2- Antimicrobial approach

Question 1

What is antimicrobial stewardship

Answer 1

the interventions to make sure antimicrobials are used correctly, they aim to achieve optimal clinical outcomes, minimise toxicity, and limit the development of antimicrobial resistant strains

Question 2

Which characteristics of the pt must we consider before perscribing an antibiotic

Answer 2

age
allergies
renal/hepatic failure
underlying diseases
immunocompromised
diabetes

Question 3

what characteristics of the antibiotic must be considered

Answer 3

spectrum of action
pharmacokinetic abilities (bactericidal/bacteriostatic)
adequate penetration into infection site
hydrophilic or lipophilic

Question 4

Name the bactericidal antibiotics

Answer 4

B lactams, glycopeptides, aminoglycosides, daptomycin, quinolones

Question 5

name the bacteriostatic antibiotics

Answer 5

macrolides, linezolid, tetracyclines, tigecycline

Question 6

name the hydrophilic antibiotics

Answer 6

B lactams, glycopeptides, aminoglycosides, daptomycin

Question 7

name the lipophilic antibiotics

Answer 7

macrolides, fluoroquinolones, tetracyclines, rifampicin, linezolid

Question 8

main 3 resistant strains in a hospital

Answer 8

• enterobacteriacae (E coli) producing ESBL - resistant to cephalosporins
• K pneumonia producing carbapenemase (KPC)
• S aureus resistant to B lactams (methocillin, oxacillin, MRSA)

Question 9

how to check for colonisation

Answer 9

nasal swab for MRSA/MSSA carriage

rectal swab for KPC carriage