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Sepsis > Choosing Antibiotics > Flashcards

Choosing Antibiotics Flashcards

1
Q

What are the aims and areas targeted by the 5 Year National Action Plan?

A

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

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2
Q

What are the antibiotic use indicators?

A

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

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3
Q

What are the 4C antibiotics?

A

Co-amoxiclav, cephalosporins, clindamycin, ciprofloxacin

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4
Q

What are some ways bacteria become resistant?

A

Active efflux, target replication, modified drug target, decreased permeability, drug deactivating mechanisms

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5
Q

Where does the most antibiotic use in humans take place?

A

80% occurs in primary care = 60% of this is for respiratory infections

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6
Q

When should you review prescribed antibiotics?

A

After 48-72 hours

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7
Q

What effect does giving IV antibiotics within 1 hour of diagnosing sepsis have?

A

Improves survival

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8
Q

Are lower doses of antibiotics better?

A

No = results in suboptimal treatment leading to relapse and resistance

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9
Q

What are the benefits of oral antibiotics?

A

Fewer PVCs inserted, reduced incidence of skin and soft tissue infection, reduced length of stay, cheaper

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10
Q

What are some governing bodies involved in antibiotics?

A

European Medicine Association = licences medication in EU

Medicines and Healthcare products Regulatory Agency = UK based

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11
Q

What is the purpose of the Scottish Medicines Consortium?

A

Reviews medications licensed by the EMA and MHRA

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12
Q

What are the classifications of antibiotics?

A

Gram positive, gram negative, anaerobes, atypicals

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13
Q

Why do gram positives stain purple?

A

They have a thick peptidoglycan layer in the cell wall which retains staining

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14
Q

Where are most gram negative bacteria found?

A

GI tract and gut

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15
Q

Where are most gram positive bacteria found?

A

Skin and mucous membranes

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16
Q

Where are most atypical bacteria found?

A

Chest and genito-urinary tract

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17
Q

Where are anaerobes found?

A

Mouth, teeth, throat, sinuses, lower bowel

18
Q

What is the common side effect associated with penicillins?

A

Hypersensitivity/skin reactions

19
Q

What are some antibiotics that can cause cholestatic jaundice?

A

Flucloxacillin and co-amoxiclav

20
Q

What are some antibiotics that can cause C.difficile colitis?

A

Clindamycin, cephalosporin and quinolones

21
Q

What are some antibiotics that can prolong the QT interval?

A

Macrolides and quinolones

22
Q

What are some side effects of macrolides?

A

GI disturbance, hepatitis, QT prolongation

23
Q

What are some side effects of quinolones?

A

QT interval prolongation, convulsions, tendonitis

24
Q

What are the side effects of aminoglycosides?

A

Nephrotoxicity and ototoxicity

25
Q

What is a side effect of vancomycin?

A

Red man syndrome

26
Q

What are some side effects of tetracycline?

A

Hepatotoxicity, staining of teeth, dysphagia, photosensitivity

27
Q

What are some side effects of nitrofurantoin?

A

Peripheral neuropathy, pulmonary fibrosis

28
Q

What are some side effects of sulphonamides?

A

Stevens-Johnson syndrome, blood dyscrasias

29
Q

What is a side effect of trimethoprim?

A

Blood dyscrasias

30
Q

What are some side effects of chloramphenicol?

A

Aplastic anaemia, grey baby syndrome

31
Q

What are some side effects of linezolid?

A

Blood dyscrasias, MAOI, optic neuropathy

32
Q

What is a side effect of sodium fusidate?

A

Hepatotoxicity

33
Q

What are some antibiotics that act as enzyme inhibitors?

A

Erythromycin, clarithromycin, isoniazid, metronidazole, ciprofloxacin

34
Q

What is an example of an antibiotic that acts as an enzyme inducer?

A

Rifampicin

35
Q

What antibiotics do antacids and calcium reduce the absorption of?

A

Tetracyclines and quinolones

36
Q

What are some interactions of broad spectrum antibiotics?

A

Cause oral contraceptives to fail

Increase INR of warfarin

37
Q

What does metronidazole interact with?

A

Alcohol

38
Q

What are some drugs that aminoglycosides interact with to cause nephrotoxicity?

A

Loop diuretics, cyclosporin, tacrolimus

39
Q

What are some interactions of quinolones?

A 
Steroids = causes tendonitis
NSAIDs = causes convulsions
40
Q

What are some antibiotics that interact with QT prolonging drugs?

A

Macrolides and quinolones

Sepsis (7 decks)

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