5. Antibiotic Stewardship Flashcards
What are the 3 main consequences of antibacterial resistance?
Treatment failure
Prophylaxis failure
Economic costs
What is the definition of a multi-drug resistant antimicrobial?
Non-susceptibility to at least one agent in three or more antimicrobial categories
What is the definition of an extensively drug resistant antimicrobial?
Non-susceptibility to at least one agent in all but two or fewer antimicrobial categories
What is the definition of a pan-drug resistant antimicrobial?
Non-susceptibility to all agents in all antimicrobial categories
What are the 5 main objectives of antimicrobial stewardship?
Appropriate use of antibiotics
Optimal clinical outcomes
Minimise toxicity and other adverse events
Reduce the costs of healthcare for infections
Limit the selection for antimicrobial resistant strains
What are the 3 main elements of an antimicrobial stewardship programme?
Multidisciplinary team
Surveillance eg process and outcome measures
Interventions eg persuasive, restrictive, structural
What intervention type is more successful in the short term with regards to both appropriate prescribing of antibiotics and improving microbial outcomes; restrictive or persuasive?
Restrictive over persuasive
What are the requirements for successful stewardship?
Long term resources
Hospital leadership support
Integration into hospital care structure and organisational patient safety
Is resistance emergence driven by long or short courses of antibiotics?
Long
What is a static antibiotic?
Prevents organism from multiplying, but patients own immune system kills it off
What are Vidal antibiotics?
Kills bacteria without reliance on the patients immune system for help. Is superior in clinical outcomes and has a lover risk of emergence of resistance
