Case Study 3- 2.1

Question 1

What is the COMS criteria? What does it stand for?

Answer 1

Criteria to asses patients on whether they can move from IV to oral antibiotics

C- Clinical improvements observed
O- Oral route
M- Markers showing trend towards normal
S- Specific indication

Question 2

What needs to be considered when switching an IV antibiotic to an oral antibiotic if they’re different antibiotics?

Answer 2

The oral antibiotic needs to cover a similar range of bacteria to the IV in order to have effective eradication of the infection.

For example, a broad spectrum IV antibiotic which is effective against gram positive, gram negative and anaerobic bacteria should be switched to an oral antibiotic which can cover the same or similar range

Question 3

What are the advantages of switching from IV to oral antibiotics?

Answer 3

• Less monitoring required
• Less staff needed to set up the IV
• Greater adherence (cannot take IVs home)
• Less invasive and comfortable for the patient

Question 4

If a patient is on haloperidol (antipsychotic) and is due to have antibiotics, what cautions should we take when considering an appropriate antibiotic

Answer 4

We should avoid antibiotics that increase the Q-T interval in the heart

This is because if used in combination with haloperidol it can increase the risk of AF, seizures and sudden fainting

Question 5

Why should cultures be taken before administering antibiotics to a patient?

Answer 5

Will help identify which bacteria is causing the infection meaning that a more specific antibiotic can be prescribed to target the bacteria and effectively eradicate the infection

Question 6

what is the differences between first generation and second generation antipsychotics? Give an example

Answer 6

1st generation
- blocks dopamine
- Patients more likely to develop extrapyramidal side effects
- Haloperidol

2nd generation
- blocks dopamine and serotonine
- patient is more likely to develop metabolic side effects
- Risperidone