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Antimicrobial general considerations, Superinfection, CDK, Elaboration of…
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Superinfection
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Broad spectrum antibiotics AACCT aminoglycosides, ampicillin, chloramphenicol,clindamycin and tetracyclines may kill the normal flora and result in the development of new infections.
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Oropharynx, intestine, respiratory and genitourinary tract are common sites for the development of new infection.
Organisms frequently involved are candida albicans, clostridium difficle, staphylococci, proteus and pseudomonas.
Clostridium difficle superinfection may result in pseudomembranous colitis most commonly due to third generation cephalosporins for which metronidazole is the drug of choice alternative drug is Vancomycin.
Further due to loss of commensal flora, there may be decreased formation of vitamin K leading to enhanced coagulation effects of warfarin.
CDK
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These drugs produce better action when used as a large single dose as compared to same daily dose divided into 2-3 portions.
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TDK
TDK means antimicrobial action depends on the length of time the concentration remains above the MIC. E.g. BV B-lactams and vancomycin.
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Macrolides and clindamycin also possess time dependent activity. However these are static drugs not TDK but Time dependent inhibitory activity drugs. Remember most common.
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Antibiotics
Antibiotics are the substances produced by microorganisms, which suppresses the growth of or kill other microorganisms at very low concentrations.
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Conjugation
Conjugation is due to physical contact between bacteria and is responsible for multidrug resistance.
Important mechanism for the development of resistance against SC streptomycin and chloramphenicol.
Transduction
Transduction is the transfer of resistance gene through bacteriophage e.g. PEC penicillin, erythromycin and chloramphenicol.
Transformation
Transformation is the transfer of resistance gene through environment and is not significant clinically e.g. penicillin G
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