-)
Reach therapeutic
level sooner
Contraindication for
oral
Empirical therapy
based on clinical
diagnostic and
suspected
microorganism
Drug of choice and
alternative drugs
Definitive
therapy
Based on positive
result of culture &
sensitivity test
Flowchart of bacterail
infection treatment
Recov
er
Narrow
spectrum
antiiotic
Probable
Bacte
rial
infect
ion
Empiric therapyCultur
Definitiv
e
therapy
Pathoge
n
identific
ation
Laboaratory
assesment
Few infective condition present a typical picture
with a definitive clinical & microbiological
diagnosis without lab. exam
Treatment evaluation
Antibiotic therapy
failure
Inaccurate dose
Wrong diagnosis
Antibiotic stewardship
Thank you