ic6

Question 1

antimicrobial vs antibiotics

Answer 1

antimicrobial: drugs that treat microorganisms by killing/inhibiting growth
antibiotics: drugs that treat bacteria by killing/inhibiting growth
antifungal/antiviral: drugs that treat other non-bacterial microorganisms

Question 2

why antibiotic resistance forms?

Answer 2

1) nature: mutation in DNA, gene transfer
2) environmental factors: appropriate use (prescription), inappropriate use (Agriculture, pharmacy waste, irresponsible use & disposal

Question 3

mechanism of antibiotic resistance

Answer 3

1) inactivation/modification of antibiotic (e.g. by enzyme produced by bacteria)
2) alteration of target site, decreased antibiotics binding capacity
3) modification of metabolic pathway to circumvent antibiotics effect
4) lower antibiotic accumulation in bacterial cell

Question 4

what is antimicrobial stewardship

Answer 4

optimal selection, dosage, duration of antimicrobial (including antibiotic) that results in best outcome for treatment/prevention of infection
4D for optimal: Drug, Dose, De-escalation, Duration of therapy
co-led by physician & pharmacist

Question 5

goals of antimicrobial stewardship

Answer 5

1) work with healthcare providers to ensure patients receive right antimicrobial, at the right dosage, and at the right duration
2) prevent antimicrobial overuse & misuse
3) minimise development of resistance

Question 6

strategies for antimicrobial stewardship

Answer 6

1) education
2) develop clinical treatment guidelines
3) track antimicrobial use & resistance rate
4) microbiology reporting & surveillance
5) audit prescriptions w intervention & feedback
6) restrict use of antimicrobials (spectrum, toxicities, cost)
7) computer surveillance & decision support

Question 7

aseptic techniques

Answer 7

1) clean room (actual septic compounding)
2) anteroom (hand hygiene, donning of PPE)
3) hood with filtered airflow
4) cleaning of working surfaces
5) appropriate technique to handle needles & syringes
6) beyond-use date (BUD)

Question 8

goals of sterilisation & disinfection

Answer 8

1) prevent transmission of microorganisms

2) minimise damage to devices, equipment & surfaces

Question 9

sterilisation

Answer 9

eliminate disease-causing microorganisms (bacterial spores)

methods: heat, chemical (e.g. 6% h202)