5: Antimicrobial resistance and antimicrobial stewardship Flashcards Preview

Gastrointestinal Week 6 2016/17 > 5: Antimicrobial resistance and antimicrobial stewardship > Flashcards

Flashcards in 5: Antimicrobial resistance and antimicrobial stewardship Deck (25)
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1

What percentage of antibiotic prescriptions are unneccessary?

Around 50%

2

What do antimicrobials act on?

All microorganisms

bacteria, fungi, viruses, protozoa

3

What do antibacterials act on?

Bacteria only

4

Antibiotics are mainly (antimicrobials / antibacterials).

antibacterials

5

What are antibiotics?

Produced naturally by microorganisms

Kill/inhibit growth of bacteria (mainly)

6

What is antibiotic resistance?

Ability of a bacteria to protect itself from the effects of an antibiotic

7

What is clinical resistant infection?

Bacteria which can survive in the antibiotic concentrations reached during therapy

8

Is resistance the same as immunity?

No

Bacteria are resistant to varying concentrations of antimicrobials, not totally immune

9

What is the susceptibility of a bacterium to an antibiotic?

Concentration of antibiotic at which it will start to be inhibited / die

10

MDR

PDR

XDR

Define these terms.

 

MDR - multi-drug resistant (susceptible to 3+ drugs)

XDR - extremely drug resistant (susceptible to 2 or less drugs)

PDR - pandrug resistant (susceptible to nothing)

11

Resistance is either ___ or ___.

innate , acquired

12

How is resistance transferred between bacteria?

Horizontal gene transfer via plasmids

13

Generally, by which two means to bacteria gain resistance?

Vertical transmission (accumulation of mutations through generations)

Horizontal transmission (swapping genes in the same generation)

14

Where are three means of horizontal gene transfer?

Transformation - resistance genes scavenged from dead bacterial cells

Transduction - resistance genes transferred from bacteriophage to bacteria

Conjugation - resistance genes transferred between living bacteria via pilli

15

How do healthy people pick up highly resistant strains of bacteria?

Foreign travel

16

What is an example of an enzyme, produced by resistant bacteria, which inactivates antibiotics?

Beta lactamase

17

Resistant bacterial membranes can be ___ to antibiotics.

impermeable

18

Which antibiotic is usually used to treat Staph. aureus infection?

Flucloxacillin

19

(Under/over)dosing of antibiotics can drive resistance.

Underdosing

20

The use of (narrow / broad) spectrum antibiotics drives resistance.

broad spectrum

e.g cephalosporins, quinolones

21

Antibiotic prescribing is ___ in some countries and this drives resistance.

unregulated

22

How do farmers increase the growth of their stock and prevent them from getting diseases?

Antibiotics in feed

23

The reasoning for prescribing antibiotics should be recorded in a patient's ___.

notes

24

How long should surgical antibiotic prophylaxis be given for?

A day or so

any longer is excessive

25

What are the four Ds of antimicrobial stewardship?

Choose the right drug

and the right dose

for the right duration

de-escalate if possible