Antimicrobial Resistance Flashcards
what is under dosing
exposure to non lethal quantities of infection, leads to resistance
what general things are antibiotics used for
bacterial pneumonia,
treatment and prophylaxis of surgical site infections,
prevention and treatment of infection following cancer chemotherapy
how many people die a year from AMR in the UK
10000
what are antimicrobials
agents that act against microorganisms (bacteria, fungi, viruses and protozoa)
what are anti bacterial
agents that act only on bacteria (inc antibiotics and disinfectants)
what are antibiotics
agents that are produced naturally/synthetically and kill or inhibit the growth of other organism inc bacteria
what is antibiotic resistance
the ability of bacteria to protect themselves against the effects of an antibiotic
what is clinical resistance
the ability of an bacterium to grow in the antibiotic concentrations reached in the body during therapy
what is susceptibility
an antimicrobial will inhibit bacterial growth at clinically achievable concentrations
what is MDR
non-susceptibility to at least 1 agent in 3 or more antimicrobial categories
what is XDR
non-susceptibility to at least 1 agent in all but 2 or fewer antimicrobial categories (ie, bacterial isolates remain susceptible to only 1 or 2 categories)
what is PDR
non-susceptibility to all agents in all antimicrobial categories(ie, no agents tested as susceptible for that organism)
what creates AMR
Resistance is either innate or acquired.
can be a natural phenomenon (vertical transmission during replication)
or
mutations in susceptible bacteria create resistant genes which are passed on via conjugation, transposition, or transformation to new bacteria making them resistance (horizontal transmission)
what are the resistance mechanisms
inactivation, impermeability, efflux, bypass, Pbps, altered target
why are antibiotics used in agriculture
as growth promotors
why is resistance increasing
Increasing resistance in community
complacency regarding antibiotics
increased use of empiric broad spectrum antibiotics
antibiotic use in livestock
increasing availability to antibiotics
what is antimicrobial stewardship
the optimal selection, dosage, and duration of antimicrobial treatment that results in the best clinical outcome for the treatment or prevention of infection, with minimal toxicity to the patient and minimal impact on subsequent resistance
an organisational or healthcare system wide approach to promoting and monitoring judicious use of antimicrobials to preserve their future effectiveness
what are the 4 D’s of AMS (AM stewardship)
drugs, dosage, duration, de escalation
what is poor practise
unnecessary use of broad spectrum, not following guidance, not streamlining or responding to pos microbiology, not considering switching from IV to PO, prolonged duration, underdosing
what antibiotics cause C diff infections
quinolones, cephalosporins, broad spectrum;
clindamycin, fluoroquinilones (levofloxacin, ciprofloxacin), pencillins
what are the 4 c antiobiotics to avoid prescribing
clindamycin, cephalosporins, co-amoxiclav, ciprofloxacin
