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DONE CLINICAL > ANTIBIOTICS > Flashcards

ANTIBIOTICS Flashcards

1
Q

What symptom may suggest C.diff infection?

A

Diarrhoea - smelly liquid stool, green in colour

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2
Q

What should happen if a patient is suspected of having C.diff infection?

A
  • Isolate patient in side room
  • Send stool specimen to microbio for C.diff toxin testing
  • Oral Metronidazole until toxin result known
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3
Q

Name some drugs that can increase C.Diff risk…

A 
Ampicillin
Amoxicillin 
Ciprofloxacin
Co-amoxiclav
2nd and 3rd gen cephalosporins
Clindamycin 
Quinolones
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4
Q

List some potential treatments for C.diff

A

Metronidazole
Vancomycin
Fidaxomicin

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5
Q

How should diarrhoea be monitored in those with C.diff infection?

A

Use of bristol stool chart - type 7 = diarrhoea

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6
Q

If oral metronidazole does not help C.diff infection, what should be 2nd line treatment?

A

Oral Vancomycin 125mg QDS 10 days

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7
Q

What is Augmentin?

A

Amoxicillin and Clavulonic acid

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8
Q

Describe the results of a POSITIVE gram stain and explain why these are the results

A
  • Stains blue/purple
  • Gram POSITIVE bacteria
  • Due to thick peptidoglycan cell wall retaining primary stain
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9
Q

What happens to atypical bacteria in a gram stain?

A
  • No stain retained - no colour stain
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10
Q

Describe the colour change that takes place during a gram stain with gram NEGATIVE bacteria

A
  • Pink/red stain retained

- Thin peptidoglycan cell wall does not retain primary stain well

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11
Q

Staphylococci
Streptococci
Enterococci
Peptococci

Are gram WHAT?!

A

Gram POSITIVE cocci

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12
Q

Pseudomonas
Haemophilus
Legionella
Helicobacter

Are gram WHAT?

A

Gram NEGATIVE rods

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13
Q

Chlamydia is WHAT?

What is the result obtained when it is gram stained?

A

Atypical organism

  • Not detectable on gram stain
  • No peptidoglycan in cell wall
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14
Q

Commensal bacteria are usually found where?

A

On body surfaces

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15
Q

Briefly list the antibiotic prescribing decision process (6) steps

A

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

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16
Q

How do you diagnose and infection?

A

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
17
Q

Allergy and anaphylaxis is common across which 3 agents? Due to what?

A
  • Penicillins
  • Cephalosporins
  • Carbapenems
  • BETA LACTAM RING
18
Q

If history if Ig_ mediated allergic reactions, patient should not receive penicillin

A

IgE

19
Q

Name 2 healthcare associated infections…

A

MRSA and ESBL (extended spectrum beta lactamase producing bacteria)

20
Q

What are 3 cons of using empirical therapy in the treatment of infection?

A

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

21
Q

Name the 3 steps taken in MC and S guided therapy…

A

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)

22
Q

Name 3 cons of MC and S therapy…

A

1) Time consuming
2) More costly
3) May be wrong with diagnosis - contaminant may have been cultured instead

23
Q

A review of parenteral antibiotic treatment should be carried out after ___ hours to see if can switch to oral route

A

24

24
Q

Why do we prefer the oral route of admin over parenteral?

A
  • 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
25
Q

C.Diff is an _____ infection

A

Opportunistic infection due to overgrowth of anaerobic bacteria (usually after a broad spec antibiotic has killed off other susceptible bacteria)

26
Q

The ____ of C.Diff lead to diarrhoea

A
  • Toxins
27
Q

What should the pre dose levels of Gent be before admin?

A

Pre-dose levels less than 1.0mg/L 18-24hrs after the previous dose

28
Q

What should the post dose levels of Gent be?

A

3-5mg/L

29
Q

What type of antibio is Vancomycin?

A

Glycopeptide

30
Q

What are the recommended trough levels of Vanc?

A

10-15mg/L

31
Q

What type of antibio is Teichoplanin?

When should it’s first levels be taken?

A

Glycopeptide

After 7 days

32
Q

Which antibio can cause urine to turn orange/red colour?

A

Rifampicin

33
Q

Name an antibio cautioned in liver impairment…

A

Fucidin

DONE CLINICAL (10 decks)

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