antimicrobial stewardship

Question 1

consequences of antibacterial resistance

Answer 1

treatment failure
prophylaxis failure
economic costs

Question 2

what is MDR, XDR and PDR

Answer 2

MDR- multi drug resistance. resistant to at least one agent in three or more antimicrobial categories.
XDR- extensively drug resistant. non -susceptibilty to at least one agent in all but two or fewer antimicrobial categories.
PDR- pan-drug resistant. resistant to all agents in all antimicrobial categories

Question 3

evidence that antibacterials cause resistance

Answer 3

laboratory evidence- provides biological plausibility
ecological studies - relates levels of antibacterial use in a population with levels of resistance.
individual level data- relates prior antibacterial use in an individual with the subsequent prescence of bacterial resistance (detected by culture or molecular mean)

Question 4

IDSA objectives of antimicrobial stewardship

Answer 4

• appropriate use of antibiotics
• to achieve optimal clinical outcomes
• minimize toxicity and other adverse events
• reduce the costs of health care for infections
• limit the selection for antimicrobial resistant strains