antimicrobial stewardship Flashcards
(28 cards)
What is antimicrobial resistance (AMR)?
A big problem causing healthcare costs and drug-resistant pathogens.
What is enzymatic degradation in the context of AMR?
Bacteria produce enzymes that inactivate antibiotics by breaking down their structure.
How does target modification contribute to AMR?
Bacteria alter the binding site of antibiotics, preventing effective binding and compromising function.
What role do efflux pumps play in antimicrobial resistance?
They pump out antibiotics from bacterial cells, reducing intracellular concentration and contributing to multidrug resistance.
What is reduced permeability in AMR?
Altered membrane channels limit antibiotic entry into bacterial cells.
What are bypass pathways in the context of AMR?
Bacteria develop alternate metabolic pathways to bypass the function of antibiotics.
How are resistant genes spread in bacteria?
Through horizontal gene transfer mechanisms such as conjugation, transformation, and transduction.
What is a biofilm?
A physical barrier created by bacteria on surfaces that makes it hard for antibiotics to penetrate.
What is MRSA?
A type of Staphylococcus aureus bacteria resistant to beta-lactam antibiotics.
What infections does MRSA cause?
Hospital and community-acquired infections leading to high healthcare costs.
What are the mechanisms by which MRSA resists beta-lactam antibiotics?
By reducing binding affinity, using efflux pumps, or forming biofilms.
What is used to diagnose MRSA infections?
Blood cultures and molecular tests.
What is antimicrobial stewardship?
A system approach to promote and monitor judicious use of antimicrobials.
What should be reviewed 48-72 hours after initiating antimicrobial treatment?
Whether to stop, continue, or change the treatment based on evidence of infection.
What are the benefits of IV-to-oral switch in antimicrobial therapy?
Decreased risk of bloodstream infections, reduced hospital stays, and better carbon footprint.
What is antifungal stewardship?
Aims to optimize antifungal use to improve patient outcomes and reduce resistance.
What are the classes of antifungal agents mentioned?
- Polyenes * Azoles * Allylamines * Pyrimidine analogs
What are the first-line treatments for invasive fungal infections?
- Candidemia: echinocandins or fluconazole * Cryptococcal meningitis: amphotericin B + flucytosine * Aspergillosis: voriconazole
What is the importance of therapeutic drug monitoring (TDM) in antifungal therapy?
To ensure efficacy, prevent toxicity, and avoid underdosing and resistance.
What are the side effects of amphotericin B?
- Nephrotoxicity * Hypokalaemia
What mechanisms contribute to antifungal resistance?
- Reduced drug uptake * Drug efflux pumps
What are the clinical implications of antifungal resistance?
- Treatment failure * Limited therapeutic options * Increased healthcare burden
What is the pharmacist’s role in antifungal stewardship?
Optimizing therapy through appropriate drug selection, dosing adjustments, and preventing drug interactions.
Fill in the blank: The good virus that infects and destroys bacteria is called _______.
[Bacteriophage]
