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Manual of Childhood Infections: The Blue Book (4 edn)

Online ISBN:
9780191796142
Print ISBN:
9780198729228
Publisher:
Oxford University Press
Book

Manual of Childhood Infections: The Blue Book (4 edn)

Mike Sharland (ed.),
Mike Sharland
(ed.)

Consultant in Paediatric Infectious Diseases

Consultant in Paediatric Infectious Diseases, St George's Hospital Trust, London, UK
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Karina Butler (ed.),
Karina Butler
(ed.)
Our Lady's Hospital for Sick Children, Dublin, Ireland
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Andrew Cant (ed.),
Andrew Cant
(ed.)
Newcastle upon Tyne Hospitals, NHS Foundation Trust, Newcastle, UK
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Ron Dagan (ed.),
Ron Dagan
(ed.)
Soroka University Medical Center, Israel
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Graham Davies (ed.),
Graham Davies
(ed.)
Great Ormond Street Hospital for Children, London
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Ronald de Groot (ed.),
Ronald de Groot
(ed.)
Radboud University Nijmegen Medical Centre, Nijmegen, Netherlands
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David Elliman (ed.),
David Elliman
(ed.)
Great Ormond Street Hospital for Children, London
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Susanna Esposito (ed.),
Susanna Esposito
(ed.)
University of Milan, Italy
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Adam Finn (ed.),
Adam Finn
(ed.)
UHB Education and Research Centre, Bristol, UK
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Manolis Galanakis (ed.),
Manolis Galanakis
(ed.)
Paediatric Infectious Diseases Unit, Heraklion University Hospital, Crete, Greece
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... more
Published online:
June 2016
Published in print:
April 2016
Online ISBN:
9780191796142
Print ISBN:
9780198729228
Publisher:
Oxford University Press

Abstract

Antimicrobial agents either kill (bactericidal) or inhibit (bacteriostatic) the growth of a microorganism by targeting specific unique bacterial sites or metabolic pathways. Common antibiotic adverse effects and toxicities include allergic reactions, numerous possible toxicities, alteration of human flora, drug interactions, and promoting of antibiotic resistance. Presumptive and empirical therapy relies on the clinical syndrome and anatomical site of infection. Factors to consider when choosing empirical therapy include identification of the organism, the estimated benefit to the patient, the probable susceptibility of the isolated (or suspected) pathogen based on laboratory results or local epidemiological parameters, and pharmacokinetic/pharmacodynamic considerations. Host factors, including age, immune deficiency status, and other underlying conditions, should always be considered when choosing an antibiotic. There are few absolute indications for the prophylactic use of antimicrobials, and this is one area where misuse is common. The susceptibility of common pathogens is often predictable, allowing adequate empirical treatment. The main driver for the development of antibiotic resistance is the inappropriate use of antibiotics. Bacteria may be naturally resistant or may acquire resistance by means of DNA mutation or acquisition of resistance-conferring DNA from another source (e.g. plasmids). Mechanisms of antibiotic resistance include chemical modification of antibiotics, reduced uptake into cells, active efflux from cells, target site modification, overproduction of antibiotic target, and metabolic bypass of inhibited reaction. Control of resistance may be achieved through adherence to prescribing guidelines, restriction policies that reduce the use of certain antibiotics, and antimicrobial stewardship programmes.

Disclaimer
Oxford University Press makes no representation, express or implied, that the drug dosages in this book are correct. Readers must therefore always … More Oxford University Press makes no representation, express or implied, that the drug dosages in this book are correct. Readers must therefore always check the product information and clinical procedures with the most up to date published product information and data sheets provided by the manufacturers and the most recent codes of conduct and safety regulations. The authors and the publishers do not accept responsibility or legal liability for any errors in the text or for the misuse or misapplication of material in this work. Except where otherwise stated, drug dosages and recommendations are for the non-pregnant adult who is not breastfeeding.
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