LECTURE 1 Overview Of Infectious Diseases And Antimicrobial Stewardship Flashcards
Define antibiotic
A substance created by a microorganism to inhibit or kill another microorganism
Define antibacterial
A substance that inhibits or kills bacteria
Define antifungal
Substance that inhibits or kills fungus
Define antiviral
A substance that inhibits the development and transmission of viruses
Define antiprotozoal
Substance that kills Protozoa
Anti-infective
Substance that inhibits,prevents, or kills the source of an infection
Antiseptic
Substance that is applied to living tissue/skin to prevent, treat, or reduce infection
Disinfectant
Substance that is applied to inanimate objects/surfaces to kill microbes
Antimicrobial
Substance that inhibits or kills microbes
Leading cause of death in 2021 globally was……
Ischaemic heart disease
What are the 4 categories of bacterial resistance
Decreased permeability, Enzyme modification, Target site changes, Active efflux
What is an example of Decreased Permeability in terms of bacterial resistance
Cell wall changes, Porin channel changes, Biofilm production
What is an example of enzyme modification in terms of bacterial resistance
Beta-lactamases, aminoglycoside-modifying enzymes, Methylation
What is an example of target site changes in terms of bacterial resistance
Alteration of penicillin binding proteins, ribosomal modification
What is example active efflux in terms of bacterial resistance
Tetracycline efflux, Fluoroquinolone efflux
HINT FOR EXAM
if you stop antibiotics earlier, for example 5 days rather than typical 10 less chance at getting resistance, duration is for effectiveness.
What are the costs of bacterial resistance
Increased use of broad spectrum antibacterial
Increased us of IV antibacterial
Increased hospitalizations
Increased infection control
Diminished quality of life
Increased morbidity and mortality
Findings on the overuse of fluroquinolones
In 2 academic medical centres with 100 consecutive patients
81% had inappropriate indication
53% was not first line
33% no evidence of infection
Only 1 had correct dosage and duration
__-__% of adults and children seeking care for viral respiratory tract infections receive a prescription for an antibacterial
40-75
What are steps to reducing antibacterial resistance
Use antibacterial only when necessary
Do not use antibacterial for viral infections
Use antibacterial for appropriate duration
Ensure patient adherence
Use antibacterial with the narrowest spectrum of activity possible
Prevent spread of infections
Vaccinate
What are the specific site factors that impede drug diffusion, are difficult to treat, may require direct injection. Etc..
Eye, brain, prostate
Biofilms
Can form on many surfaces
Frequently forms on foreign substances inserted or implanted into the body if the come in contact with bacterial organisms
May also form on some tissues in the body resulting in infections that are very difficult to treat
Most infections can be treated with a ____ agent
Single
Why are combinations of antibacterial required
Broaden empirically coverage
Polymicrobial coverage
Prevent emergence of resistance
Synergy
Antibacterial combination, explain the 4 terms (synergy, addition,indifference,antagonism)
Synergy : superior to the sum of effects of both antibacterial given separately (1+1 >2)
Addition: Superior to either antibacterial given separately (1+1+ 1-2)
Indifference: Equal to either antibacterial alone (1+1=1)
Antagonism: Inferior to either antibacterial alone (1+1<1)
What are some examples of synergism in clinical settings
Penicillin + aminoglycoside, against eneterococci
Piperacillin + aminoglycoside
Sulfonamides + trimethoprim
Beta-lactam + beta-lactamase inhibitor
What are some examples of antagonism
Penicillin + tetracycline
Gentamicin + chloramphenicol
Consideration with Antimicrobial therapy
Oral anticoagulants
- antibacterial inhibits vitamin K synthesis in GI tract
Oral contraceptives
- reduce birth control pill effectiveness, associated with OC failure, rifampin, amplicilin,metronidazole, cephalexin, eryhthromycin, dapsone, clindamycin
