lecture 11 Flashcards
what is ams
right antibiotic for the right patient, at the right time with the right dose and the right route causing the least harm to the patient and future patients
what are the goals of AMS
Improving patient outcomes
Reducing antibiotic resistance
Minimising adverse effects
Reducing healthcare costs
Enhancing infection control
What are the key drivers for prudent antimicrobial use?
Reduce incidence of adverse antibiotic associated events
Clostridium difficile infection (CDI)
Antibiotic associated diarrhoea (AAD)
Allergic reactions and other toxic effects
Reduce resistance
Reserve some antibiotics to preserve effectiveness?
Pharmacoeconcomics
Practice cost-effective prescribing
Emphasis on EFFECTIVE
effects of C.difficile
Opportunistic infection
Overgrowth of anaerobic bacteria in the bowel
Associated with previous antibiotic administration
Faecal–oral transmission from spore contact
Associated colitis and diarrhoea
Mortality and morbidity worse in elderly
what are the actions to reduce C. difficile
Diagnosis of C diff
How to manage positive patients
Prevention through isolation
Prevention through prudent prescribing of antibiotics
Prevention through environmental cleaning
Prevention through hand hygiene
Training, audit and feedback
Trust Board level input
what is Faecal microbiota transplant (FMT)
FMT is recommended as an option to treatrecurrentC diffinfection in adults who have had 2 or more previous confirmed episodes.
Aims to restore a healthy gut microbiome.
It involves transferring intestinal bacteria and other microorganisms from healthy donor faeces into the gut of the recipient.
what is MRSA
Methicillin resistant Staph. aureus
Can cause invasive infections
Treatment with Glycopeptide antibiotic (Vancomycin/Teicoplanin or Linezolid
what is GRSA
Glycopeptide intermediate/resistant Staph. aureus
what is GRE
Vancomycin/Glycopeptide Resistant Enterococci (VRE/GRE)
Acquired resistance, first identified in 80s
Wound infections / UTIs / intra-abdominal collections
Treatment = Linezolid or Tigecycline
what is ESBL
Extended spectrum beta-lactamase producing bacteria (ESBL)
Enzymes produced by some G-ve bacteria.
Leads to resistance to Penicillins and Cephalosporins
Isolates of ESBL producing E coli on increase – esp. in UTI in elderly
what is NDM-1
“Superbugs” Carbapenemase producing bacteria
Resistant to Carbapenems e.g. Meropenem
Reports of Colistin resistant strains
what is super-gonorrhoea
Gonorrhoea superbug
Neisseria gonorrhoeae - increasing Cephalosporin and Azithromycin resistance
explain multi-drug resistant tuberculosis and who is it common for
Drug-resistant TB can occur when the drugs used to treat TB are misused or mismanaged.
People do not complete a full course of TB treatment
Health care providers prescribe the wrong treatment (the wrong dose or length of time)
Drugs for proper treatment are not available
Drugs are of poor quality
Drug-resistant TB is more common in people who:
Do not take their TB drugs regularly
Do not take all of their TB drugs
Develop TB disease again, after being treated for TB disease in the past
Come from areas of the world where drug-resistant TB is common
Have spent time with someone known to have drug-resistant TB disease
