Antibiotic Resistance (29/01/19)

Question 1

What is MRSA?

Answer 1

Meticillin resistant staphylococcus aureus

Question 2

What is MRSA resistant to?

Answer 2

Meticillin, but alos beta lactam antibiotics like (PENICILLIN, CEPHALOSPORINS, CARBAPENEMS).

Also other antibiotics (MACROLIDES [erythromycin], QUINOLONES [ciprofloxacin], CLINDAMYCIN)

Question 3

Does MRSA colonisation mean infection?

Answer 3

NO

Question 4

What are the symptoms of MRSA?

Answer 4

• High temp/fever
• High white cell count
• Inflammation at infection site

Question 5

MRSA treatment for serious systemic infection?

Answer 5

1st Line: IV VANCOMYCIN or TEICHOPLANIN

2nd line: LINEZOLID, DAPTOMYCIN, TIGECYCLINE

Question 6

What are ESBLs?

Answer 6

Extended-spectrum beta lactamases

Question 7

What is caused by ESBL UTIs?

Answer 7

Septicaemia

Question 8

What is GRE?

Answer 8

Glycopeptide resistant enterococci

Question 9

What is a major risk of antibiotic over use?

Answer 9

Clostridium difficile

Question 10

How to treat c. diff?

Answer 10

-Assess severity including WCC, abdominal pain, temperature
-Stop precipitating antibiotics if possible
-Stop / avoid anti-diarrhoeal agents
-Stop gastric acid suppressive agents if possible
-Stop laxatives
-Assess fluid balance and ensure adequate hydration
-Assess nutritional status – refer to dietitian if necessary
-Initiate treatment for C. difficile (Mild disease – ORAL metronidazole)
(Severe disease – ORAL vancomycin)

Question 11

What antibiotics cause high risk of c. diff. infection?

Answer 11

• Fluoroquinolones
• Cephalosporins
• Clindamycin