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a property of some antibiotics, especially aminoglycosides, whereby achieving a relatively high plasma drug concentration, even if briefly, resulting in the most effective bacterial kill (compare time-dependent killing).
A group of beta-lactamase enzymes produced by some organisms that makes the organism resistant to all beta-lactam antibiotics (penicillins and cephalosporins) and aztreonam. Patients infected by such organisms must be in contact isolation, and proper hand washing is key to
preventing the spread of the infections.
Extended-spectrum beta-lactamases (ESBLs)
An enzyme first found in isolates of the bacterium Klebsiella pneumoniae that renders the organism resistant to all carbapenem antibiotics as well as beta-lactam
antibiotics and monobactams. Such organisms produce a very serious resistant infection
Klebsiella pneumoniae carbapenemase (KPC)
A strain of Staphylococcus aureus that is resistant to the beta-lactamase penicillin known as methicillin. Originally, the abbreviation MRSA referred exclusively to
methicillin-resistant S. aureus that are resistant to several drug classes, and therefore, depending on the context or health facility, it may also stand for “multidrug-resistant S. aureus.
Methicillin-resistant Staphylococcus aureus (MRSA)
One millionth of a gram. Be careful not to confuse with milligram (one thousandth of a gram), which is a thousand times greater than 1 microgram. Confusion of these two units sometimes results in drug dosage errors
A laboratory measure of the lowest concentration of a drug needed to kill a certain standardized amount of bacteria
Minimum inhibitory concentration (MIC)
Bacteria that are resistant to one or more classes of antimicrobial drugs. These include multidrug resistant
Staphylococcus aureus, extended-spectrum beta-lactamase-producing organisms, and Klebsiella pneumoniae carbapenemase-producing organisms
Toxicity to the kidneys, often drug induced and manifesting as compromised renal function
Toxicity to the ears, often drug induced and manifesting as varying degrees of hearing loss that is more likely to be permanent than the impaired renal function resulting from nephrotoxicity
A period of continued bacterial suppression that occurs after brief exposure to certain antibiotic drug classes, especially aminoglycosides and carbapenems. The mechanism of this effect is uncertain.
A necrotizing inflammatory bowel condition that is often associated with antibiotic therapy. Some antibiotics
(e.g., clindamycin) are more likely to produce it than others. A more general term that is also used is antibiotic-associated colitis
Drug interactions in which the bacterial killing effect of two antibiotics given together is greater than the sum of the individual effects of the same drugs given alone
Ongoing monitoring of plasma drug concentrations and dosage adjustment based on these values as well as other laboratory indicators such as kidney and liver function
test results; it is often carried out by a pharmacist in collaboration with medical, nursing, and laboratory staff
Therapeutic drug monitoring
A property of most antibiotic classes whereby prolonged high plasma drug concentrations are required for effective bacterial kill (compare concentration-dependent killing).
Enterococcus species that are resistant to beta-lactam antibiotics and vancomycin. Most commonly refers to Enterococcus faecium
Vancomycin-resistant Enterococcus (VRE)