rational atb use Flashcards

1
Q

antimicrobial agent

A

chemical compound that kills or inhibits the growth of a microorganism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

antibiotic

A

only natural compound of microbial origin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

antimicrobial resistance

A

bacterial ability to survive antimicrobial treatment
quantitative property

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

rational antimicrobial use

A

suggests a responsible attitude to antimicrobial use, optimising clinical efficacy while minimising development of resistance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

MRSA/MRSP

A

Methylin resistant staphylococcus aureus/pseudointermedius
contain mecA gene conferring resistance to all beta lactams (penicillins and cephalosporins) detection using oxacillin/cefoxitiem discs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

ESBL

A

extended spectrum beta lactamase inhibitors
enzyme able to hydrolyse/inactivate most beta lactams (except carbapenemes), these strains are often resistant to other drug classes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

MDR

A

multi drug resistant
resistance to 3 or more antimicrobial classes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

CIA

A

critically important antimicrobials
reserved for use in humans

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

how does resistance occur

A

antibiotics kill most of the bacteria
some resistant ones survive
the resistant bacteria multiply and pass on their resistant gene
the new population are the more resistant to the drug
occurs in whole body (Gut) not just at treated site

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

causes of atb resistance

A

over prescribing
wrong dose/kind/duration
over use in farm animals
poor infection control in hospitals and clinics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

antimicrobial stewardship

A

minimise development through
- rational use of antimicrobials
- infection control practices (biosafety) means less need
- education and surveillance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

ways of classifying antimicrobials

A

chemical structure
origin
application
type or action
mechanisms
spectrum
efficacy dependent on

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

chemical structure of atb

A

b-lactams
aminoglycosides
macrolides
quinolones
fluroquinolones

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

origin fo atb

A

natural
synthetic
semi sythetci

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

mechanism of action atb

A

cell wall synthesis inhibitors
inhibitors of membrane function
inhibitors of protein synthesis
inhibitors of nucleic acid synthesis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

type of action atb

A

bacteriostatic - tetracyclines, sulphonamides, macrolides
bacteriocidal - aminoglycosides, cephalosporins, penicillins, quinolones
often dose dependant - aminoglycosides, fluroquinones, metronidazole

17
Q

efficacy dependent on

A

dose - quinolones, aminoglycosides
Time - penicillins, cephalosporins
dose and time - clindamycin

18
Q

criteria for empirical antimicrobial choice

A

ants susceptibility of suspected pathogen
drug penetration and efficacy at infection site
route of admin
frequency of admin toxicity
cost

19
Q

bacteriology testing and AST indicated in case of

A

complicated or serious infections
lack of response/inadequate response to therapy
recurrent infections
immunocompromised patients
suspicion of MDR bacteria
always preferable in skin and UTI when systemic treatment is planned

20
Q

treating pyoderma

A

generalized pyoderma - always secondary
for localised and superficial infections - topical therapy
topical antiseptics - chlorhexidine
systemic therapy only if really deep/topical not working (check owner compliance)
first choice = clindamycin - mostly staphylococci infections
cytology v useful

21
Q

treating otitis externa

A

almost always secondary - treat underlying cause
cytology first - so so important
most common = Malassezia pachydermatitis and bacteria (cocci, rods)
if Malassezia then no atb just antifungals
if cocci - often staph - topical therapy
if rods - bacteriology needed. gram neg rods eg Pseudomonas and proteus may need systemic therapy in which AST needed

22
Q

treating urinary infections

A

always check sediment and do bacterial culture
bacteria in urine has to be quantified
atb based on AST and/or guidelines
some drugs concentrate in urine so even drugs that are intermediately sensitive on AST can be used (aminopenicillines) - they reach higher concs in urine than in serum

23
Q

treating the oral cavity

A

systemic treatment if fever, lymphadenopathy, swelling or leukocytosis
clindamycin often first choice - ideally based on AST
for gingivitis or parodontitis - systemic therapy not indicated
often topical with chlorhexidien and removal of predisposing condition (tartar) needed

24
Q

treating acute gastroenteritis

A

often just supportive therapy (often self limiting)
if general condition of animal unchanged, no atb
diagnosis related to bacteria important fo public health esp if immunocompromised or children in house
quantification important as GI pathogens can be found in gut of healthy animals

25
isolating Campylobacter
CCDA podloga microaerophilic conditions 42 degrees species identification important
26
isolating salmonella
several culture mediums aerobic conditions 37 degrees
27
isolation of E.coli
aerobic 37 degrees typisation isolation of E.coli from faeces is irrelevant
28
isolation of clostridia
anaerobes 37 degrees detection of toxins more important
29
treating resp infections
infection of upper resp tract often viral suboptimal sampling conditions for bacteriology and therefore misguided therapy If obligatory resp pathogen isolated from nasal/throat swab, it should be considered relevant if lower airways unaffected and no fever - no atb consult national or international guidelines
30
diagnosing tick borne diseases
snap test - for antibody detection interpreted in relation to presenting signs - seropositivity is not necessarily related to manifesting disease, especially in endemic areas if clinical signs are due to infection - first choice is doxycycline
31
treating sepsis
only clinical condition where immediate antimicrobial therapy, with as wide a spectrum as possible is indicated hemoculture maybe but often not enough time to isolate causative bacteria and AST before death
32
treating MDR infections
whenever possible try local therapy MRSA/MRSP often in skin and ear susceptible to fucidic acid ESBL producing enterobacteria in urine - nitrofurantoin