Infections diagnosis and therapy go hand in hand

Added: 12/17/2005

Infections diagnosis and therapy depend on each other. As a rule, in order to define the bacteria that cause this or that infection, culture is used. But it is necessary to be very careful and to provide the protection from contamination in order to get accurate results. Infectious disease therapy is traditionally empirical. It is executed in order to define the bacteria causing the condition.

There are some aspects that require special attention to infections diagnosis and therapy. It is necessary to say that infections diagnosis and therapy usually need some specimen to be taken from the potentially infected areas.

As infections diagnosis and therapy depend on each other, it is of paramount importance to identify the pathogenic organisms that usually cause the disease. Traditionally culture is used for it. When antimicrobial therapy starts, cultures render sterile results in spite of the fact that the viable organisms stay in the host. It is also of paramount importance to minimize the the risk of contamination while collecting specimens.

There are cases when it is impossible to form the adequate infectious disease diagnosis of the nature of the infecting organisms before the use of antimicrobial therapy. Nevertheless, the infectious disease therapy must be empirical in order to identify the infecting organisms out of a great number of other microorganisms. So, it is possible to say that such empirical definition of the microorganisms in combination with local antibiotic resisting patterns may be very helpful.
In a lot of patients it is quite possible to monitor therapeutic response only on clinical grounds. So, when the fever drops, the well-being returns, systemic and local symptoms of the infection disappear, it means that the therapy has turned out to be efficient. As a rule there is no need for further monitoring of the condition.

There are also cases when the therapy is not effective. It can happen because of the resistance of the microbes, inappropriate administration of the treatment and other reasons. It is recommended to hold careful reassessment while examining the changes of antimicrobial therapy.

While using antibiotics in infections diagnosis and therapy to patients, it is necessary to be very careful with the doses. For example, the excessive use of such antibiotics as vancomycin and aminoglycosides may lead to toxicity, but it is going to provide the adequate levels of the therapy.

In order to choose the adequate antibiotic and to define the correct dose, it is necessary to know about kinetic and pharmacodynamic properties of antibiotics. It is necessary to follow a number of tips to make the antibiotic treatment effective.

First of all, it is necessary to remember that microbiological activity of antibiotics can be stimulated. It is necessary to be careful with antibiotics concentration. The higher the concentration is, the larger quantity of binding sites are occupied. It is important that antibiotics should stay on the sites for a sufficient period of time. There is also such an important aspect as MIC (Minimum inhibitory concentration) which shows what quantity of drugs is necessary to contact the bacteria, so that the treatment were effective.

There are two groups of antibiotics. The first one is called time dependant killing and the second is called concentration dependant antibiotics. Antibiotics of the former group include cephalosporins, penicillins, azalides/macrolides. As for the latter, it includes aminoglycosides and quinolones.

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