Causes of drug resistance - Answers Recent use of antibiotics
Over use of broad spectrum antibiotics
Age less than 2 years or greater than 65 years
Daycare center attendance
Exposure to young children
Multiple medical comorbidities
Immunosuppression
True or false
Every antibiotic class has resistant organisms - Answers True
How can your identify local resistance patterns - Answers By monitoring the antibiogram of the local
laboratory
What vaccine has decreased resistance in older populations - Answers Pneumococcal vaccine
Commitment - Answers Demonstrate dedication to and accountability for optimizing antibiotic
prescribing and patient safety
Action for policy and practice - Answers Implement at least one policy or practice to improve antibiotic
prescribing assess whether it is woking and modify as needed
Tracking and reporting - Answers Monitor antibiotic prescribing practices, and offer regular feedback to
clinicians or have clinicians assess their own antibiotic prescribing practices themselves
,Education and expertise - Answers Provide educational resources to clinicians and patients on antibiotic
prescribing and ensure access to needed expertise on optimizing antibiotic prescribing
Core elements of antibiotic stewardship - Answers Commitment
Action for policy and practice
Tracking and reporting
Education and expertise
Pharmacodynamics of beta-lactams (Penicillins) - Answers Inhibit the biosynthesis of peptidoglycan
bacterial cell wall
Natural penicillins are sensitive to what - Answers Streptococcus
Some Enterococcus
Some non-penicillinase producing Staphylococcus
Aminopenicillin sensitivity - Answers Greater activity against gram-negative bacteria because of
enhanced ability to penetrate the outer membrane organisms
What are beta-lactams used for - Answers Gram negative urinary and GI pathogens
•Escherichia coli, Proteus mirabilis, Salmonella, some Shigella species, and Enterococcus faecalis; active
against the common gram-negative respiratory pathogens Moraxella catarrhalis (and Haemophilus
influenzae type B)
How do you broden the spectrum of beta lactams - Answers Combine with beta-lactamase inhibitors:
Clavulanate
, Sulbactam
Tazobactam
True or false
Few allergies are seen with beta-lactams - Answers False
May cause serious immediate allergic reactions
When will you seen an allergic reaction occur with beta lactams - Answers Within 2 to 30 minutes of
administration
What does the typical beta-lactam rash look like - Answers Maculopapular
True or false
The beta lactam maculopapular rash is allergic in origin - Answers False
How often do rashes occur with beta-lactam use - Answers About 9% of the time
When do rashes associated with beta-lactam use typically present - Answers 7-10 days into treatment
SE with beta lactam use - Answers Diarrhea
N/V
True or false
Adding clavulanate to beta lactams increases the risk of diarrhea - Answers True
Can lead to C.diff
Beta lactam drug category during pregnancy - Answers Category B
Clinical use for beta lactams - Answers Commonly prescribed for infections seen in primary care