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Related Concept Videos

Antibiotic Selection00:57

Antibiotic Selection

Overview
Antimicrobial Effectiveness01:28

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The effectiveness of antimicrobial agents depends on various factors influencing their ability to eliminate microbial populations. Larger microbial populations require more time for complete eradication, emphasizing the importance of population size analysis when evaluating antimicrobial efficacy.Microbial resistance to antimicrobial agents varies significantly. Highly resilient microorganisms include endospores, gram-negative bacteria, and non-enveloped viruses, while prions are exceptionally...
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Synergism is a useful mechanism where combining two or more drugs is more effective than each constituent used alone. Such combinations are also called supra-additive interactions. The drugs collectively enhance the final therapeutic effect by acting on different targets. Another advantage is that the low dose of each constituent drug is sufficient to achieve the desired effect. This helps reduce the duration of therapy and lower the adverse effects of these drugs.
Such synergistic combinations...
Dosage Interval and Administration Route: Determination Methods01:19

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A medication’s effectiveness largely depends on its appropriate dosage and the route of administration. Dosage ensures that a sufficient drug concentration is maintained in the bloodstream to elicit the desired therapeutic effect without causing toxicity. The route of administration affects the drug's bioavailability, rate of absorption, and onset of action, which are crucial for achieving optimal therapeutic outcomes. Drug dosage calculations are critical to tailoring therapy to individual...
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Updated: May 17, 2026

Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses
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Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses

Published on: August 30, 2018

Choosing optimal antimicrobial therapies.

Thomas J Lynch1

  • 1Department of Family and Community Medicine, Eastern Virginia Medical School, Norfolk, VA 23501, USA. lyncht@evms.edu

The Medical Clinics of North America
|October 30, 2012
PubMed
Summary
This summary is machine-generated.

Immediate parenteral antimicrobial therapy is crucial for life-threatening infections, often starting with broad-spectrum antibiotics. Tailoring treatment to narrow-spectrum agents post-culture results minimizes resistance and adverse effects.

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Area of Science:

  • Infectious Diseases
  • Pharmacology
  • Critical Care Medicine

Background:

  • Life-threatening infections necessitate prompt parenteral antimicrobial administration.
  • Empiric therapy is standard before culture and sensitivity results are available.
  • Broad-spectrum bactericidal agents are essential for presumed multidrug-resistant organisms.

Purpose of the Study:

  • To outline appropriate empiric antimicrobial selection for various severe infections.
  • To emphasize the importance of de-escalation to narrow-spectrum agents.
  • To discuss strategies for managing gram-positive, gram-negative, and anaerobic infections.

Main Methods:

  • Review of common antimicrobial choices for empiric parenteral therapy.
  • Discussion of agents effective against resistant pathogens like MRSA and P aeruginosa.
  • Guidance on selecting narrow-spectrum agents after culture data is obtained.

Main Results:

  • Vancomycin is recommended for suspected gram-positive infections, including MRSA.
  • Broad-spectrum β-lactams (ceftriaxone, piperacillin-tazobactam, carbapenems) or fluoroquinolones for gram-negative infections.
  • Antipseudomonal agents (cefepime, ceftazidime, piperacillin-tazobactam, doripenem, ciprofloxacin) for nosocomial infections; metronidazole or clindamycin for anaerobic coverage.

Conclusions:

  • Empiric broad-spectrum antibiotic use is critical for severe infections.
  • De-escalation to the most narrow-spectrum agent based on culture results is vital.
  • This approach optimizes treatment, reduces adverse drug effects, and combats antibiotic resistance.