Lab_AMS

Question 1

medicines used to prevent and treat infections in humans,
animals and plants.

Answer 1

ANTIMICROBIALS

Question 2

Mother or umbrella term that includes antibiotics, antivirals, antifungals, and antiparasitics

Answer 2

ANTIMICROBIALS

Question 3

Occurs when bacteria, viruses, fungi and parasites change over
time and no longer respond to medicines making infections harder
to treat and increasing the risk of disease spread, severe illness and
death.

Answer 3

ANTIMICROBIAL RESISTANCE (AMR)

Question 4

Caused by improper utilization of antimicrobials

Answer 4

ANTIMICROBIAL RESISTANCE (AMR)

Question 5

factors causing AMR

Answer 5

o evaluation of validity of prescriptions (especially e-
prescriptions)
o dispensing without prescriptions or erroneous and
invalid prescriptions
o over-prescribing of antibiotics
o patient not taking antibiotics as prescribed
o unnecessary antibiotics used in agriculture
o poor infection control in hospitals and clinics
o poor hygiene and sanitation practices
o lack of rapid laboratory tests

Question 6

organizations that unite to win the war against anti-microbial resistance

Answer 6

DOH and WHO

Question 7

Goal is to reduce the morbidity and mortality due to AMR (Philippine
Action Plan to Combat Antimicrobial resistance: One Health
Approach)

Answer 7

National Antimicrobial Stewardship (AMS) Program

Question 8

CORE ELEMENTS OF THE NATIONAL AMS PROGRAM

Answer 8

Leadership
Policies, Guidelines, Pathways
Surveillance, AMU and AMR
Action
Education
Performance Evaluation

Question 9

A dedicated multi-disciplinary AMS Committee and Team supported by the
hospital administration shall be responsible to successfully implement,
perform, and monitor the AMS Program in each hospital

Answer 9

LEADERSHIP

Question 10

also part of the team that
chooses the implementation of the AMS Project

Answer 10

PTC and AMS Clinical Pharmacist

Question 11

A team responsible for the effecting and monitoring of AMS
strategies to promote appropriate antimicrobial use shall be
created under the AMS Committee.

Answer 11

• THE AMS TEAM

Question 12

Implementation of the AMS strategies and perform AMS
interventions as needed;

Answer 12

AMS TEAM

Question 13

Development and review of standard treatment
guidelines and prescribing policies;

Answer 13

AMS TEAM

Question 14

Regular collection, analysis and reporting on the
progress of the AMS program to the hospital AMS
committee, administrators and DOH;

Answer 14

AMS TEAM

Question 15

Education of healthcare staff on appropriate
antimicrobial prescribing and resistance;

Answer 15

AMS TEAM

Question 16

Identification and designing of systems/processes to
facilitate appropriate antimicrobial use;

Answer 16

AMS TEAM

Question 17

Provision of expert advice on development of policies
related to appropriate use of antimicrobials and control
of AMR in the hospital.

Answer 17

AMS TEAM

Question 18

How to solve the errors and problems encountered

Answer 18

ACTION

Question 19

Very important not only for the team but also for the patient and
other healthcare workers

Answer 19

EDUCATION

Question 20

At the end of the year, a report is submitted to the DOH to assess if
the AMS program is working or progressing

Answer 20

PERFORMANCE EVALUATION

Question 21

AMS should be spearheaded by ____________ and physicians
(especially Infectious Disease Specialists) → ensure the right drug is
being prescribed at the right time for the right diagnosis or
indication.

Answer 21

PHARMACISTS

Question 22

ROLES OF ANTIMICROBIAL STEWARDSHIP PHARMACIST

Answer 22

Surveillance, optimizing drug therapy, drug therapy monitoring and adherence to cpg, education/training and public engagement

Question 23

T/F: Pharmacists should have access to patients’ chart

Answer 23

T

Question 24

T/F: Pharmacists can recommend dose adjustments

Answer 24

T

Question 25

Guidelines for AMR

Answer 25

7th day antibiotic stop policy Antibiotic Restrictions Surgical prophylaxis

Question 26

exceptions for 7th day antibiotic stop policy

Answer 26

osteomyelitis (requires 6 weeks of therapy)

Question 27

T/F: according to surgical prophylaxis, antibiotics are taken prior to surgery and can also be taken post-op

Answer 27

T

Question 28

Keeping up-to-date with treatment guidelines, new evidences and studies

Answer 28

EDUCATION/TRAINING AND PUBLIC ENGAGEMENT

Question 29

Goal: * To safeguard and ensure the optimal use of antimicrobials * To optimize clinical outcomes of the patient

Answer 29

AMS INTERVENTIONAL STRATEGIES

Question 30

Persuasive strategies aim to persuade health professionals to prescribe appropriately by addressing underlying knowledge deficiencies, attitudes and/or behaviour through _____________ and __________

Answer 30

active interaction and discussion

Question 31

Persuasive strategies include the following:

Answer 31

Audit and Feedback (Prospective Audit of Antimicrobial Prescribing and Direct Intervention and Feedback) Point of Care Interventions (IV to PO, De-escalation, Dose optimization)

Question 32

Occur routinely at the ward level

Answer 32

Point of Care Interventions

Question 33

With direct feedback to the prescriber/attending physician at the time of prescription or laboratory diagnosis

Answer 33

Point of Care Interventions

Question 34

Advantages of Point of Care interventions

Answer 34

- Improves patient management and outcomes ▪ An excellent opportunity to educate clinical staff on appropriate prescribing

Question 35

Function of the clinical pharmacist

Answer 35

RESTRICTIVE STRATEGIES

Question 36

Control the use of antimicrobials by instituting “barriers”

Answer 36

RESTRICTIVE STRATEGIES

Question 37

Restrictive strategies includes the following strategies:

Answer 37

* Formulary restriction and pre-authorization * 7 th day automatic stop policy

Question 38

Requires clinicians to obtain approval for use of selected antimicrobials before prescribing

Answer 38

ANTIMICROBIAL RESTRICTION AND PRE-AUTHORIZATION STRATEGY

Question 39

To preserve last-line antimicrobials to use for conditions where they are truly indicated

Answer 39

ANTIMICROBIAL RESTRICTION AND PRE-AUTHORIZATION STRATEGY

Question 40

To help minimize unnecessary patient exposure to toxicities and costs associated with inappropriate therapy

Answer 40

ANTIMICROBIAL RESTRICTION AND PRE-AUTHORIZATION STRATEGY

Question 41

Scope: use of restricted antimicrobials orally and intravenously to all patients (inpatient and outpatient settings).

Answer 41

ANTIMICROBIAL RESTRICTION AND PRE-AUTHORIZATION STRATEGY

Question 42

Exceptions of ANTIMICROBIAL RESTRICTION AND PRE-AUTHORIZATION STRATEGY:

Answer 42

o Use of treatment of MDR tuberculosis under the Programmatic Management of Drug Resistant Tuberculosis (PMDT) o Antimicrobial prescribed/order by an IDS or AMS Clinician

Question 43

Preauthorization of broad-spectrum antibiotics and prospective review after______________ of treatment should form the cornerstone of antibiotic stewardship programs to ensure the right drug is prescribed at the right time for the right diagnosis.

Answer 43

two or three days

Question 44

T/F:the stat/now dose or the first dose of the medication can be given prior to the result of the pre- evaluation but succeeding dose will require approval

Answer 44

T

Question 45

This policy shall govern the duration of antimicrobial use by requiring prescriptions to be regularly reviewed, specifically in the need to continue therapy beyond seven (7) days.

Answer 45

- 7 TH DAY AUTOMATIC STOP POLICY

Question 46

7 TH DAY AUTOMATIC STOP POLICY standard operating procedure shall cover the use of all antimicrobials administered ___________ and _________ to all patients admitted in the hospital (inpatient setting only)

Answer 46

orally and intravenously

Question 47

Exceptions of 7TH DAY AUTOMATIC STOP POLICY

Answer 47

o Use in HIV/AIDS or cancer patients as antimicrobial prophylaxis according to guidelines; and o Use as anti-tuberculosis antibiotics

Question 48

In 7th Day automatic stop policy, the nurse or pharmacist in charge of the patient shall alert the attending physician no later than on the _______ day of antimicrobial therapy

Answer 48

6th

Question 49

In 7th Day automatic stop policy, Counting is reset if discontinued or put on hold for more than ______ hours

Answer 49

24

Question 50

In case the AMS Officer cannot be contacted, it is documented on the form and _____________ may dispense the first dose; but the succeeding dose will require approval already

Answer 50

Pharmacy

Question 51

There is no need to fill out the 7th-day antimicrobial form if:

Answer 51

- Total treatment duration is intended to be ≤7 days; -Use of the antimicrobial beyond 7 days has been recommended by the AMS clinician, IDS or IPC Chairperson