Download Treatment strategies that maximize antibiotic effectiveness

I.
Background information
A. Overview
B. Does your patient have any special considerations?
1. Age
2.
Health problems or allergies?
3.
Pregnant or nursing?
C. General antibiotic considerations
1. Choosing an antibiotic
a) What’s the most likely pathogen?
b) What are the options based on antibiotic spectra?
c)
Topical or oral?
2. The importance of a proper dosing schedule
a) Concentration and duration guidelines
(1) Concentration or time-dependent antibiotic?
3.
What if you use lab tests?
a) Interpreting culture results
(1) Limitations of drug sensitivity results
b) Using Gram stain findings
II. Treatment strategies for specific infections
A. Bacterial conjunctivitis
1. When do you need conjunctival cultures?
2. What’s the most likely bug?
a) Adult or child?
(1) Most common adult pathogens
(2) Most common pediatric pathogens
3. Which antibiotic(s) should you choose?
a) Treatment considerations
(1) Severity
(2) Any corneal involvement?
b) Antibiotic activity spectra
B. Blepharitis, blepharoconjunctivitis, and angular blepharitis
1. Blepharitis - to treat or not to treat?
2. Narrow or broad-spectrum topical antibiotic?
3. Topical or oral?
4. When do you need steroids?
C. Corneal ulcers
1. When to consider corneal cultures- looking at the whole picture
a)
b)
c)
Central or peripheral?
Size
History and symptoms
1) How much pain does your patient have?
2) Anterior chamber reaction?
3) History of trauma, or recent surgery?
2. Guidelines for choosing the antibiotic
a) Contact lens wearer?
b) Antibiotic choices
1) Fluoroquinolones
(a) Monotherapy
(b) Combined therapy
2) Fortified antibiotics?
3. Dosing guidelines for concentration dependent and time dependent drugs
4. What role do steroids play?
5. Sample case
D. Hordeola, pre-septal cellulitis, dacryocystitis
1. When do you need to culture?
2. Antibiotic guidelines and dosing schedules
III.
Summary