Antimicrobial resistance and stewardship Flashcards Preview

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Flashcards in Antimicrobial resistance and stewardship Deck (20)
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1
Q

what are antibiotics used for?

A

surgery prophylaxis
chemotherapy prophylaxis?
bacterial pneumonia

2
Q

what are antibiotics not used for?

A

most throat infections
parasitic infections
influenza

3
Q

is resistance a normal function?

A

yes, always some in the gut but don’t cause an issue

only cause problem when they get into sterile site

4
Q

what is the clinical vs laboratory phenomenon of AMR?

A

Lab
- grow bacteria on petri dish
- dot antimicrobial on dish to see if it inhibits growth
Clinical
- bacteria grow and proliferate causing disease

5
Q

what are the 4 types of resistance?

A

resistance = lab confirmed resistance to 1 antibiotic agent
MDR = non-susceptibility to at least 1 agent in 3 or more antimicrobial categories
XDR =
PDR =

6
Q

is AMR usually innate or acquired?

A

acquired

7
Q

what things could make normal asymptomatic resistant bacteria in the gut become dangerous?

A

change in diet
illness (bacteria can get into sterile site)
antibiotic treatment

8
Q

how does AMR spread through bacteria at times of vulnerability?

A

mutation (vertical transfer)
explode releasing resistant genetic material
phage viruses take gene from one bacteria to another (transduction)
release genetic material through plasmates into susceptible bacteria

9
Q

name 6 resistance mechanisms

A
Efflux
Impermeability
Inactivation
Altered target
Pbps
By-pass
10
Q

where is high resistant E coli most common?

A

southern European countries (as they prescribe more antibiotics)

11
Q

what are the 2 largest drivers of AMR?

A

human antimicrobial misuse

animal antimicrobial misuse

12
Q

what are some clinical and economical consequences of not prescribing antibiotics?

A

not treating wont kill but takes much longer for infection to heal so more GP visits etc

13
Q

where is growth in antimicrobial use the highest?

A

middle income countries

14
Q

where does most prescription occur?

A

community

15
Q

what are the 4 Ds of AMS?

A

drug
dose
duration
de-escalation

16
Q

what are the 4 goals of AMS?

A

improve patient care
reduce costs
reduce resistance, C. diff, toxicity

17
Q

what are some drivers for AMR?

A
unnecessary antibiotics
excessive amount
too broad spectrum
Too long duration
underdosing
18
Q

what are some drivers for C. Diff infection?

A

quinolones
cephlasporins
too long duration
too many antibiotics

19
Q

is ceftriaxone broad spectrum?

A

yes

20
Q

is it important to switch from IV to oral antibiotics ASAP?

A

yes

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