Jason Roy Edward

RATIONALE USE OF ANTIBIOTICS IN Peryashini Thambirajah

Sharmila Balakrishnan
COMMON DISEASES Durgavalli Arumugam
Eric Sivanesh
ORGANISMS INVOLVED
Bacteria Fungi Others
Viridans streptococcus Candida albicans Chlamydia
Staphylococcus aureus Aspergillus Coxiella burnetii
Enterococcus Cryptococcus neoformans
Coagulase-negative
staphylococcus
Hemolytic streptococcus
Steptococcus pneumoniae
HACEK organisms
 ANTIBIOTICS
Penicillin
First-line agent
Interferes with synthesis of
cell wall mucopeptide
during active
multiplication, resulting in
bactericidal activity against
susceptible microorganism
Ampicillin Ceftriaxone Gentamicin Vancomycin
Has bactericidal Third-generation An aminoglycoside Drug of choice in
activity against cephalosporin with antibiotic for gram- patient who cannot
susceptible broad spectrum gram negative coverage receive or whose
organisms negative activity Not drug of choice, condition fails to
Arrests bacterial but consider it if responds to penicillin
growth by binding 1 penicillin or other, and cephalosporin
or more penicillin- less toxic drugs are A potent antibiotic
binding proteins contraindicated that is directed
Used prophylactically against gram positive
for high risk patients organisms and is
undergoing dental active against
procedures enterococcus species
 PRINCIPLES OF MANAGEMENT

Selection of the antibiotic agents is based on the sensitivity of the offending organism to
antibiotics
Bactericidal rather than bacteriostatic antibiotics are preferable
Intermittent intravenous antibiotic administration to achieve high concentration of the antibiotic is
recommended
Prolonged treatment to ensure eradication of the organism is generally required
Surgery may be necessary in some cases
COMPLICATIONS
Damage to heart and heart valves (regurgitation or defects in the valve leaflets as a
result of embolization of leaflet tissue, myocardial abscess )
Cerebral abscesses
Cerebral aneurysm
Splenic abscesses

PROGNOSIS
Outcome of infective endocarditis caused by the most common organism is often good
Cure rate :
Viridans streptococcus (uncomplicated): >90%
Enterococcus treated by synergistic combination of antibiotics: 75-90%
Staphylococcus aureus with acute, severe presentation: 60-75%