Antibacterial Stewardship Flashcards
Define antibiotic stewardship
The 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 key drivers for prudent antimicrobial use?
Reduce the incidence of adverse antibiotic-associated effects - c.diff, antibiotic-associated diarrhoea allergic reactions and toxic effects
What type of antibiotics are more of a concern with a C.diff infection?
Broad spectrum antibiotics
antibiotics of particular concern - clindamycin, cephalosporins, co-amoxiclav, cephalosporins 2nd generation - amoxicillin and ampicillin
What can be done to reduce c.diff infections?
Diagnose early
isolation
prevention through prudent prescribing of antibiotics
prevention through environmental cleaning
prevention through hand hygiene
training, audit and feedback
Trust broad level input
What is faecal microbial transplant (FMT)?
Recommended as an option to treat recurrent C.diff infection in adults who have had 2 or more previous confirmed episodes
Aims to restore a healthy gut microbiome
involves transferring intestinal bacteria and other microorganisms from healthy do not faeces into the gut of the recipient
How is MRSA treated?
Treatment with glycopeptide antibiotic, vancomycin, teicoplanin or linezolid
How is Vancomycin/Glycopeptide Resistant Enterococci treated?
Linezolid or Tigecycline
Define extended spectrum beta lactamases
Enzymes produced by some gram-negative bacteria
Leads to resistance to some penicillin and cephalosporin
Define New Delhi Metallo-beta-lactmases-1 (NDM-1)
‘Superbugs’ crabapenemase producing bacteria
leads to resistance to carbapenems
How is multi-drug resistant tuberolcosis caused by?
Caused by bacteria that spread from one person to another
When is drug-resistant TB more common in?
patients do not take their TB drugs regularly
do not take all their TB drugs
develop TB disease again after previously 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
Who collects data on antibiotics and infections?
European Centre for Disease Prevention and Control (ECDC)
ESAC-net (European Surveillance of Antimicrobial Consumption)
EARS-net (European Antimicrobial Resistance Surveillance Network
Describe stewardship in hospitals
Leadership
Multidisciplinary antimicrobial stewardship (AMS) team
Ward focused antimicrobial plan
Evidence based antimicrobial guidelines
Processes for ensuring antibiotic review
IV or oral switch policies
Posses for limiting access to restricted antimicrobials
Quality assurance measures - audit, feedback, review
Education and training
What is a community pharmacists role in antibiotic stewardship?
Patient education
advise on self-limiting illness and OTC products
Educate on viral vs bacterial infections
Safety netting
Referral
Adherence to prescribed antibiotic courses
Influenza vaccine
Minor ailments scheme
