Get Smart About Antibiotics Flashcards
What are the 4 ADE’s associated with antibiotics use?
- Hypersensitivity/allergy
- Drug side effects
- Clostridium difficile infection
- Antibiotic associated diarrhea/colitis
T or F. There are alot of emergency department visits every year due to antibiotic ADE’s.
T.
Which 2 classes of antibiotics are most often associated with ADE’s?
- Penicillins
2. Cephalosporin
What are the 6 goals of antibiotic stewardship programs?
- Reduce antibiotic consumption and inappropriate use
- Reduce C. diff inections
- Improve patient outcomes
- Increase adherence/utilization of treatment guidelines
- Reduce adverse drug events
- Decrease or limit antibiotic resistance
What are the 9 factors to consider when selecting an antibiotic?
- Spectrum of coverage
- Patterns of resistance
- Evidence for the specified infection
- Achievable serum, tissue, or body fluid concentration
- Allergy
- Toxicity
- Formulation
- Adherence/convenience
- Cost
What is empiric therapy?
Initiation of treatment without a firm diagnosis.
What are the 6 principles of empiric therapy?
- Infection not well defined
- Broad spectrum
- Multiple drugs
- Evidence is usually only 2 randomized controlled trials
- More adverse reactions
- More expensive
What are the 6 principles of directed therapy?
- Infection well defined
- Narrow spectrum
- One, seldom 2 drugs
- Evidence usually stronger (doesn’t kill off normal flora)
- Less adverse reactions
- Less expensive
What are the 4 reasons empiric therapy is given?
- Need for prompt therapy with certain infections (life or limb threatening infection)
- Cultures difficult to do to provide microbiologic definition
- Negative cultures
- Care provider beliefs (fear or error of missing something)
T or F. The therapeutic benefit of antibiotics should be balanced with their unintended adverse consequences.
T.
T or F. Antibiotic prescribing should be prudent, thoughtful, and rational.
T.
Why aren’t many companies developing new antibiotics?
No money to be made. A new antibiotic will probably be useless soon after release due to mutations resulting in resistance.
What are the 3 principal causes of the antibiotic market failure?
- Scientific: not many targets left to choose from
- Economic: no money to be made
- Regulatory: FDA has high standards for approval
What are 3 reasons there is no money to be made for developing a new antibiotic?
- High cost of development
- Short duration of treatment
- Limited patient pool
What was the Telithromycin (Ketex) Effect?
So this drug killed a dude. FDA got their panties in a wad and made it harder to get a new antibiotic approved. Companies were like that’s some baby back bulls*** and stopped trying.
