Choosing Antibiotics Flashcards
What are the aims and areas targeted by the 5 Year National Action Plan?
Reducing need and unintentional exposure including lowering burden of infection
Optimise use of antimicrobials through stringer lab capacity and surveillance
Innovation, supply and access for diagnostics and treatment
What are the antibiotic use indicators?
10% reduction of use in primary care by 2022
Use of IV antibiotics in secondary care with DDD/1000 population/day no higher in 2022 than it was in 2018
Use of WHO Access antibiotics >=60% of total antibiotic use in acute hospitals by 2022
What are the 4C antibiotics?
Co-amoxiclav, cephalosporins, clindamycin, ciprofloxacin
What are some ways bacteria become resistant?
Active efflux, target replication, modified drug target, decreased permeability, drug deactivating mechanisms
Where does the most antibiotic use in humans take place?
80% occurs in primary care = 60% of this is for respiratory infections
When should you review prescribed antibiotics?
After 48-72 hours
What effect does giving IV antibiotics within 1 hour of diagnosing sepsis have?
Improves survival
Are lower doses of antibiotics better?
No = results in suboptimal treatment leading to relapse and resistance
What are the benefits of oral antibiotics?
Fewer PVCs inserted, reduced incidence of skin and soft tissue infection, reduced length of stay, cheaper
What are some governing bodies involved in antibiotics?
European Medicine Association = licences medication in EU
Medicines and Healthcare products Regulatory Agency = UK based
What is the purpose of the Scottish Medicines Consortium?
Reviews medications licensed by the EMA and MHRA
What are the classifications of antibiotics?
Gram positive, gram negative, anaerobes, atypicals
Why do gram positives stain purple?
They have a thick peptidoglycan layer in the cell wall which retains staining
Where are most gram negative bacteria found?
GI tract and gut
Where are most gram positive bacteria found?
Skin and mucous membranes
Where are most atypical bacteria found?
Chest and genito-urinary tract
Where are anaerobes found?
Mouth, teeth, throat, sinuses, lower bowel
What is the common side effect associated with penicillins?
Hypersensitivity/skin reactions
What are some antibiotics that can cause cholestatic jaundice?
Flucloxacillin and co-amoxiclav
What are some antibiotics that can cause C.difficile colitis?
Clindamycin, cephalosporin and quinolones
What are some antibiotics that can prolong the QT interval?
Macrolides and quinolones
What are some side effects of macrolides?
GI disturbance, hepatitis, QT prolongation
What are some side effects of quinolones?
QT interval prolongation, convulsions, tendonitis
What are the side effects of aminoglycosides?
Nephrotoxicity and ototoxicity
