Lec 22 Rational Use of Antibiotics Flashcards Preview

OS 217 Infectious Diseases > Lec 22 Rational Use of Antibiotics > Flashcards

Flashcards in Lec 22 Rational Use of Antibiotics Deck (16)
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1

What does the mnemonic "I MIND ME" stand for?

I - Is this antibiotic necessary
M - Microbiology guides therapy whenever possible
I - Indications should be evidence-based
N - Narrowest spectrum required
D - dosage appropriate to the site and type of infection
M - Minimize duration of therapy
E - Ensure monotherapy in most cases

2

What is the first-line therapy indicated for suspected E. coli, Klebsiella, Enterobacter, or Citrobacter infections in the age range 2 months to 18 years?

IV - Ampicillin-Sulfabactam
Oral - Amoxicillin - Clavulanate

3

What is the first-line therapy indicated for suspected E. coli, Klebsiella, Enterobacter, or Citrobacter infections for patients

Cefotaxime + Amikacin

4

When should you consider a switch from IV to oral therapy?

"COMS"
Clinical improvement
Oral route not compromised
Markers showing a trend towards normal
Specific indication/deep-seated infection

5

What is de-escalation therapy?

change in antibiotic regimen from broad-spectrum to a narrower spectrum or from multiple to a single antibiotic

6

How often should you reevaluate the patient's pharmacological regimen and consider de-escalation?

48-72 hours

7

What are the advantages of switching from IV to oral therapy?

* reduction in the likelihood of HCAIs
* patient is more likely to receive medications at the correct times
* reduction in the risk of adverse effects
* reduction in patient discomfort

8

What are the characteristics of drugs that can be used in switch therapy?

* both drugs should target the pathogen
* bioavailability of both drugs must be considered

9

What are the 7 pathogens identified by the Antimicrobial Resistance global report to have very high resistance?

E. coli, Klebsiella, S. aureus, S. pneumoniae, nontyphoidal Salmonella, Shigella, N. gonorrhea

10

(T/F) antimicrobial resistance is more prevalent in HCAIs compared with those from community-acquired infections

T

11

An Antimicrobial Stewardship team should include:?

physician, pharmacist, clinical microbiologist, infection preventionist, informatics specialist

12

What is an antimicrobial formulary?

list of drugs used by a hospital ensuring that there are no overlapping uses between medications

13

What antibiotics are restricted (require approval) in the entire PGH?

ertapenem, meropenem, vancomycin

14

What antibiotics are restricted for the department of pediatrics and OB-Gyn?

ceftazidime, piperacillin-tazobactam, quinolones, fluconazole

15

What antibiotics can only be prescribed by IDS fellows/consultants?

colistin, linezolid, tigecycline, amphotericin, caspofungin, andulafungin

16

What are the 12 WHO Steps in preventing antimicrobial response?

1. vaccinate
2. get the catheters out
3. target the pathogen
4. access the experts
5. practice antimicrobial control
6. use local data
7. treat infection, not contamination
8. treat infection, not colonization
9. know when to say no to vanco
10. stop treatment when cured
11. isolate the pathogen