Lecture 8.2 - Resistance and Stewardship Flashcards
What are the 3 major consequences of antibiotic resistance?
Treatment failure
Prophylaxis failure
Economic cost
Define what is meant by “resistance”
Non-susceptibility to 1+ agent in 2 or fewer antimicrobial categories
What is “multi-drug resistance”?
Non-susceptibility to 1+ agents from 3+ antimicrobial categories
What is “extensive drug resistance” (XDR)
Non-susceptibility to 1+ agents in all but 2 or fewer antibacterial categories
What is “pan drug resistance”? (PDR)
Non-susceptibility to all agents in all antimicrobial categories
What are the main aims of a stewardship programme?
Reduce selection for resistant strains
Improve clinical outcomes
Decrease cost of infection care
What are the major elements of a stewardship programme?
1) MDT
2) Surveillance
3) Interventions
What does surveillance involve as part of a stewardship programme?
Recording what people are doing and what the outcomes are
What are the 3 types of intervention used in a stewardship programme?
Persuasive
Restrictive
Structural
Briefly outline how bacteria develop resistance
Some bacteria will have random mutations that give them resistance. These survive and reproduce under the selection pressure of antibiotics, passing the mutations on to offspring vertically. Also pass on mutation horizontally to same generation.
