ANTIBIOTICS Flashcards
What symptom may suggest C.diff infection?
Diarrhoea - smelly liquid stool, green in colour
What should happen if a patient is suspected of having C.diff infection?
- Isolate patient in side room
- Send stool specimen to microbio for C.diff toxin testing
- Oral Metronidazole until toxin result known
Name some drugs that can increase C.Diff risk…
Ampicillin Amoxicillin Ciprofloxacin Co-amoxiclav 2nd and 3rd gen cephalosporins Clindamycin Quinolones
List some potential treatments for C.diff
Metronidazole
Vancomycin
Fidaxomicin
How should diarrhoea be monitored in those with C.diff infection?
Use of bristol stool chart - type 7 = diarrhoea
If oral metronidazole does not help C.diff infection, what should be 2nd line treatment?
Oral Vancomycin 125mg QDS 10 days
What is Augmentin?
Amoxicillin and Clavulonic acid
Describe the results of a POSITIVE gram stain and explain why these are the results
- Stains blue/purple
- Gram POSITIVE bacteria
- Due to thick peptidoglycan cell wall retaining primary stain
What happens to atypical bacteria in a gram stain?
- No stain retained - no colour stain
Describe the colour change that takes place during a gram stain with gram NEGATIVE bacteria
- Pink/red stain retained
- Thin peptidoglycan cell wall does not retain primary stain well
Staphylococci
Streptococci
Enterococci
Peptococci
Are gram WHAT?!
Gram POSITIVE cocci
Pseudomonas
Haemophilus
Legionella
Helicobacter
Are gram WHAT?
Gram NEGATIVE rods
Chlamydia is WHAT?
What is the result obtained when it is gram stained?
Atypical organism
- Not detectable on gram stain
- No peptidoglycan in cell wall
Commensal bacteria are usually found where?
On body surfaces
Briefly list the antibiotic prescribing decision process (6) steps
1) Diagnosis and rating of severity
2) Agent - empirical guidelines/MC&S
3) Route - IV or ORAL
4) Dose
5) Duration or Review date (IV to ORAL switch)
6) Monitoring and safety netting
How do you diagnose and infection?
Symptoms:
- Fever
- Redness, inflammation
- Fatigue, unwell feeling
- Site of infection - pus, laceration, bite
- Nausea and vom, diarrhoea, abdo pain
- Inc urination, dysuria
Tests:
- Elevated WBC count
- Elevated CRP
- Heart rate, BP
- CT scan - shadowing on lungs pneumonia
- Test sputum of rest tract e.g tuberculosis
- Blood cultures to see if infection spread
Allergy and anaphylaxis is common across which 3 agents? Due to what?
- Penicillins
- Cephalosporins
- Carbapenems
- BETA LACTAM RING
If history if Ig_ mediated allergic reactions, patient should not receive penicillin
IgE
Name 2 healthcare associated infections…
MRSA and ESBL (extended spectrum beta lactamase producing bacteria)
What are 3 cons of using empirical therapy in the treatment of infection?
1) Only a guess, may not cover rarer causes of infection
2) Causative organism may be resistant to selected treatment
3) Tends to be broader spectrum of antibiotic used - more risk of side effects and nosocomial infections
Name the 3 steps taken in MC and S guided therapy…
1) Culture positive (growing organism)
2) Identify it (e.g gram +ve cocci)
3) Sensitivities (grow it with this antibiotic and see if susceptible to it)
Name 3 cons of MC and S therapy…
1) Time consuming
2) More costly
3) May be wrong with diagnosis - contaminant may have been cultured instead
A review of parenteral antibiotic treatment should be carried out after ___ hours to see if can switch to oral route
24
Why do we prefer the oral route of admin over parenteral?
- Risk of infection at cannula site
- IV more expensive
- IV more time consuming with admin
- Oral route preferred by patient
- Oral route admin can be carried out at home
