Infection Flashcards
Who discovered the first Penicillin and from what organsim
Sir Alexander Fleming, from Penicillium notatum
Bactericidal vs bacteristatic
Bacteristatic relies on normal host defences to kill the pathogen after its growth has been inhibited.
Bactericidal are used to remove or destroy pathogen when host defences can’t be relied upon
Competency framekwork for prescribers
Infection prevention and control Antimicrobial resistance and antimicrobials Prescribing of antibiotics Antimicrobial stewardship Monitoring and learning
What is susceptible to an antibiotic
Implies an antimicrobial will inhibit bacterial growth at clinically achievable concentrations
What is MDR
MDR - Multidrug resistance, non-susceptibility to at least 1 agent in 3 or more antimicrobial categories
What is XDR
XDR - Extremely drug resistance, non-susceptibility to at least 1 agent in 2 or fewer antimicrobial categories, i.e bacterial isolates remain susceptible to only 1 or 2 categories
What is PDR
Pandrug resistance, Non susceptible to all agents in all antimicrobial categories, i.e. no agent tested as susceptible for that organism
Important source of resistance antimicrobial
Chromosomal mutation
What ways can antibiotic resistance be acquired
Vertical or horizontal transmission
Vertical - Due to errors in mutation, passed onto subsequent generations
Horizontal - Resistant genes are swapped from one to another
Types of horizontal transmission
Transformation - Bacteria scavenge resistant genes from dead bacteria cells
Transduction - Resistant genes are transferred by bacteriophage
Conjugation - Pilli used to transfer genes
Broad vs narrow spectrum in inducing resistance
Broad spectrum are more likely
What is antimicrobial stewardship
Optimal selection, dosage and duration of antimicrobial treatment that results in the best clinical outcome for treatment or prevention of infection
4D’s of antimicrobial stewardship (AMS)
Drug, Dose, Duration, De-Escalate
How should antibiotics be prescribed
Start smart - Review and decision at 48 hours
Switch from IV to oral
Change to narrow-spectrum
Continue and review again after a further 24 hours
Outpatient parenteral antimicrobial therapy
Antibiotics for surgery
Surgical prophylaxis - One dose within 60 minutes before knife to skin