Anaerobic Infections
ANAEROBIC INFECTIONS
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Introduction
· Anaerobic infections
are caused by anaerobic bacteria, which thrive in environments with low or no
oxygen.
· These infections
often occur in deep tissues, such as deep wounds, the gastrointestinal tract,
and the oral cavity.
· Effective treatment
requires antibiotics that specifically target anaerobic bacteria.
Definition
· Anaerobic infections
are infections caused by bacteria that do not require oxygen to live and grow.
· These bacteria can be
classified as obligate anaerobes, which are harmed by oxygen, or facultative
anaerobes, which can survive in both aerobic and anaerobic environments.
Classification
1.
Nitroimidazoles:
o
Example: Metronidazole
2.
Lincosamides:
o
Example: Clindamycin
3.
Beta-lactams with beta-lactamase inhibitors:
o
Example: Amoxicillin-clavulanate
4.
Carbapenems:
o
Example: Imipenem
5.
Glycopeptides:
o
Example: Vancomycin (for gram-positive
anaerobes)
Pharmacokinetics
·
Metronidazole:
o
Absorption: Well absorbed orally
o
Distribution: Widely distributed in body tissues
and fluids, including the CNS
o
Metabolism: Metabolized in the liver
o
Excretion: Primarily excreted in urine
·
Clindamycin:
o
Absorption: Well absorbed orally
o
Distribution: Widely distributed in body tissues,
including bones
o
Metabolism: Metabolized in the liver
o
Excretion: Primarily excreted in bile and urine
·
Amoxicillin-clavulanate:
o
Absorption: Well absorbed orally
o
Distribution: Widely distributed in body tissues
o
Metabolism: Minimal hepatic metabolism
o
Excretion: Primarily excreted in urine
Mechanism of Action
·
Metronidazole: Disrupts DNA synthesis in anaerobic
bacteria by producing reactive nitro radicals.
·
Clindamycin: Inhibits bacterial protein synthesis
by binding to the 50S ribosomal subunit.
·
Amoxicillin-clavulanate: Amoxicillin
inhibits cell wall synthesis; clavulanate inhibits beta-lactamase enzymes,
protecting amoxicillin from degradation.
Uses
·
Metronidazole: Used to treat anaerobic bacterial
infections such as bacterial vaginosis, pelvic inflammatory disease, and
intra-abdominal infections.
·
Clindamycin: Effective against anaerobic
infections like dental infections, intra-abdominal infections, and some skin
and soft tissue infections.
·
Amoxicillin-clavulanate: Broad-spectrum
antibiotic used for respiratory tract infections, urinary tract infections, and
skin infections.
Adverse Effects
·
Metronidazole: Nausea, headache, dry mouth, metallic
taste, and potential neurotoxicity with prolonged use.
·
Clindamycin: Diarrhea, nausea, rash, and a risk of
Clostridium difficile-associated diarrhea.
·
Amoxicillin-clavulanate: Diarrhea, nausea,
rash, and potential liver toxicity.
Contraindications
·
Metronidazole: Hypersensitivity to metronidazole or
other nitroimidazole derivatives, first trimester of pregnancy.
·
Clindamycin: History of colitis, hypersensitivity
to clindamycin or lincomycin.
·
Amoxicillin-clavulanate: History of jaundice
or hepatic dysfunction associated with amoxicillin-clavulanate.
Role of Nurse
·
Assessment: Monitor patient's symptoms, vital
signs, and signs of infection.
·
Administration: Ensure correct dosage and route of
administration, monitor for adverse reactions.
·
Patient Education: Instruct patients on the importance
of completing the full course of antibiotics, potential side effects, and signs
of adverse reactions.
·
Monitoring: Watch for therapeutic effectiveness
and adverse effects, such as allergic reactions or signs of secondary
infections.
·
Support: Provide emotional support and
information about managing side effects and the importance of maintaining
hydration and nutrition.
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