facultative anaerobes can deplete the amount of oxygen present Anaerobic bacteria are the predominant flora in the normal human skin and mucous membranes and are, therefore, a common cause of endogenous infections
It is approved by the US Food and Drug Administration for the treatment of anaerobic and protozoal infections
Aspiration pneumonitis follows the aspiration of gastric contents, and often no organism is implicated
Rashes, fever, anaphylaxis, erythema multiforme
The spectrum of infections ranges from local abscesses to life-threatening infections
2 This is pertinent as long as the antimicrobial agent used has reliable activity against the Ba Source Reference: Bai AD, et al "Anaerobic antibiotic coverage in aspiration pneumonia and the associated benefits and harms: a retrospective cohort study" CHEST 2024; DOI: 10
However, pharmacokinetic data demonstrate that the half-life of metronidazole is 8-12 h and blood levels at 12 h exceed the in vitro minimum inhibitory concentration (MIC) for most anaerobic infections
Cloxacillin and clindamycin typically have less than 40% activity for S
Abdominal infections are usually polymicrobial and result in an intra-abdominal abscess or secondary peritonitis, which may be generalized or localized (phlegmon)
2024 Feb 20:S0012-3692(24)00260-5
Metronidazole has been successfully used in the treatment of anaerobic infections of the chest, head, gastrointestinal and female genitourinary tract, and of anaerobic septicaemia and bacteraemia
Being a frequent pathogen in infections involving anaerobes and with reports of emerging resistance from across the globe including multi-drug reistance, it becomes essential to monitor the While antibiotics covering anaerobes are thought to be necessary based on old studies reporting anaerobes as causative organisms, recent studies suggest that it may not necessarily benefit prognosis, or even be harmful
are likely to test sensitive to metronidazole, but resistant isolates are probably encountered with greater frequency than with the Gram-n Aerobic: Grow in 18% O2 10% CO2
In polymicrobial infections, these different types of bacteria can coexist: e
7%) of whom were nonetheless prescribed anaerobic antibiotics (Table (Table2)
Goldstein et al
The anaerobic GPC isolates exhibited various rates of resistance to penicillin, clindamycin, and metronidazole
It is a combination of two separate drugs: amoxicillin and clavulanic acid
; Due to increasing resistance rates, do not use the following drugs for severe infections where B
Antibiotic resistance among anaerobic Gram-negative bacilli: lessons from a French multicenter survey
Meropenem Similar to third-generation quinolones but with improved gram-positive coverage and added anaerobic coverage: Because of their extensive gram-negative coverage, quinolone antibiotics were These medications should be prioritized as key targets for antibiotic stewardship
Cefazolin
One single center retrospective analysis isolated Candida and Aspergillus species from 65 critically ill patients w/ variable comorbidities, including malignancy
INTRODUCTION
Clindamycin and moxifloxacin are effective against aspiration pneumonia and lung abscess caused by anaerobic organisms
4
When several antibiotics have similar coverage, select the least expensive
difficile infections (frequently associated with use of clindamycin), the question of adding empiric anaerobic coverage (clindamycin or β-lactam/β-lactamase inhibitors) in addition to routine CAP treatment in patients with suspected aspiration is an important one
Methods: A total of 113 GPAC isolates consisting predominantly of current or former members of the genus Peptostreptococcus was obtained from 17 sentinel Infections of ulcers that are chronic or previously treated with antibiotics may be caused by aerobic Gram-negative bacilli, S
Once the culture results are obtained, the antibiotic regimen should be narrowed to organism-specific antibiotics
Ciprofloxacin has FDA approval to treat urinary tract infections, sexually transmitted infections (gonorrhea and chancroid), skin, bone, joint infections, prostatitis, typhoid fever, gastrointestinal infections, lower respiratory tract infections Trimethoprim-sulfamethoxazole (TMP-SMX), also known as co-trimoxazole, is a combination of two antimicrobial agents that act synergistically against a wide variety of bacteria
Pregnancy is Gram-negative anaerobic bacilli may cause infections anywhere in the body; the most common types are oral and dental, pleuropulmonary, intra-abdominal, female genital tract and skin, soft tissue and bone infections ( Table 20-1 )
Eric Strong @DrEricStrong - Strong Medicine #Antibiotics #Anaerobic #Bacteria #Pharmacology #Table #Susceptibility #Coverage #Management
OR
In the absence of specific risk factors for anaerobic infections, do not routinely provide anaerobic coverage
The use of double anaerobic coverage (DAC) has been associated with increased risks of drug resistance, adverse reactions, and hospital costs
Background: Antibiotics with extended anaerobic coverage are commonly used to treat
Chest
The antimicrobials potentially effective against anaerobic bacteria include beta-lactams
Metronidazole 500 mg PO BID Nausea, neuropathy Anaerobic coverage is not
“Unasyn and Flagyl” for suspected intra-abdominal infections provides
, metronidazole + carbapenem [such as ertapenem or meropenem])
Antibiotic resistance among anaerobic Gram-negative bacilli: lessons from a French multicenter survey
Imipenem/cilastatin
Amoxicillin
The majority of Resistance of anaerobic bacteria to certain classes of antibiotics is increasing globally
fragilis (author’s comment: not a first-line agent for anaerobes, should confirm susceptibility)
The spectrum of activity of cephalosporins
4
When several antibiotics have similar coverage, select the least expensive
500 mg orally every 8 With increasing rates of C
Aspiration pneumonia refers to adverse pulmonary consequences due to entry of gastric or oropharyngeal fluids, which may contain bacteria and/or be of low pH, or exogenous substances (eg, ingested food particles or liquids, mineral oil, salt or fresh water) into the lower airways [ 1 ]