{"id":48,"date":"2023-01-16T11:26:54","date_gmt":"2023-01-16T16:26:54","guid":{"rendered":"https:\/\/teachmepharm.com\/wp\/?p=48"},"modified":"2023-07-06T17:00:30","modified_gmt":"2023-07-06T21:00:30","slug":"antibiotic-selection-and-the-triangle","status":"publish","type":"post","link":"https:\/\/teachmepharm.com\/wp\/?p=48","title":{"rendered":"Antibiotic Selection and The Triangle"},"content":{"rendered":"\n<p>Choosing the right antimicrobial is a most difficult task. There are many factors to consider. Most antibiotic prescribing (~75%) is <strong>&#8220;empiric&#8221;<\/strong> before you know the organism that is causing the infection. Therefore getting the choice right on the front end is critical to ensure appropriate treatment while limiting toxicity.<\/p>\n\n\n\n<p>For years I have taught my students the triangle approach that addresses 3 primary areas that you have to consider when selecting an antibiotic:<\/p>\n\n\n\n<ol class=\"wp-block-list\">\n<li><strong>Patient:<\/strong> Patient characteristics are important to consider when choosing an antibiotic. For example, what allergies does the patient have? Are they pregnant? Is this a pediatric patient? <\/li>\n\n\n\n<li><strong>Bug:<\/strong> Where is the infection? Choosing an antibiotic depends on where the infection is originating. A skin\/soft tissue infection will often involve gram positive organisms such as <em>Streptococcus pyogenes<\/em> or even MRSA while a urinary tract infection will most often involve gram-negative organisms such as <em>E. coli<\/em>. In addition some infections like diabetic foot infections, involve multiple organisms together termed &#8220;polymicrobial&#8221;. <\/li>\n\n\n\n<li><strong>Drug:<\/strong> Sometimes there are <em>many right answers<\/em> for treating a patient when the organism is very susceptible. But sometimes a potential toxicity (e.g. nephrotoxicity from vancomycin) or multidrug resistance may lead you to choose a different agent. <\/li>\n<\/ol>\n\n\n\n<p>Choosing an appropriate antibiotic involves asking the appropriate questions from each of these 3 parts of the triangle. <\/p>\n\n\n\n<p>At teachmepharm.com, we have many videos devoted to helping you choose the correct antibiotic using these principles. Feel free to try us out here: https:\/\/www.teachmepharm.com\/subscribe. <\/p>\n\n\n\n<p>Have a great weekend!<\/p>\n\n\n\n<p>Chris<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Choosing the right antimicrobial is a most difficult task. There are many factors to consider. Most antibiotic prescribing (~75%) is &#8220;empiric&#8221; before you know the organism that is causing the infection. Therefore getting the choice right on the front end is critical to ensure appropriate treatment while limiting toxicity. For years I have taught my [&hellip;]<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[12,23],"class_list":["post-48","post","type-post","status-publish","format-standard","hentry","category-uncategorized","tag-antibiotics","tag-antimicrobial-stewardship"],"_links":{"self":[{"href":"https:\/\/teachmepharm.com\/wp\/index.php?rest_route=\/wp\/v2\/posts\/48","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/teachmepharm.com\/wp\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/teachmepharm.com\/wp\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/teachmepharm.com\/wp\/index.php?rest_route=\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/teachmepharm.com\/wp\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=48"}],"version-history":[{"count":1,"href":"https:\/\/teachmepharm.com\/wp\/index.php?rest_route=\/wp\/v2\/posts\/48\/revisions"}],"predecessor-version":[{"id":50,"href":"https:\/\/teachmepharm.com\/wp\/index.php?rest_route=\/wp\/v2\/posts\/48\/revisions\/50"}],"wp:attachment":[{"href":"https:\/\/teachmepharm.com\/wp\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=48"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/teachmepharm.com\/wp\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=48"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/teachmepharm.com\/wp\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=48"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}