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House Microbiology > Antibiotic Therapy > Flashcards

Antibiotic Therapy Flashcards

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1
Q

Types of antibiotic therapy

  • ________ therapy
    -__________ therapy
  • __________ therapy
A

empiric

definitive

prophylactic

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2
Q

Types of antibiotic therapy

-empiric therapy: to provide initial treatment when _____________________________

A

the identity of causative organisms isn’t known

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3
Q

Types of antibiotic therapy

-definitive therapy: treatment of any infection in which ____________________________________

A

the Aetiologic pathogen and its antibiotic susceptibility is known

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4
Q

Types of antibiotic therapy

-prophylactic therapy: to ___________ (______ type and _____ type)

A

prevent infection

medical

surgical

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5
Q

GOOD CLINICAL EVIDENCE OF INFECTION

*systemic inflammatory response

-heart rate is ___________

-respiratory rate is _______
-fever is ______ or _____

A

greater than 90b/min

greater than 20c/min

> 38 or < 36

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6
Q

Have relevant specimen been collected before commencement of antibiotic therapy?

*____________ testing: blood culture, urine culture , csf culture

*Prior antibiotic use may ____________ thereby _________

*_______ antibiotic use or _____ can fuel ____________

A

culture and sensitivity

damage bacteria without killing thereby preventing growth in vitro

inappropriate; overuse
antibiotic resistance

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7
Q

To aid empiric therapy

*biomarkers for infection such as ______,_______, and ________
*serum/plasma for antigen or antibody testing, PCR

A

Procalcitonin, C reactive protein , and white cell count

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8
Q

gram stain can help predict useful antibiotics

T/F

A

T

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9
Q

Choose antibiotics based on _______

A

lab results

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10
Q

When microbiological data is now available

*Use a _____ spectrum antibiotic to treat specific pathogens

*Re-evaluate antibiotic therapy based on ________ and _______ such as organism ID and the _______

*________ or ________ based on the susceptibility result

A

narrower

clinical response and microbiological data; antibiotic susceptibility testing

streamline or De-escalate

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11
Q

When microbiological data is now available

*Host factors
-____
-_______of site of infection
-age and underlying disease
-________ of illness

A

allergy

penetration

severity

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12
Q

When microbiological data is now available

*Multiple antibiotic use
-risk of _________
-some antibiotics may be _____
- __________

A

adverse drug reaction

antagonistic

superinfection

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13
Q

The more quickly the ————- of broad spectrum antibiotic coverage can be discontinued, the lower the risk of __________

A

selective pressures

selecting for highly resistant pathogens

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14
Q

When microbiological data is now available

Other principles
* Treat ______ and not ______

  • _____ before ____ of _______ avoid inordinate delay)
  • ______ evaluation of appropriateness of antibiotic therapy
A

infection; colonisation

Culture; initiation of antibiotics

Daily

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15
Q

When microbiological data is now available

Other principles

*___/_____ date
- Ensure all antibiotic prescription are _____

  • Write _________ for antibiotic use in case notes

*Antibiotic prescription should comply with ________________________

A

Stop/review ; closed

indications (diagnosis)

antibiotic treatment guidelines in the hospital

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16
Q

Advantages of IV to Oral switch

• Reduced risk of __________ infections

• No risk of ________ in case of oral administration

A

cannula-related

thrombophlebitis

17
Q

• which is less expensive between oral and IV therapy

A

Oral is Less expensive than IV therapy:

18
Q

IV to Oral switch

• Reduction in the _____ costs which mainly refer to cost of ____,______ for administration, ———,———, and ______

A

hidden

diluents, equipments

needles, syringes, and nursing time.

19
Q

In IV to Oral switch

• (Earlier or Later?) discharge
• (Reduced or Increased?) toxicity

A

Earlier

Reduced

20
Q

When doing the IV to Oral switch

Make sure the Oral bioavailability can _______________________________________

A

Achieve serum concentrations comparable to antibiotics administered intravenously

21
Q

The Golden Rules of Antimicrobial Prescribing: __________

A

MINDME

22
Q

The Golden Rules of Antimicrobial Prescribing

A

Microbiology guides therapy wherever possible

Indications should be evidence based

Narrowest spectrum required

Dosage appropriate to the site and type of infection

Minimize duration of therapy

Ensure monotherapy in most cases

23
Q

Antimicrobial resistance
• Resistance to antimicrobials is a __________ phenomenon that can be ______ by a variety of factors

A

natural biological

amplified

24
Q

Antimicrobial resistance

• The use of an antimicrobial forces microbes to ____________ in a phenomenon known as “ ____________ “

A

either adapt or die

selective pressure

25
Q

Bacteria will be killed rather than adapt

T/F

A

F

Bacteria will adapt rather than be killed

26
Q

Antimicrobial resistance can occur when anti-microbials are used incorrectly.

  • for ________ time
  • at _______ dose
  • at ______ potency
  • for the _____ disease

• The microbes which ________ and ———- carry ________, which can be _________

A

too short a

too low a

inadequate

wrong

adapt and survive ; genes for resistance; passed on

27
Q

Antimicrobial resistance

• Paradoxically, underuse through lack of _____, inadequate _____, poor _____, and substandard anti-microbials may play (equal, subpar, more?) role as overuse

A

access

dosing; adherence

Equal

28
Q

Total consumption of antimicrobials is a critical factor in selecting resistance

T/F

A

T

29
Q

Definition of Antimicrobial stewardship

• Refers to ____________ designed to ______ and _______ the ______ of antimicrobial agents by promoting the _______ of ______ antibiotic drug regimens including ______,_______, and ______

A

coordinated interventions

improve and measure

appropriate use

selection of optimal

dosing, duration of therapy and route of administration

30
Q

The antimicrobial stewardship program is a/an (formal or informal?) program that ________ and ________ the __________ of antibiotics

A

Formal

Monitors and manages

appropriate use

31
Q

Goals of The antimicrobial stewardship program

  • _______ antimicrobial therapy

• right _____, _____, _____, ________

A

Optimise

selection, duration, dose, route of administration

32
Q

Goals of The antimicrobial stewardship program

  • Reduce _______ costs

• Limiting ________ and ______

A

treatment related

overuse and inappropriate use

33
Q

Goals of The antimicrobial stewardship program

• Promote active _________ switch therapy
-Minimise adverse events
- Decrease the risk of development of _________

A

IV to PO

antimicrobial resistance

House Microbiology (93 decks)

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