Antimicrobial Stewardship Flashcards
What is an antimicrobial?
Any substance that destroys or inhibits the growth of microorganisms, especially pathogenic ones.
ex: Antiviral, Antifungal, Antibacterial.
What is a microorganism?
An organism of microscopic or ultramicroscopic size.
ex: Bacteria, Fungus, Virus, Amoeba.
When and where did Alexander Fleming discover penicillin?
1928 in his laboratory at St. Mary’s Hospital in London.
What is the story behind the discovery of penicillin?
Alexander Fleming left some petri dishes he had been working with on his lab bench. He went on vacation for a week and came back to find that Penicillium mold had grown in the petri dishes. Upon closer inspection, he discovered that rings of inhibition had formed around the Penicillium mold, meaning the mold was secreting something that inhibits bacterial growth.
What was discovered in 1945 by British scientists?
The beta-lactam ring.
What has happened with the invention of penicillin?
Antibiotic resistance.
What class of drugs was discovered in the 1930s?
Sulfonamides.
What is the function of sulfonamides?
To inhibit bacterial growth.
What were sulfonamides first used to treat?
Mastitis.
Sulfonamides become more effective when combined with what drug?
Diaminopyrimidines.
What is the most commonly used diaminopyrimidine used in combination with sulfonamides?
Trimethoprim.
What are the mechanisms of action that antibiotics may have?
- Metabolic pathway inhibition (Trimethoprim, Sulfonamides).
- Nucleic acid synthesis inhibitors (Fluoroquinolones).
- Protein synthesis inhibition (Tetracyclines, Aminoglycosides).
- Cell membrane depolarization (Lipopeptides).
- Cell wall synthesis inhibitors (Cephalosporins, Beta-lactams).
What are the 2 types of mechanisms of resistance that bacteria can have?
- Intrinsic.
- Acquired.
What is an intrinsic trait?
A universally shared trait by bacteria in a given species.
ex: Cell wall permeability, efflux pump.
What is an acquired trait?
A trait individual bacteria gain through horizontal gene transfer, plasmid gene transfer, and/or self-mutations.
What are some mechanisms of resistance that bacteria can have?
- Efflux of a drug.
- Drug inactivation.
- Limiting drug uptake.
- Modification of the drug target.
- Alteration of metabolic pathway.
What contributes to AMR?
- Increased antimicrobial usage-both animal and human.
- Early discontinuation of therapy.
- Sharing medications.
- Prescription of the incorrect antimicrobial.
- Poor hygiene and preventative medicine.
- Antimicrobials in the food supply.
What are the strategies to combat resistance?
- New innovations.
- Judicious antibiotic use.
- Regulation of antibiotic use.
- Combination products.
- Antibiotic additives.
- Disease prevention.