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CD > CD-05 > Flashcards

CD-05 Flashcards

1
Q

What is Antibiotic?

A

Antibiotic produced by a microorganism which inhibits the growth of other microorganisms.

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2
Q

What is Antibacterial?

A

Produced by a microorganism

All antibiotics are antimicrobial but not all anti-microbial are antibiotics.

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3
Q

What is the definition of Antimicrobial?

A

Substance (synthetically or biological) that inhibits the growth of microbes.

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4
Q

Selective toxicity?

A

selectively kills or inhibits the growth of microbes

while causing minimal or no harm to the host. (it is an important quality for an antimicrobial drug is selective toxicity)

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5
Q

With Gram negative bacteria the crystal violet is washed away leaving the red safranin dye?

A

Yes

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6
Q

What acts as a virulence factor in bacteria?

A

Bacterial CAPSULES act as virulence factors

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7
Q

What protect bacteria from stress?

A

Bacterial spores

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8
Q

Bacteria reproduce by?

A

Binary fission (divide One body into two new bodies via asexual reproduction)

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9
Q

What are the key stages of microbial pathogenesis?

A

Exposure ->Adherence->Invasion->Replication

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10
Q

Which types of bacterial Cell wall mainly consists peptidoglycan?

A

Gram negative

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11
Q

cell wall Peptidoglycan and Lipid?

A

Gram Negative

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12
Q

Endotoxin?

A

Toxin is part of the bacteria

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13
Q

Exotoxin?

A

Toxin is secreted by the bacteria

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14
Q

Pathology?

A

study of causes and effects of injury

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15
Q

Pathogenesis?

A

Development of a disease

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16
Q

NICE Guideline means?

A

National Institute for Health and Care Excellence

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17
Q

Fever in under 5s

A

Patients age under 5 years Do not use ANTIPYRETIC for sole reason of reducing fever?

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18
Q

Disease of human depends on?

A

Microbes and Host so therefore treat host factors as well.

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19
Q

Fever in under 5s?

A

Assessment and initial management.

20
Q

How antimicrobials are different from another drug use?

A

Abuse potential MDR

Impact on patient’s immediate community and Global community.

21
Q

Goals of antimicrobial therapy?

A

Cure a diagnosed infection (individual)
Minimise adverse events (individual)
Minimise adverse events (society) by resistance

22
Q

How We can realise Is the Patient Infected?

A 
Feeling hot/cold
• Swelling, heat, or erythema
• Purulent discharge
• Sputum (cough) production (Change in amount/colour/SOB) 
• Diarrhea or vomiting
• Confusion
• Duration of symptoms 
• What has helped so far
23
Q

Body temperature for Fever is?

A

> 38°c

24
Q

Infection Signs or clinical test WCC?

A

White Cell Count Will Increase during infection

25
Q

what is ↑ CRP during infection?

A

C reactive protein Increase

26
Q

How to diagnose the sign of symptoms of infection?

A

Cultures (e.g. urine, stool, sputum)

Sputum mean a (mixture of saliva and mucus coughed up from the respiratory tract)

27
Q

What is positive culture?

A

Taking a swab Growing in your agar plates and identify the specific pathogen

28
Q

What are the Risk factors for infection?

A
  • Recent surgery/procedures?
  • Immunosuppressed? (Medication, HIV)
  • Co-morbidities? (eg; Diabetes)
  • Recent exposure to infected individuals or sources of infection? (eg: contact tracing in COVID-19 pandemic)
  • Vaccination status?
29
Q

What are the Probable Sources of infection?

A

Endogenous infections:(Which is remain inside the body) E. coli UTI
Staph aureus skin infections (e.g. infected IV lines)

30
Q

Exogenous infections mean?

A

Person-person, animal-person, Ex: Influenza, COVID-19, HIV (person to person)

31
Q

Is the Common Cold (Viral) or Bacterial?

A

(Viral) So, manage symptoms

32
Q

Is the Otitis Media (inflammatory diseases) of the middle ear bacterial or Viral?

A

Often Viral so Manage symptoms

33
Q

Is the Conjunctivitis viral or bacterial?

A

Both

34
Q

What is Asymptomatic UTI Viral or Bacterial?

A

Bacterial (Do not treat)

35
Q

Is the Sinusitis viral or bacterial?

A

(Bacterial): Treat if fever present

36
Q

Initiating Antimicrobial treatment what consideration I should do?

A 
Patient symptoms (swelling, erythema)
Tests results (temperature, BP, HR)
Risk factors for infection (broken skin)
Suspected source
Antimicrobial treatment needed?
Culture /swab/viral PCR
Begin empiric therapy
37
Q

What is Empiric Therapy?

A

It is a therapy, based on experience Or on the basis of a clinical “educated guess” in the absence of complete or perfect information.”

38
Q

Guidelines for Empiric therapy for different DHBs?

A
  • BPAC Antibiotic Guide
  • SCRIPT (ADHB)
  • EMPIRIC (CCDHB)
  • Pink Book (CDHB)
  • Starship (Children’s Hospital ADHB)
  • Micro guide (SDHB)
39
Q

Apply our JUDGEMENT before applying Empiric Therapy: 3 factors need to consider: Bug, Drug, Patient?

A
  1. Infection factors (Bug)
    • Organism
    • Severity of infection: Systemic? Localised?
  2. Antimicrobial factors (Drug)
    Spectrum of activity (broad vs narrow) • PK/PD: Distribution, Half life
    • Toxicity and ADR profile (risk/benefit) • Local sensitivities
    • Formulations available • Funding considerations
3. Patient factors
• Allergy status
• Age – neonates, elderly
• Renal function
• Hepatic function
• Co-morbidities (including immunosuppression)
• Pregnancy/Breastfeeding
• Previous antimicrobial exposure
• Drug interactions
• Clinical setting: inpatient/outpatient
• Site of infection: eg: CNS infection vs eye infection
40
Q

Why we need to Narrow the antimicrobial spectrum?

A

Reduce the risk of antimicrobial resistance (AMR) and improves efficacy by selecting therapy that targets specific infective organisms
Patient is clinically improving (IF NOT, aim for broader coverage)

41
Q

What is the monitoring after empiric therapy apply?

A 
1. Clinical improvement (Patient)
• Symptoms (local and systemic)
• Observations (HR, RR etc)
• Physical exam (chest sounds, abdomen exam)
• Bloods (CRP, WCC)
• Imaging (CXR)
• Possible new-onset ADRs (drug safety)
2. Therapeutic Drug Monitoring (Drug)
• Serum levels
• MIC-Time dependant killing
• Cmax-Concentration dependant killing
42
Q

What would be the Duration of Treatment for Empiric therapy?

A

Most common infections have a standard treatment regimen
• Refer to local guidelines
Guidelines typically provide a range. This requires the use of clinical judgement.
• Severity of infection • Location of infection • Drug tolerability

43
Q

What we will do if Empiric Treatment Fail to treat infection?

A
  • We will check about the empiric therapy appropriate.
  • Appropriate spectrum for suspected organism
  • Dose and frequency: PKPD factors for individual patients.
  • Removed any contributing factors? (catheters, drains, central lines, wound debridement).
  • Was it truly an infection
  • Is there a possibility of re-infection
  • Was the patient compliant
  • Antimicrobial resistance
  • Review cultures
44
Q

Antimicrobial guidelines are guides?

A

To assist provision of patient care.
Where Clinical judgement and patient cantered care must be applied.
There is no one size fit all.

45
Q

What if non-compliance apparent what are they?

A

Pill burden
Dose frequency
Special instructions
Intolerance etc

CD (23 decks)

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