Antimicrobial Therapies
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| What are the two main functions of Micro Lab? | Diagnostic and Therapeutic
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| What does the diagnostic function of the micro lab entail? | detection, isolation and identification of etiologic agents
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| What does the therapeutic function of the micro lab entail? | antimicrobial susceptibility testing as guide to appropriate therapy
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| What is the fundamental principle of antimicrobial therapy? | selective toxicity
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| What is an optimal agent? | one with narrowest spectrum of activity, fewest side effects, and lowest toxicity.
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| How is the optimal agent administered? | in dosage and schedule that will achieve a level at the site of infection equal to, or several times greater than, Minimum Inhibitory Concentration (MIC)
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| In reference to the individual patient, what must the Physician take into consideration? | site of infection, age, status of kidney and liver function, pregnancy, hypersensitivity, Idiosyncracy, and drug interactions
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| What are the disavdantages of improper use of antimicrobials? | Toxicity, drug resistance, alteration of indigenous flora, hypersensitivity
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| What are the purposes for antimicrobial suspectibility testing? | Initiation of appropriate therapy, modification of existing therapy, and determination of susceptibility patterns in local environment
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| What are the two methods of antimicrobial susceptibility testing? | Broth dilution and agar diffusion
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| Broth dilutions yield what value to be reported? | MIC value
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| Agar diffusions yield what value to be reported? | SIR value
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| What is an antibiogram? | a species’ susceptibility pattern; useful as guide to empirical therapy
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| Broth dilutions must contain what two controls? | Sterility control and growth control
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| In the broth dilution, how is the MIC determines? | The MIC is that last tube without turbidity
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| What does MIC stand for? | Minimum Inhibitory Concentration
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| What are the advantages of using a microtiter plate? | easier handling, low volumes of reagent and microbe, convenience,and automated reading
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| How is a microtiter plate read? | As inhibition of growth
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| On a microtiter plate, a button in the well indicates what? | growth
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| What method is commonly used in agar diffusion susceptibility testing? | Kirby-Bauer
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| What is the agar used in Kirby-Bauer? | Mueller-Hinton agar
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| How many drugs can be tested at once on a Mueller-Hinton plate using the Kirby-Bauer method? | 12
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| In the agar diffusion method, what does a larger zone of inhibition correlate to? | Higher susceptibility to the drug
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| A result of ~6 mm for a zone of inhibition would correlate to what? | Resistance to the drug
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| In the broth dilution technique, no turbidity in the tube means what? | no growth
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| What are the 3 susceptibility test panels? | Panel for GP and GN isolants Panel for specific species Example: P. aeruginosa Panel for urinary or CSF isolants
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| In the SIR interpretation, how does S correlate with the MIC value | S (susceptible) = MIC < therapeutic concentration; expected to respond to agent at usual dosage and schedule
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| In the SIR interpretation, how does R correlate with the MIC value | R (resistant) = MIC > achievable level by usual dosage and schedule
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| In the SIR interpretation, how does I correlate with the MIC value | I (intermediate) = MIC ≥ expected level at site of infection by usual dosage and schedule; may respond to high dosage
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| When should the plate used for Kirby-Bauer be measured? | After 16-18 hours of incubation
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| What size are the MH agar plates? | 150 mm
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