BCIDP flashcards
BCIDP · Build recall with a focused review session.
36 cards. Read the term and the definition here. The deck at the top of this page is optional.
- Time-dependent killing
- Antimicrobial activity that depends on the duration the free drug concentration remains above the MIC (fT>MIC), characteristic of beta-lactams and vancomycin.
- Concentration-dependent killing
- Antimicrobial activity that increases with higher peak concentrations, best predicted by Cmax/MIC or AUC/MIC, characteristic of aminoglycosides and daptomycin.
- Post-antibiotic effect
- Persistent suppression of bacterial growth after antimicrobial exposure has ended; prolonged for aminoglycosides, fluoroquinolones, and daptomycin.
- AUC/MIC
- Pharmacokinetic/pharmacodynamic index correlating area under the concentration-time curve with MIC; used for vancomycin and fluoroquinolone efficacy.
- Loading dose
- Initial dose calculated as Vd × target concentration to rapidly achieve therapeutic drug levels, especially when half-life is long.
- Protein binding
- Fraction of drug bound to plasma proteins; only free drug exerts antimicrobial activity and is available for distribution and elimination.
- Beta-lactam mechanism
- Acylation of penicillin-binding proteins inhibits peptidoglycan cross-linking, weakening the bacterial cell wall and causing lysis.
- Biofilm
- Surface-attached microbial community encased in extracellular matrix that increases tolerance to antibiotics and host immune defenses.
- Endotoxin
- Lipopolysaccharide component of Gram-negative outer membrane that activates TLR4 and triggers cytokine release and septic shock.
- Opsonization
- Coating of pathogens with antibody and complement (C3b) to enhance recognition and phagocytosis by neutrophils and macrophages.
- Encapsulated organisms
- Bacteria with polysaccharide capsules (S. pneumoniae, H. influenzae type b, N. meningitidis) that require opsonizing antibody for efficient clearance.
- Neutropenia
- Absolute neutrophil count below 500 cells/µL, a major risk factor for invasive bacterial and fungal infections.
- Gram stain
- Differential staining that classifies bacteria by cell wall structure: Gram-positive retain crystal violet (purple), Gram-negative decolorize (pink).
- Antibiotic time-out
- Structured reassessment at 48–72 hours of antibiotic indication, dose, duration, and need for de-escalation or discontinuation.
- De-escalation
- Narrowing antimicrobial spectrum based on culture results and clinical improvement to reduce resistance and adverse effects.
- Hand hygiene
- The single most effective intervention for preventing healthcare-associated infections; alcohol-based rubs preferred except for C. difficile spores.
- Contact precautions
- Infection control measures including gown and gloves for MRSA, VRE, C. difficile, and multidrug-resistant Gram-negative organisms.
- Surgical prophylaxis timing
- Administer antimicrobial within 60 minutes before incision; redose intraoperatively based on drug half-life and blood loss.
- Days of therapy
- Stewardship metric counting each day an antimicrobial is administered, regardless of dose, per 1000 patient-days.
- Sepsis bundle
- Obtain cultures, give broad-spectrum antibiotics within 1 hour, and provide 30 mL/kg crystalloid for hypotension or lactate ≥4 mmol/L.
- Infective endocarditis cultures
- Obtain at least three blood culture sets from separate sites before starting antibiotics to maximize pathogen identification.
- Meningitis empiric therapy
- Vancomycin plus a third-generation cephalosporin; add ampicillin when Listeria risk factors are present (age >50, immunocompromised).
- Candidemia treatment
- Echinocandin first-line; remove central venous catheters and obtain follow-up blood cultures until clearance is documented.
- Cockcroft-Gault equation
- Estimates creatinine clearance for drug dosing: ((140−age)×weight)/(72×SCr), multiplied by 0.85 for females.
- Pregnancy antimicrobial avoidance
- Avoid fluoroquinolones, tetracyclines, and aminoglycosides; beta-lactams and macrolides are generally preferred in pregnancy.
- Obesity dosing
- Use adjusted body weight for aminoglycosides; vancomycin loading dose based on actual body weight to ensure adequate exposure.
- Cystic fibrosis dosing
- Increased volume of distribution and clearance require higher doses of beta-lactams and aminoglycosides; monitor levels.
- Hemodialysis drug removal
- Vancomycin and aminoglycosides are removed by hemodialysis; dose after dialysis or supplement based on measured levels.
- MIC
- Minimum inhibitory concentration: lowest antimicrobial concentration that inhibits visible growth of a standardized bacterial inoculum.
- CLSI breakpoints
- Standardized MIC or zone diameter thresholds categorizing organisms as susceptible, intermediate, or resistant to guide therapy.
- Vancomycin AUC target
- AUC24 of 400–600 mg·h/L for serious MRSA infections; AUC monitoring is preferred over trough-only monitoring.
- Aminoglycoside TDM
- Monitor peak for efficacy and trough for toxicity; target trough <1 mg/L for gentamicin and tobramycin.
- Beta-lactam cross-reactivity
- Cross-reactivity between penicillins and cephalosporins is low (<2%); low-risk patients may undergo direct oral challenge.
- Fluoroquinolone safety
- Risks include tendinopathy, QT prolongation, aortic aneurysm, and CNS effects; avoid in myasthenia gravis.
- Linezolid interactions
- Myelosuppression, serotonin syndrome with serotonergic drugs, and peripheral neuropathy with prolonged use; monitor blood counts.
- Rifampin induction
- Potent CYP450 inducer that reduces levels of warfarin, oral contraceptives, and many antifungals; monitor for loss of efficacy.