Session 4 Lecture 2 Flashcards
What does all exposure of bacteria to antimicrobials lead to?
Antimicrobial resistance
Is antimicrobial resistance reversible or irreversible?
Effectively irreversible
What are the consequences of antibacterial resistance?
Treatment failure, prophylaxis failure and economic costs
What are the economic costs related to antibiotic resistance?
People are in hospital for a longer period of time hence you have increased costs
Define MDR
Multi drug resistant - non susceptibility to at least one agent in three of more antimicrobial categories
Define XDR
Extensively drug resistant - non susceptibility to at least one agent in all but two or fewer antimicrobial categories.
Define PDR
Pan drug resistant - non susceptibility to all agents in all antimicrobial categories.
What does antimicrobial stewardship depend on?
Causal relationship of antibacterial use leading to resistance.
What is the evidence that antibacterials cause resistance?
Lab evidence, ecological studies and individual level data
What is the “ecological study” evidence that antibacterials cause resistance?
Relates levels of antibacterial use in a population with levels of resistance
What is the “individual level data” evidence that says antibacterials cause resistance?
Relates prior antibacterial use in an individual with the subsequent presence of bacterial resistance
On an individual level, what is associated with higher resistance rates?
Longer durations and multiple courses go antibiotics
What is the definition of antimicrobial stewardship objectives?
- Appropriate use of antimicrobials
- Optimal clinical outcomes
- Minimise toxicity and other adverse events
- Reduce the costs of health care for infections
- Limit the selection for antimicrobial resistant strains
What are the different elements of an antimicrobial stewardship programme?
- MDT
- Surveillance
- Interventions
What is the different type of surveillance that are used in an antimicrobial stewardship programme?
Process measures and outcome measures
