Antimicrobials In The ER Flashcards
Why should we care about antimicrobial usage?
Patient impacts - ADE
Global impacts - emergence of resistant bacteria and pace of new antimicrobial development is slowing
When do you prescribe antibiotics?
Known bacterial infection
Suspected bacterial infection
T/F: a patient with a fever always needs antibiotics
False - fever means inflammation and not all inflammation is caused by an infection and not all infections are bacterial
What are some risk factors for resistance?
Prior, recent antimicrobial use (w/in 90d)
Hospital acquired infection
Long-standing infection
Surgical implants
Client works in hospital
You get your culture and susceptibility three days after starting your patient on broad-spectrum antibiotics. How might these results change your antibiotic therapy?
May be able to de-escalate to a more narrow spectrum drug or discontinue antibiotics all together
May also need to change drug choice because of suspected resistance
A 3 yo FS lab is presented 20 minutes after cutting her foot on some glass. The wound does not appear contaminated. What do you do?
Clip, scrubs, flush, and close the wound.
No need for antibiotics.
Tell O to monitor for signs of infection.
A 3yo MC DSH presents with stranguria and pollakiuria. What do you do?
High suspicion of idiopathic cystitis as male cats are quite resistant to UTIs
No antibiotics indicated
A 9y FS DLH is in the hospital for DKA. You know that DKA can be triggered by UTIs and that diabetic cats are prone to UTIs from glucosuria. What do you do?
Submit urine culture and start on empiric antibiotics (potentiated penicillin)
If culture results come back negative, can discontinue
T/F: for very sick patients with suspected sepsis/severe bacterial infection, aggressive antimicrobial therapy should be implicated until C&S results prove otherwise.
True - start broad-spectrum and de-escalate if needed
