Page 930 - Basic _ Clinical Pharmacology ( PDFDrive )

916 SECTION VIII Chemotherapeutic Drugs

well as the administration of drugs following colonization by or because of underlying disease (eg, immunocompromised hosts).
inoculation of pathogens but before the development of disease. Prophylaxis is most effective when directed against organisms
Nonsurgical prophylaxis is indicated in individuals who are at that are predictably susceptible to antimicrobial agents. Common
high risk for temporary exposure to selected virulent pathogens indications and drugs for nonsurgical prophylaxis are listed in
and in patients who are at increased risk for developing infection Table 51–8.

REFERENCES Martin RF: Surgical infections. Surg Clin North Am 2014;94:1135.
Baddour LM et al: Infective endocarditis: Diagnosis, antimicrobial therapy, and Mirakian R et al: Management of allergy to penicillins and other beta-lactams.
management of complications. Circulation 2015;132:1435. Clin Exp Allergy 2015;45:300.
Baron EJ et al: Guide to utilization of the microbiology laboratory for diagnosis of National Nosocomial Infections Surveillance System: National Nosocomial Infec-
infectious diseases: 2013 recommendations by the Infectious Diseases Soci- tions Surveillance (NNIS) System Report, Data Summary from January
ety of America (IDSA) and the American Society for Microbiology (ASM). 1992–June 2004, issued October 2004. Am J Infect Control 2004;32:470.
Clin Infect Dis 2013;57:e22. Panel on Opportunistic Infections in HIV-Infected Adults and Adolescents:
Blumberg HM et al: American Thoracic Society/Centers for Disease Control and Guidelines for the prevention and treatment of opportunistic infections in
Prevention/Infectious Diseases Society of America: Treatment of tuberculo- HIV-infected adults and adolescents: Recommendations from the Centers
sis. Am J Respir Crit Care Med 2003;167:603. for Disease Control and Prevention, the National Institutes of Health, and
the HIV Medicine Association of the Infectious Diseases Society of America.
Boucher HW: 10 × ‘20 Progress—Development of new drugs active against gram- Available at: https://aidsinfo.nih.gov/contentfiles/lvguidelines/adult_oi.pdf.
negative bacilli: An update from the Infectious Diseases Society of America.
Clin Infect Dis 2013;56:1685. Peleg AY et al: Hospital-acquired infections due to gram negative bacteria. N Engl
J Med 2010;362:1804.
Bratzler DW et al: Clinical practice guidelines for antimicrobial prophylaxis in
surgery. Am J Health Syst Pharm 2013;70:195. Simons FE: Anaphylaxis. J Allergy Clin Immunol 2010;125(Suppl 2):S161.
Chow AW et al: IDSA clinical practice guideline for acute bacterial rhinosinusitis Spellberg B et al: The future of antibiotics and resistance. N Engl J Med
in children and adults. Clin Infect Dis 2012;54:e72. 2013;368:299.
Holmes AH et al: Understanding the mechanisms and drivers of antimicrobial Tunkel AR et al: Practice guidelines for the management of bacterial meningitis.
resistance. Lancet 2016;387:176. Clin Infect Dis 2004;39:1267.
Kalil AC et al: Management of adults with hospital-acquired and ventilator- Wilson W et al: Prevention of infective endocarditis: Guidelines from the
associated pneumonia: 2016 Clinical practice guidelines by the Infectious American Heart Association. Circulation 2007;116:1736.
Disease Society of America and the American Thoracic Society. Clin Infect Workowski KA, Bolan GA: Sexually transmitted diseases treatment guidelines
Dis 2016;63:e61. 2015. Centers for Disease Control and Prevention. MMWR Morb Mortal
Kaye KS, Kaye D: Antibacterial therapy and newer agents. Infect Dis Clin North Wkly Rep 2015;64(RR-3):1.
Am 2009;23:757.
Mandell LA et al: Infectious Diseases Society of America/American Thoracic
Society Consensus guidelines on the management of community-acquired
pneumonia in adults. Clin Infect Dis 2007;44:S27.

C ASE STUD Y ANSWER

This patient is experiencing a post-procedure urinary negative organisms such as Pseudomonas aeruginosa. The
tract infection which may have been introduced into patient was treated with vancomycin and meropenem,
his bloodstream at the time of his cystoscopy. It is likely and blood and urine cultures were both positive for
that the patient is experiencing a sepsis-like syndrome ESBL-positive E coli that was resistant to ciprofloxacin.
and has a systemic infection with a uropathogen that The patient defervesced and hemodynamically stabilized
is resistant to the antibiotic that he has received. Pos- over the subsequent 48 hours. ESBL-positive E coli is an
sible bacteria that may be responsible for the patient’s emerging urinary tract pathogen that may be acquired in
symptoms are methicillin-resistant Staphylococcus aureus, the outpatient setting, and oral antibiotic therapy may not
Enterococcus sp., and enteric Gram-negative rods that are reliably be effective; empiric therapy with a carbapenem
resistant to ciprofloxacin such as ESBL-positive E coli or (ertapenem, doripenem, meropenem, imipenem) is recom-
Klebsiella pneumoniae, or other hospital-acquired Gram mended for serious infections due to this organism.