Introduction
As a nursing practitioner, it is necessary to understand the nuances of antimicrobial therapy, as well as the differences between viral and bacterial infections. In the following, the differing categories of antimicrobial agents will be stated and defined. Furthermore, the vital differences between viral and bacterial infections will be elucidated. Finally, the importance of differentiating between viral and bacterial infections in an antimicrobial agent prescription will be explained. The ability to treat viral and bacterial infections is greatly increased with the help of antimicrobial agents, but it is crucial to properly identify the type of infection before prescribing treatment.
Categories of Antimicrobial Agents
There are many different kinds of antimicrobial agents, depending on the particular microbe type targeted by the drug. These include penicillins, beta-lactam inhibitors, first/second/third/fourth-generation cephalosporins, monobactams, carbapenems, fluoroquinolones, macrolides, aminoglycosides, tetracyclines, glycylcyclines, sulfonamides, glycopeptides, oxazolidinones, lipopeptides, streptogramins, antianaerobic agents, and other miscellaneous agents (Arcangelo & Peterson 2011, pp. 98-99). Penicillins are utilized in order to increase resistance to beta-lactam receptors in cells. Antimicrobial agents, in essence, can be antibacterial, antifungal, antiviral or antiparasitic (Friefeld et al., 2011). Antibiotics target synthesis of the cell wall, metabolism, nucleic acids, and more, while antiviral drugs block the entry and attachment of viruses to cells (Friefeld et al., 2011). Another potential antimicrobial is polyphenol, which acts as an antimicrobial agent, inhibiting the factors that promote spreading of disease and increasing resistance to the disease through its antioxidant properties (Daglia, 2012).
Viral and Bacterial Infections
In order to properly use and administer antimicrobial agents, it is crucial to understand the differences between viral and bacterial infections. Viral infections are caused by viruses, which are essentially protein coats holding strings of nucleic acids, instead of the whole organisms that comprise bacteria. Many times, viral infections will go away on their own, such as the common cold or influenza, and are easily detected. Many upper respiratory infections (URIs) can go away within 14 days. Viruses are more likely to cause infection, due to their ability to easily attach to cells. Antiviral drugs simply inhibit the development of a virus instead of actually destroying the pathogen they are targeting (Freifeld et al., 2011).
Bacterial infections are caused by bacteria, single-celled organisms that can operate independently of human interaction or harm. Bacteria can survive in a variety of environments and temperatures, and often do no harm to a human host. Bacteria can reproduce on their own, and in more extreme conditions, they can exacerbate the symptoms of a viral infection if they are a secondary infection (Freifeld et al., 2011). Examples of bacterial infections include ear infections, pneumonia, and sinusitis. In these cases, more specific antimicrobials must typically be administered to address symptoms and eliminate the infection. Antibacterial agents are normally considered of low risk to humans, and their chief role is to kill the bacteria in question, as well as inhibit its growth (Freifeld et al., 2011).
Importance of Viral/Bacterial Infection Identification When engaging in the selection of the proper antimicrobial agent, it is absolutely vital that nurse practitioners be able to properly identify and select the correct agent for the problem at hand. Determining the correct type of infection will permit the more accurate type and dosage of antimicrobial agent to be administered (Abbo et al., 2012). Furthermore, resistance to the agent itself will increase if incorrectly given; strict and accurate stewardship must be given over antimicrobial agents available to ensure that they are not utilized without careful physician supervision.
There are several ways in which to make antibiotic use as effective as possible. Formulatory restrictions must be put in place to ensure proper administration of agents, as well as evidence-based prescribing to guide treatment (Arcangelo & Peterson, p. 117). Doses must be optimized for maximum effectiveness, and must be de-escalated along the most appropriate schedule for the client. Care must be taken not to confuse antivirals with antibacterial agents, as they serve fundamentally different functions, and so their mechanism of action is different (Abbo et al., 2012). In the case of a fever or neutropenia, it is advised to start the patient with a penicillin or other beta-lactam inhibitor to start and observe for changes. By working up as symptoms are addressed, nurses have the ability to adjust dosages and regimens as required by the demands of the patient’s condition (Abbo et al., 2012). Without the proper identification of a viral or bacterial infection, the incorrect antimicrobial agent is not selected, which provides little to no assistance in building resistance to the organism. Additionally, it provides a weakened ability for the body to fight the infection with an incorrect agent (Friefeld et al., 2011).
Summary
Several different major categories of antimicrobial agents have been identified, including penicillins, cephalosporins, fluoroquinolones, etc. While bacterial infections can last longer in a patient and consist of single-celled organisms, viruses allow for greater binding to cells and are much easier to contract in patients. When administering antimicrobial treatment to a patient, it is crucial to determine the specific viral or bacterial organism that is contained within a patient in order to find the proper antimicrobial agent.
References
Abbo, L., Smith, L., Pereyra, M., Wyckoff, M., & Hooton, T. M. (2012). Nurse Practitioners'
Attitudes, Perceptions, and Knowledge About Antimicrobial Stewardship. The Journal for Nurse Practitioners, 8(5), 370-376.
Arcangelo, V.P., Peterson, A.M. (2011). Pharmacotherapeutics for advanced practice.
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Daglia, M. (2012). Polyphenols as antimicrobial agents. Current Opinion in
Biotechnology, 23(2), 174-181.
Freifeld, A. G., Bow, E. J., Sepkowitz, K. A., Boeckh, M. J., Ito, J. I., Mullen, C. A., &
Wingard, J. R. (2011). Clinical practice guideline for the use of antimicrobial agents in neutropenic patients with cancer: 2010 update by the Infectious Diseases Society of America. Clinical infectious diseases, 52(4), e56-e93.
