Lec 22 Rational Use of Antibiotics Flashcards
What does the mnemonic “I MIND ME” stand for?
I - Is this antibiotic necessary
M - Microbiology guides therapy whenever possible
I - Indications should be evidence-based
N - Narrowest spectrum required
D - dosage appropriate to the site and type of infection
M - Minimize duration of therapy
E - Ensure monotherapy in most cases
What is the first-line therapy indicated for suspected E. coli, Klebsiella, Enterobacter, or Citrobacter infections in the age range 2 months to 18 years?
IV - Ampicillin-Sulfabactam
Oral - Amoxicillin - Clavulanate
What is the first-line therapy indicated for suspected E. coli, Klebsiella, Enterobacter, or Citrobacter infections for patients
Cefotaxime + Amikacin
When should you consider a switch from IV to oral therapy?
"COMS" Clinical improvement Oral route not compromised Markers showing a trend towards normal Specific indication/deep-seated infection
What is de-escalation therapy?
change in antibiotic regimen from broad-spectrum to a narrower spectrum or from multiple to a single antibiotic
How often should you reevaluate the patient’s pharmacological regimen and consider de-escalation?
48-72 hours
What are the advantages of switching from IV to oral therapy?
- reduction in the likelihood of HCAIs
- patient is more likely to receive medications at the correct times
- reduction in the risk of adverse effects
- reduction in patient discomfort
What are the characteristics of drugs that can be used in switch therapy?
- both drugs should target the pathogen
* bioavailability of both drugs must be considered
What are the 7 pathogens identified by the Antimicrobial Resistance global report to have very high resistance?
E. coli, Klebsiella, S. aureus, S. pneumoniae, nontyphoidal Salmonella, Shigella, N. gonorrhea
(T/F) antimicrobial resistance is more prevalent in HCAIs compared with those from community-acquired infections
T
An Antimicrobial Stewardship team should include:?
physician, pharmacist, clinical microbiologist, infection preventionist, informatics specialist
What is an antimicrobial formulary?
list of drugs used by a hospital ensuring that there are no overlapping uses between medications
What antibiotics are restricted (require approval) in the entire PGH?
ertapenem, meropenem, vancomycin
What antibiotics are restricted for the department of pediatrics and OB-Gyn?
ceftazidime, piperacillin-tazobactam, quinolones, fluconazole
What antibiotics can only be prescribed by IDS fellows/consultants?
colistin, linezolid, tigecycline, amphotericin, caspofungin, andulafungin
