Antibiotics

Question 1

What are the side effects associated with aminoglycosides?
- gentamicin, amikacin

Answer 1

ototoxicity
- hear loss
nephrotoxicity

must measure trough levels to avoid toxicity

Question 2

What should patients taking trimethoprim/sulfamethoxazole or nitrofurantoin be screened for and why?

Answer 2

glucose-6-phosphate dehydrogenase (G6PD) levels
- deficiency can result in haemolytic anaemia during antibiotic use

G6PD is an enzyme essential for the protection of erythrocytes from oxidative damage and maintenence of erythrocyte stability

Question 3

What drug class are tazobactam and clavulanic acid?

Answer 3

beta lactamase inhibitors
- block enzyme hydrolysis of penicillins

Question 4

What are the side effects of macrolides?
- clarithromycin

Answer 4

cardiac side effects
- QT prolongation
- Torsade de pointes

increased risk of myocardial infarction

Question 5

What antibiotic is associated with clostridium difficile infection? What antibiotics can be used to treat it?

Answer 5

4C’s
- clindamycin
- ciprofloxacin (fluoroquinolone)
- co-amoxiclav
- cephalosporin

treatment
- metronidazole and vancomycin

Question 6

What side effect is associated with vancomycin? How can it be prevented?

Answer 6

red man syndrome
- infusion related reaction/hypersensitivity reaction
- pruritus, an erythematous rash that involves the face, neck, and upper torso.
- less frequently, hypotension and angioedema can occur

prevention
- administer diphenhydramine (antihistamine) prior to vancomycin infusion
- use slow infusion rates

Question 7

What is antibiotics stewardship?

Answer 7

a program to change and direct antimicrobial use at health care institutions
- a system of optimising antimicrobial prescribing and minimising unintended harm whilst preserving clinical outcomes

Question 8

What are the aims of antimicrobial stewardship?

Answer 8

reduce inappropriate use of antimicrobials
improve patient outcomes
reduce emergence of antimicrobial resistance
save money