3. Infection Symposium - Antibiotic Resistance Testing & Stewardship Flashcards
In terms of measuring antibiotic resistance, what is a breakpoint ?
Chosen concentration (mg/L) of antibiotic which defines whether a species of bacteria is susceptible or resistant to antibiotic.
In terms of measuring antibiotic resistance, what is clinical resistance defined as ?
When infection is unlikely to respond even to maximum doses of an antibiotic.
What are clinical confounding variables to consider when measuring antibiotic resistance ?
Patient co-morbidities.
Site of infection.
Foreign bodies.
Pus collections.
Biofilm infection.
Biofilm infections are much harder to treat with antibiotics. What does this mean for MIC ?
Minimum inhibitory concentration is much higher due to microbial interactions.
What type of antibiotics do not treat bone infections well ?
Beta-lactamase antibiotics.
SIR acronym was developed by EUCAST to classify antimicrobial susceptibility. What is the modern definition of S ?
Susceptible, standard dosing regimen.
When there is high likelihood of therapeutic success using a standard dosing regimen of the agent.
SIR acronym was developed by EUCAST to classify antimicrobial susceptibility. What is the modern definition of I ?
Susceptible at increased dosing regimen.
SIR acronym was developed by EUCAST to classify antimicrobial susceptibility. What is the modern definition of R ?
Resistant - high likelihood of therapeutic failure even when there is increased exposure.
What are components of exposure with relation to microbial susceptibility ?
Function of -
Mode of administration.
Dose, dosing intervals, infusion time.
Distribution/excretion.
Interactions with bacteria at site of infection.
“An Outcome Audit of the Treatment of Acute Dentoalveolar Infection - Impact of Penicillin Resistance” T. Kuriyama et al.
What is the principle management of dentoalveolar infection ?
Surgical drainage as principle tx.
? Questions the value of prescribing penicillin for these infections ?
What is the aim of antimicrobial stewardship ?
Coherent set of actions which promote using antimicrobials responsibly.
- Systematic effort to preserve future effectiveness of antimicrobials.
- Educate and persuade prescribers.
National Action Plan (Scotland) - what are the two key ways which it focussed on tackling antimicrobial resistance ?
Reduce need for and unintentional exposure to antimicrobials.
Optimising the use of antimicrobials.
National Action Plan (Scotland) - what can a GDP do to aid the two key ways on tackling antimicrobial resistance ?
Reduce need for and unintentional exposure to antimicrobials - OHI chair side, National OH programmes - i.e. increase prevention.
Optimising the use of antimicrobials - make appropriate clinical decisions.
What is the first line antimicrobial for acute dentoalveolar infection ?
Phenoxymethylpenicllin (PenV).
Spectrum of antimicrobial activity - what microbes is PenV effective against ?
Most oral streptococci.
Anaerobes.
Selected gram-negative cocci.
