The Antibiotic Ladder
The anti-infection stepping stool is utilized to dial back the anti-infection obstruction that the microbes are creating. The thought is to utilize the most vulnerable anti-infection that is adequate to kill off the given bacterial province. This way there is no summed up killing of all bacterium, prompting the arrangement of superbugs.
As a general rule, going higher on the stepping stool implies utilizing more up to date anti-toxins.
Different anti-infection agents and their inclusion.
- Penicillin
- The main anti-infection created
Loads of microbes have created protection from this and as of now, syphilis is one of the main creatures vulnerable to penicillins
Microscopic organisms advanced to deliver the beta-lactamase compound to separate penicillins
We figured out how to foster new penicillins
- Aminopenicillins
- Intended for gram-negative microscopic organisms
- Little in size to go through the gram-negative bacterial divider
- The little size brought about them being helpless to beta-lactamase proteins
- Models
- Anti-toxins that beginning with "Am"
- Ampicillin
- Amoxicillin
- Aminopenicillins notwithstanding beta-lactamase inhibitors
- Makes these impervious to beta-lactamases
- Can be utilized for gram up-sides
- Models
- Amoxi clavulin
- Ampicillin sulbactam
- Against pseudomonal penicillins
- Possibly use in case Pseudomonas is being treated notwithstanding a wide inclusion
- These incorporate beta-lactamase inhibitors too
- Models
- Piperacillin/Tazobactam (Piptazo)
- Ticarcillin/Clavulanate
- More grounded hostile to pseudomonal penicillins - Carbapenems
- Models
- Meropenem
- Monobactam
- Aztreonam - utilized as first-line in serious penicillin sensitivity
- Methicilin delicate staph aureus (MSSA) anti-infection agents
- Models
- Nafcillin
- Dicloxacillin - oral
- Methicillin-safe staph aureus (MRSA) anti-infection agents
Vancomycin
Utilized solely for MRSA
Daptomycin
Used to treat blood diseases
Doesn't work for lung diseases
Linezolid - L=lung
Used to treat lung diseases
Doesn't work for blood diseases
Cephalosporins
Ages
first
Function admirably on gram up-sides
Not helpful for gram negatives
Utilized for skin contamination prophylaxis or for the treatment of cellulitis
Models
Cephalexin/Keflex
Cefazolin/Ancef
second
Not useful for gram negatives
OK for gram up-sides
third
Work better on gram negatives
Likewise deals with strep
Models
Ceftriaxone
fourth
Models
Cefepime
Utilized as an antipseudomonal
Fluoroquinolones
Models
Ciprofloxacin
Used to treat gram negatives solely
Used to be utilized for UTI's before - does not work anymore
Right now utilized for Pseudomonas (twofold inclusion)
Levofloxacin
On the off chance that the bug is defenseless to levofloxacin, use levofloxacin before moxifloxacin
Moxifloxacin
Respiratory fluoroquinolone
Used to treat gram-positive life forms like strep (pneumonia bugs)
Enemies of anaerobes
Models
Metronidazole
Utilized in the gut and vagina for anaerobes
Clindamycin
Utilized in different spots for anaerobes
Anti-infection use standards
General anti-infection use directs that debilitated patients get wide anti-microbials. In case patients are not beating that, different anti-infection agents are added. When attempting to limit the anti-infection agents a patient is on, eliminate the anti-toxins each in turn. Doing this guarantees that if the patient deteriorates after the anti-microbial expulsion it is clear which anti-infection should be returned on.
Local area obtained pneumonia
Ceftriaxone + azithromycin
Whenever hospitalized
Azithromycin
Locally
Moxifloxacin
Utilized if the patient is hypersensitive to beta-lactams
Pseudomonas and MRSA
Vancomycin and piptazo
Linezolid and meropenem
On the off chance that vancomycin and piptazo can't be utilized (sensitivity)
Meningitis
Vancomycin + Ceftriaxone + steroids + ampicillin (if immunocompromised)
UTI
Amoxycillin
Best for outpatient
Macrobid = Nitrofurantoin
On the off chance that oversensitive to beta-lactams
Sulfamethoxazole and trimethoprim
More terrible than the 2 above
Ciprofloxacin
Not ready to utilize this any longer
Pyelonephritis
Ceftriaxone
Cellulitis
Brought about by strep
Amoxicillin - outpatient
Ceftriaxone - inpatient
Brought about by staph
Clindamycin - outpatient
Vancomycin - inpatient
All data gave on this site is to instructive purposes and doesn't comprise any clinical counsel. Kindly address you specialist prior to changing your eating routine, movement or drugs.
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