Antimicrobial Stewardship Flashcards
1
Q
How is antimicrobial stewardship achieved through
A
- Monitoring/surveillance
- Guidelines and protocols
- education
- Specific restrictions
- Specific interventions
- Multidisciplinary working
2
Q
What are some of the general prophylaxis antibiotic guidlines?
A
- Prophylaxis for high risk surgeries/procedures in conjunction with full surgical asepsis. The aim is to maintain suffcient antibiotic concentration to surgical site for duration of surger
- medical prophylaxis only when patient is immunocompromised.
3
Q
What are the situations when you should not prescribe an antibiotic
A
- Viral or self limiting bacterial infections (sinusitis, utis, diarrhoea)
- Asymptomatic bacteriuria/cystitis
- In-growing toe nails
- Leg ulcer without celluitis
- Varicose eczema
3
Q
What are the different types of UTIs
A
- Asymptomatic bacteriuria (only prescribe if symptomatic)
- Uncomplicated UTI (NSAIDs can be jsut as effective as antibiotics so consider delaying antibiotics)
- Catheter-associated UTI (remove catheter and prescribe if symptomatic/septic)
4
Q
What are the non-antibiotics measures to take first
A
- Reassurance/explination
- Symptomatic measures like fluids, analgesia
- Give a ‘delayed’ script
- Saftey netting
5
Q
What antibiotics can be used in a lower respiratory tract infection?
A
- Amoxicillin or doxycyclin
6
Q
What antibiotics are used in lower UTIs
A
- Trimethoprim or nitrofurantoin
7
Q
What antibiotics are used in mild cellulitis
A
- Flucloxacillin or doxycycline
8
Q
What is the SOFA score?
A
- ‘Seqeuntial organ failure assessment’ used in sepsis to quantify end organ damage.
- Quick SOFA = Confusion or hypotension or tachypnoea
9
Q
What are the indications for delivering antibiotic therapy IV
A
- Sepsis
- Conditions such as endocarditis, CNS infections and bacteraemias and osteomyelitis
- Severe skin and soft tissue infections
- Compromised oral route
- No oral formulation available
10
Q
What are the antimicrobial stewardship interventions?
A
- Be restrictive so use short duration, automatic stop, restrict overuse of broad spectrum antibiotics as it can reduce C.diff, MRSA
- Persuasive - education, feedback, reminders, specialist advice and lab reporting
11
Q
What are 10 standard infection control precautions
A
- Patient placement/assessment for infection risk
- Hand hygine
- respiratory and cough hygine
- PPE
- Safe management of care equipment
- Safe management of care environment
- Safe management of linen
- Safe management of blood and body fluid spills
- Sade disposal of waste
- Occupational saftey
12
Q
What are the contact precautions?
A
- Decontaminate gands
- use PPE
- Keep door closed
- Removal all PPE before leaving
Use when spread is via direct contact
13
Q
What are the droplet precautions?
A
- Decontaminate hands
- Use PPE including surgical masks and eye protection
- Keep door closed
- Removal all PPE before leaving and decontaminate hands
14
Q
What are the airborne precautions?
A
- Decontaminate gands
- Use PPE with FFP3 face mask, eye protection and normal
- Keep fore closed
- Removal all PPE before leaving except FFP3 mask and decontaminate hands
- After leaving remove FFP3 hands and decontaminate hands
