Lecture 10 - Antimicrobial Stewardship

Question 1

What is antimicrobial stewardship?

Answer 1

Coordinated interventions that improve and measure the use of appropriate antimicrobials
(Dose, regimen, duration of therapy and route of administration)

Question 2

What is the point of antimicrobial stewardship?

Answer 2

Minimise toxicity
Reduces cost of health care for infections
Limit selection for antimicrobial resistant strains

Question 3

Why is antimicrobial stewardship important?

Answer 3

To minimise emergence of resistance of microbes to antimicrobials

(Correct prescribing method and correct antimicrobials used)

Question 4

What are the 3 levels of antimicrobial resistance?

Answer 4

Multi-drug resistant (MDR)
Extensively drug resistant (XDR)
Pan-drug resistant (PDR)

Question 5

What does it mean if a microbe is MDR (Multi-drug resistant)?

Answer 5

Resistance to at least one agent in 3 or more antimicrobial categories

Question 6

What does it mean if a microbe is XDR (Extensively-drug resistant)?

Answer 6

Resistant to at least one agent in all but TWO or fewer antimicrobial categories

Question 7

What does it mean if a microbe is PDR (Pan-drug resistant)?

Answer 7

Resistance to all agents in all antimicrobial categories
(Most difficult to treat)

Question 8

What are the consequences of antibacterial resistance?

Answer 8

Treatment failure

Prophylaxis failure

Economic costs

Question 9

In successful antimicrobial stewardship what 4 questions are asked when giving antibiotics?

Answer 9

Does they patient actually need antibiotics?
Can the antibiotics be switched from IV to oral?
Can the broad spectrum antibiotics be switched to narrow spectrum and targeted antibiotics
Is special permission required from microbiology to prescribe the antibiotics?