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.
What is the purpose of the GAIN Act that took effect on October 1, 2012?
To increase the number of new antibiotics by lowering standards for approval and an increased exclusivity period.
Antibiotcs were approved based on what before the GAIN Act? After?
Before: approved to treat a particular indication. After: approved for a particular microorganism.
