Infection

Question 1

Who discovered the first Penicillin and from what organsim

Answer 1

Sir Alexander Fleming, from Penicillium notatum

Question 2

Bactericidal vs bacteristatic

Answer 2

Bacteristatic relies on normal host defences to kill the pathogen after its growth has been inhibited.
Bactericidal are used to remove or destroy pathogen when host defences can’t be relied upon

Question 3

Competency framekwork for prescribers

Answer 3

Infection prevention and control
Antimicrobial resistance and antimicrobials
Prescribing of antibiotics
Antimicrobial stewardship
Monitoring and learning

Question 4

What is susceptible to an antibiotic

Answer 4

Implies an antimicrobial will inhibit bacterial growth at clinically achievable concentrations

Question 5

What is MDR

Answer 5

MDR - Multidrug resistance, non-susceptibility to at least 1 agent in 3 or more antimicrobial categories

Question 6

What is XDR

Answer 6

XDR - Extremely drug resistance, non-susceptibility to at least 1 agent in 2 or fewer antimicrobial categories, i.e bacterial isolates remain susceptible to only 1 or 2 categories

Question 7

What is PDR

Answer 7

Pandrug resistance, Non susceptible to all agents in all antimicrobial categories, i.e. no agent tested as susceptible for that organism

Question 8

Important source of resistance antimicrobial

Answer 8

Chromosomal mutation

Question 9

What ways can antibiotic resistance be acquired

Answer 9

Vertical or horizontal transmission
Vertical - Due to errors in mutation, passed onto subsequent generations
Horizontal - Resistant genes are swapped from one to another

Question 10

Types of horizontal transmission

Answer 10

Transformation - Bacteria scavenge resistant genes from dead bacteria cells
Transduction - Resistant genes are transferred by bacteriophage
Conjugation - Pilli used to transfer genes

Question 11

Broad vs narrow spectrum in inducing resistance

Answer 11

Broad spectrum are more likely

Question 12

What is antimicrobial stewardship

Answer 12

Optimal selection, dosage and duration of antimicrobial treatment that results in the best clinical outcome for treatment or prevention of infection

Question 13

4D’s of antimicrobial stewardship (AMS)

Answer 13

Drug, Dose, Duration, De-Escalate

Question 14

How should antibiotics be prescribed

Answer 14

Start smart - Review and decision at 48 hours
Switch from IV to oral
Change to narrow-spectrum
Continue and review again after a further 24 hours
Outpatient parenteral antimicrobial therapy

Question 15

Antibiotics for surgery

Answer 15

Surgical prophylaxis - One dose within 60 minutes before knife to skin

Question 16

When is a repeat surgical prophylaxis dose needed

Answer 16

For prolonged procedure or when there is significant blood loss

Question 17

Broad spectrum or narrow spectrum in combination

Answer 17

Combination of narrow spectrum

Question 18

Shorter or longer duration of administration

Answer 18

Shorter is better