Bugs, Antibiotic prescribing, resistance & Special populations

Question 1

What G+ve organisms particularly affect diabetics and commonly cause nasty joint infections, endocarditis?

Answer 1

Group B Strep

Question 2

Colours G+ve and G-VE?

Answer 2

Gram POSITIVE is PURPLE (violet stain held in by much thicker GP wall)

Gram -ve in PINK : Stain washout much easier

Question 3

Name common URT commensals that become pathogenic when disseminated in blood

Answer 3

Strep.pneumoniae

Haem.influenzae

Fusobacterium necrophorum

Other Streptococci

Neisseria meningtitidis

Question 4

Examples of good G +VE coverage ONLY

Answer 4

Question 5

What global intitiatives are there to monitor and respond to growing AMR, and how many people die per year as a result of these infections?

Answer 5

700,000 die per year.

WHO Glass

Question 6

Spectrums of normal flora and the impact of changes post-antibiotics

Answer 6

Question 7

Treatment of malaria in pregnancy

Answer 7

– Uncomplicated falciparum malaria in 1st trimester = quinine and clindamycin (but there is evidence that ACTs are safe)

– Avoid primaquine

– Avoid doxycycline

If severe:
IV Artemesinin: risks outweigh benefits (Preterm, Spont. abortion, stillbirth)

Question 8

How do you treat TB in Pregnancy?

Answer 8

RISK OF TB > RISK OF RX

1. ) First line drugs the same
2. ) Second line trickier. Streptomycin is ototoxic so contraindicated
   3) Continue breastfeeding ( low concentrations of antiTB drugs present)

Question 9

Antimalarials contraindicated in pregnancy?

Answer 9

Primaquine & Doxy.

Question 10

What drug classes are usually safe in pregnancy?

What are borderline?

What are totally contraindicated?

Answer 10