BS (empirical) antibiotic therapy that acts against both G(+) and G(-) bacteria. Bacterial infection is suspected but group of bacteria is unknown. - powerful but pose specific risks- disruption of native, normal bacteria and development of antimicrobial resistance. E.g. ampicillin
Narrow-spectrum antibiotic- effective against specific families of bacteria.
Uses of emprical antibiotic therapy
- Empirically, when the causative organism is unknown, but delays in treatment would lead to worsening infection or spread of bacteria to other parts of the body. e.g. meningitis- fatal within hours if BS antibiotics are not initiated. For drug-resistant bacteria that do not respond to narrow-spectrum antibiotics. - In the case of superinfections, where there are multiple types of bacteria causing illness, thus warranting either a BS antibiotic or combination antibiotic therapy. - For prophylaxis in order to prevent bacterial infections occurring e.g. before surgery, to prevent infection during the operation, or for patients with immunosuppression who are at high-risk for dangerous bacterial infections.
❖ Productive cough, fever, rigors, dyspnoea, pleuritic chest pain ❖ Diagnosis: respiratory rate, oxygen saturation, sputum culture, blood test, urinary antigen, chest X-ray, CT scan ❖ Promote immunisation against S.pneumoniae in patients at risk of recurrence
Two types of pneumonia
Community acquire pneumonia (CAP) and Hospital acquired pneumonia (HAP)
Mechanism of pneumonia
Infection that inflames the air sacs in one or both lungs. The air sacs may fill with fluid or pus causing cough with phlegm or pus, fever, chills and difficulty breathing. A variety of organisms including bacteria, viruses and fungi can cause pneumonia.
Mild CAP Amoxicillin 1g orally, 8 hourly for 7 days. Hyp. sensitive to penicillin Doxycycline 100mg, 12 hourly (7day treatment)
Moderate CAP Benzylpenicillin IV 1.2 G6H + doxycycline 100mg BD
Severe CAP Ceftriaxone IV 1g D + azithromycin IV 500mg D