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NAJRAN UNIVERSITY College of Applied Medical Sciences. General Microbiology Course Lecture No. 11. By. Dr. Ahmed Morad Asaad Associate Professor of Microbiology. Choice of antimicrobial agent 1- In vitro tests of bacterial sensitivity to antibiotics 2- Emprical use of antibiotics
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NAJRAN UNIVERSITY College of Applied Medical Sciences General Microbiology Course Lecture No. 11 By Dr. Ahmed MoradAsaad Associate Professor of Microbiology
Choice of antimicrobial agent 1- In vitro tests of bacterial sensitivity to antibiotics 2- Emprical use of antibiotics 1- In vitro tests A- Disc diffusion method - A culture medium is inoculated with the organism - Discs impregnated with different antibiotics are placed and the plate is incubated at 37ºC - The degree of inhibition by antibiotic is measured by the diameter of the inhibition zone
B- Dilution method • Serial dilutions of the antibiotics are inoculated with the organism to determine: • Minimum inhibitory concentration (MIC): The lowest concentration of the antibiotic that inhibit the growth of the organism • Minimum bactericidal concentration (MBC): The lowest concentration of the antibiotic that kill the organism • C- E test • Strips with antibiotic gradients • D- Automated systems
Antibiograms: periodic reports that indicate the susceptibility of clinically isolated organisms to the antibiotics in current local use.
Empirical use of antibiotics: Use of antibiotics without in vitro tests is indicated in: 1- In closed lesions with no available samples (brain abscess) 2- While waiting for the results of in vitro sensitivity tests 3- Drug combination: *- Sever infection *- To avoid microbial resistance *- Synergism: The combined effect of a pair of antibiotics is greater than the sum of their independant activities
Factors affecting antimicrobial activity in-vitro: 1- pH of the environment 2- components of the medium 3- Size of the inoculum 4- Stability of the drug 5- Duration of incubation
Complications of antimicrobial chemotherapy: 1- Toxicity: Streptomycin is toxic to 8th cranial nerve Aminoglycosides are nephrotoxic Tetracycline causes teeth deformity and liver damage 2- Hypersensitivity Penicillin (anaphylaxis) 3- Superinfection An infection on top of antibiotic adminstration 4- Masking the diagnosis 5- Development of resistance (TUTORIAL) Non-genetic OR genetic drug resistance