Antimicrobials in ER/ICU

Question 1

List the healthcare impacts of inappropriate antimicrobial prescriptions

Answer 1

Global impacts of emerging resistance to bacteria while the pact of new antimicrobials is slowing. Patients may be impacted by adverse and unintended effects of v/d, long term changes to normal flora (juveniles more susceptible), neuro implications,

Question 2

Provide justification for not prescribing antimicrobials in situations where they are not indicated

Answer 2

• You can’t pinpoint where you thin the infection is (maybe its viral)
• Signs are consistent with a common syndrome for which antibiotics are not recommended
• the patient is otherwise stable, healthy and you can safely monitor for a couple of days

Question 3

provide justification for appropriate empiric antimicrobial prescriptions

Answer 3

If can identify or highly suspect a bacteria OR the animal is extremely sick (the sicker the patient the more aggressive you should be with empiric therapy)

Question 4

identify excellent resources to help guide antimicrobial therapy

Answer 4

Target book (bayer)

Question 5

fever does not =

Answer 5

infections, not all inflammation is caused by an infection and not all infections are caused by bacteria

Question 6

how should you alter your antibiotic tx once you get culture results/more information?

Answer 6

You should de-escalate or discontinue antimicrobials once culture results become available. while shorter courses of antibiotics should be utilized when possible, switching from broad spectrum to narrow spectrum is also ideal

Question 7

what are some considerations for antimicrobials and sepsis?

Answer 7

severe sepsis/bacterial infections needs aggressive antimicrobials and often need broad spectrum combination coverage. take culture and susceptibility before starting broad spectrum antibiotics