This document discusses the use of antibiotics in surgery. It begins by classifying antibiotics based on their mechanisms and targets, such as cell wall synthesis inhibitors and protein synthesis inhibitors. It then covers the principles of using antibiotics for prophylaxis and therapy in surgery. Antibiotic prophylaxis involves administering antibiotics before surgery to prevent infection, typically using a single pre-operative dose. Therapeutic antibiotics treat existing infections and require determining the causative organism and administering effective antibiotics, usually for a short course. The document stresses the importance of appropriate antibiotic use to minimize resistance.
Antibiotics are used against a wide range of pathogens and are very important in preventing and treating infections. The use of appropriate choice of antibiotics, dose and enforcing compliance is important in patient's care and preventing drug resistance.
This ppt discusses what factors to keep in mind while choosing an appropriate antimicrobial agent . It also discusses briefly when antimicrobial prophylaxis is justified as well as failure of antimicrobial therapy.
Antibiotics are used against a wide range of pathogens and are very important in preventing and treating infections. The use of appropriate choice of antibiotics, dose and enforcing compliance is important in patient's care and preventing drug resistance.
This ppt discusses what factors to keep in mind while choosing an appropriate antimicrobial agent . It also discusses briefly when antimicrobial prophylaxis is justified as well as failure of antimicrobial therapy.
Rational Use of Antibiotics. Infection was a major cause of morbidity and mortality, before the development of antibiotics.
The treatment of infections faced a great challenge during those periods.
Later in 1928, the discovery of Penicillin, a beta-lactam antibiotic, by Alexander Fleming opened up the golden era of antibiotics.
It marked a revolution in the treatment of infectious diseases and stimulated new efforts to synthesize newer antibiotics.
The period between the 1950s and 1970s is considered the golden era of discovery of novel antibiotic classes, with very few classes discovered since then.
Antibiotic policy and trends in antibiotic policy,
References
Infection control: Basic concepts and practices, 2nd edn.
www.cdc.org
Antibiotics guide: choices for common infections
Chennai Declaration
Rational Use of Antibiotics. Infection was a major cause of morbidity and mortality, before the development of antibiotics.
The treatment of infections faced a great challenge during those periods.
Later in 1928, the discovery of Penicillin, a beta-lactam antibiotic, by Alexander Fleming opened up the golden era of antibiotics.
It marked a revolution in the treatment of infectious diseases and stimulated new efforts to synthesize newer antibiotics.
The period between the 1950s and 1970s is considered the golden era of discovery of novel antibiotic classes, with very few classes discovered since then.
Antibiotic policy and trends in antibiotic policy,
References
Infection control: Basic concepts and practices, 2nd edn.
www.cdc.org
Antibiotics guide: choices for common infections
Chennai Declaration
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
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3. ANTIBIOTICS: a natural substance produced by a micro-organism to
kill another.
• They include the culture extracts and filtrates of fungi such as
penicillium and cephalosporium and bacteria such as streptomyces
and bacillus species.
4. ANTIMICROBIAL: any natural or synthetic agent that kills
pathogens
• They include the sulfonamides, trimethoprim, cotrimoxazole,
nitrofurantoin, nalidixic acid, metroniadazole, P.aminosalicylic
acid, isoniazid and ethambutol.
• Antifungal agents include nystatin, and flucytosine.
6. Mechanism of Action
• Inhibition of Cell Wall Synthesis
• Disruption of Cell Membrane
• Inhibition of Protein Synthesis
• Inhibition of Nucleic acid synthesis
• Interference with Metabolic Processes
11. Mechanism of action :
1. The β-lactam binds to Penicillin Binding
Protein (PBP)
2. PBP is unable to crosslink peptidoglycan
chains
3. The bacteria is unable to synthesize a stable
cell wall
4. The bacteria is lysed
17. Antibiotics Prophylaxis inSurgery
• Use of antibiotic where there is no evidence of infection
but expected to be exposed to pathogens that constitutes
a major risk of infection.
• Single dose regime, based on the most common organism,
which is given at the time of induction to ensure the minimum
inhibitory concentration during skin incision –reduces risk of
surgical site infection (SSI)and post op infection.
18. • Usually a single dose is sufficient. A second dose
may be required in the following situations:
a. in prolonged operations
b. when there is contamination during operation
• Giving more than 1 or 2 doses postoperatively is
generally not advised. The practice of continuing
prophylactic antibiotics until surgical drains have
been removed is not recommended.
19. General Principles ofSurgical
Prophylaxis
• A single preoperative dose of antibiotic is as effective as
full five days course of therapy assuming uncomplicated
procedure.
• Prophylactic antibiotics should be administered within 1
hour prior to incision, preferably with induction of
anesthesia.
• Prophylactic antibiotics should targetanticipated
organisms.
20. • Prophylaxis is generally recommended for clean-
contaminated (risk of infection is 6%) and
contaminated (risk of infection is 15%)
operations.
• In clean operation prophylaxis is also indicated under
certain conditions i.e. where there is prosthesis
implanted, high risk perforation where infection is
catastrophic e.g. neurosurgery or cardiac surgery.
22. GoalsofAntibiotic Prophylaxis
• Reducethe incidence of surgical site infection (SSI)
• Minimize the effect on the patient’s normal bacterial
flora.
• Minimize adverse side effects of antibiotics.
• Minimize the emergence of antibiotics resistant strains of
bacteria.
• Costeffectiveness.
23. PROCEDURE SUGGESTED ANTIBIOTIC
1. GI surgery
2. HBS surgery
IV Cefoperazone 1g PLUS IV
Metronidazole 500mg
1.Hernia repair with mesh
(includes laparoscopic repair)
2. Breast
(not recommended for minor
excision
3.Burns
IV Cloxacillin 1G
Vascular Operation IV Ampicillin/Sulbactam 1.5g
Neurosurgery IV Ceftriaxone 1gm AND
IV Metronidazole 500mg
Urology IV Amoxicillin / clavulanate 1.2g
GUIDELINES FOR SURGICAL
PROPHYLACTICANTIBIOTICS
29. EMPIRIC THERAPY
• When to start?
• Riskof surgicalinfection is high - basedon the underlying disease
process(e.g.perforated appendicitis)[prophylaxis empiric]
• Significant contamination during surgeryhasoccurred(e.g.
considerablespillageof colon contents)
• In critically ill patients –potential site of infection hasbeenidentified
• Severe sepsisor septicshock
• Short course (3-5days)
• Stop if the presence of alocal site or systemic infection is not
revealed.
30. MONOMICROBIALVS
POLYMICROBIAL
• Monomicrobial infections:
• Nosocomialwhich occurredin postoperative patients, e.g.UTI,
pneumonia, catheter-relatedinfection
• Polymicrobial infections:
culture results lesshelpful
• Thus,antibiotic regimen should not be modified solely on
culture information. Clinical course is moreimportant.
31. Systemic InflammatoryResponse
Syndrome(SIRS)
• Empiric antibiotics are not indicated for all patients with
SIRS
• Indications for antibiotic therapy include the following:
• Suspected or diagnosedinfectious etiology (e.g.UTI,
pneumonia,cellulitis)
• Neutropenia or other immunocompromised states
• Asplenia- Dueto the potential for overwhelming
postsplenectomyinfection
33. DURATION OF THERAPY
• Duration should be long enough to prevent relapse
yet not excessive, asit canincrease side effects and
resistance.
• Factors suchasdecreasing trend ofWBCsand lack of
fever guide the length of therapy.
• The search for extra abdominal source of infection
or aresidual /ongoing source of intra abdominal
infectionshould be sought.
35. SIDE EFFECTS
Antibiotic Side Effects
Penicillins • Allergy (seriousanaphylaxis)
Cephalosporins • Allergy
Aminoglycosides • Hearing loss
• Vertigo
• Renaldysfunction
Carbapenems • Seizures(Imipenem)
• Rashes
Macrolides • Prolonged QTinterval
(Erythromycin)
• Hearing loss
• Jaundice
36. ANTIBIOTICRESISTANCE
• Resistance of amicroorganism to an
antimicrobial agent to which it was previously
sensitive.
• Resistant organisms are able to withstand attack
by antimicrobial medicines so that standard
treatments become ineffective and infections
persist and may spread to others
37. ANTIBIOTICRESISTANCE
Intrinsic
• Drug target is not present in the bacteria’s metabolic
pathways
Acquired
• Mutation
• Transferof genetic material from resistant to susceptible
organisms (plasmids, transposons,bacteriophages)
39. Resistance to Antibiotics
• By genetic mutation — changes to the proteins and other
components of bacterial cells which Antimicrobial use as
binding sites (DRUG INACTIVATION OR
MODIFICATION).
• Gene transfer: plasmids (via conjugation and
transduction);
• By bacteria producing enzymes (β-lactamase) that destroy or
inactivate Antimicrobial.
• Microbes may cease active uptake of certain
40. Resistance to Antibiotics
• Changes in receptors which decrease antibiotic binding and
action : ALTERATION OF TARGET OR BINDING SITE
OF ANTIBIOTICS)
• Microbes may synthesize compounds that antagonize drug
actions.
• By bacteria altering the permeability of their cell membrane
making it difficult for Antimicrobial to enter (ACTIVE
EFFLUX).
• Antibiotic use promotes the emergence of drug-resistant
microbes.
