Antimicrobials Quiz 1
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Questions and Answers

What is the primary consideration before prescribing an antibacterial?

  • Whether bacteria are present and if an antibacterial will improve prognosis (correct)
  • The patient's previous prescription history
  • The overall cost of the treatment
  • The availability of the drug in local pharmacies

Which step involves identifying the likely causative organisms for infection?

  • Monitoring antimicrobial sensitivity
  • Presenting options to the client
  • Taking microbiological samples
  • Choosing the right drug for the right bug (correct)

When should antimicrobial sensitivity be monitored?

  • Before any clinical decision is made
  • During the initial consultation with the patient
  • After taking a sample and sending it for culture (correct)
  • Only when the patient shows signs of adverse drug reactions

What factors should be considered when evaluating the benefits and harms for an individual patient?

<p>The potential therapeutic effect and the risks associated with treatment (A)</p> Signup and view all the answers

In what situation is it appropriate to use antimicrobials?

<p>Only when there is evidence that it will reduce morbidity or mortality (B)</p> Signup and view all the answers

What distinguishes bactericidal antimicrobials from bacteriostatic antimicrobials?

<p>Bactericidal antimicrobials kill bacteria. (A)</p> Signup and view all the answers

Which statement is true about time-dependent antimicrobials?

<p>Efficacy is influenced by the duration above the MIC. (C)</p> Signup and view all the answers

In the context of antimicrobial drugs, what is meant by the term 'spectrum of activity'?

<p>The range of Microbial species that the drug can act against. (B)</p> Signup and view all the answers

Which of the following statements about Gram +ve and Gram -ve bacteria is accurate?

<p>Gram +ve bacteria are surrounded by a thick peptidoglycan cell wall. (C)</p> Signup and view all the answers

What is the primary characteristic of concentration-dependent antimicrobials?

<p>Higher concentrations lead to more rapid bacterial count reduction. (B)</p> Signup and view all the answers

What is the purpose of recording and justifying protocol deviations?

<p>To explain and justify the chosen course of action (B)</p> Signup and view all the answers

What does the minimum inhibitory concentration (MIC) indicate?

<p>The lowest concentration that inhibits visible growth of a microorganism (B)</p> Signup and view all the answers

Why is it important to report suspected treatment failures?

<p>They may indicate the development of antimicrobial resistance (A)</p> Signup and view all the answers

Which of the following best defines an antimicrobial agent?

<p>Any substance that destroys or inhibits microorganisms (C)</p> Signup and view all the answers

What does broad-spectrum antimicrobials refer to?

<p>Agents that have a wide range of activity against many organisms (B)</p> Signup and view all the answers

How can regular health checks benefit antimicrobial use?

<p>They prevent the unnecessary use of antimicrobials (B)</p> Signup and view all the answers

What is the meaning of 'spectrum of activity' in relation to antimicrobials?

<p>The variety of microorganisms that an antimicrobial can effectively target (D)</p> Signup and view all the answers

Antibiotics are defined as substances that what?

<p>Are produced by one organism that selectively inhibit another organism (C)</p> Signup and view all the answers

What is an antimicrobial primarily defined as?

<p>A substance that inhibits micro-organisms (A)</p> Signup and view all the answers

What does the term 'minimum inhibitory concentration' (MIC) refer to?

<p>The lowest concentration of an antimicrobial that inhibits visible growth (A)</p> Signup and view all the answers

What differentiates a bactericidal from a bacteriostatic agent?

<p>Bactericidal agents kill bacteria, while bacteriostatic agents inhibit their growth (D)</p> Signup and view all the answers

In veterinary medicine, what is the concept of empirical prescribing focused on?

<p>Selecting treatment based on previous clinical experience and data (B)</p> Signup and view all the answers

What is a key concern associated with antimicrobial resistance (AMR)?

<p>Results in a higher incidence of zoonoses and cross-species gene transfer (D)</p> Signup and view all the answers

Which of the following best describes the spectrum of activity of an antimicrobial?

<p>The range of micro-organisms that the antimicrobial can inhibit or kill (B)</p> Signup and view all the answers

What is a characteristic of time-dependant modes of action in antimicrobials?

<p>Duration above the MIC is crucial for effectiveness (B)</p> Signup and view all the answers

What distinguishes an antibiotic from an antimicrobial?

<p>Antibiotics are produced by one organism to inhibit another, antimicrobials may not be (B)</p> Signup and view all the answers

What distinguishes concentration-dependent antimicrobials from time-dependent antimicrobials?

<p>They achieve the highest dose in a short period. (A)</p> Signup and view all the answers

What is the primary concern regarding antimicrobial resistance?

<p>It poses a significant threat to global health and food security. (D)</p> Signup and view all the answers

What does empirical prescribing involve?

<p>Treating based on the most likely cause of disease without definitive tests. (B)</p> Signup and view all the answers

Which of the following correctly describes time-dependent antimicrobials?

<p>They maintain drug levels above the MIC for an extended period. (D)</p> Signup and view all the answers

What are critically important antimicrobials?

<p>Antimicrobials that are essential for treating serious bacterial infections. (C)</p> Signup and view all the answers

Which factor is NOT considered when determining whether a patient needs an antimicrobial?

<p>The patient's history of allergies to medications. (C)</p> Signup and view all the answers

What is one of the objectives in discussing responsible antimicrobial use?

<p>To minimize the risk of antimicrobial resistance in both humans and animals. (B)</p> Signup and view all the answers

What is the risk associated with bacteria that acquire resistance genes from non-human sources?

<p>They may cause more severe infections in humans. (C)</p> Signup and view all the answers

How does the efficacy of a time-dependent antimicrobial relate to its exposure time?

<p>Efficacy depends on the exposure time above the MIC. (A)</p> Signup and view all the answers

What does empirical prescribing involve in veterinary medicine?

<p>Selecting a drug based on the most likely causative species. (B)</p> Signup and view all the answers

Which of the following strategies helps promote responsible antimicrobial use?

<p>Regularly monitoring local sensitivity patterns. (B)</p> Signup and view all the answers

What is the primary concern related to antimicrobial resistance (AMR)?

<p>It poses one of the greatest threats to modern medicine. (B)</p> Signup and view all the answers

What is a concentration-dependent antimicrobial's characteristic regarding bacterial cure?

<p>Rapid bacterial cure results from high concentrations above the MIC. (B)</p> Signup and view all the answers

Which is NOT a recommended practice to combat antimicrobial resistance?

<p>Using the same antibiotics repeatedly without assessing the infection. (A)</p> Signup and view all the answers

What is the typical duration for a course of a time-dependent antimicrobial?

<p>5-7 days. (B)</p> Signup and view all the answers

Flashcards

Antimicrobial

A substance that destroys or inhibits the growth of microorganisms like bacteria, viruses, and protozoa.

Antibacterial

A substance that specifically destroys or inhibits the growth of bacteria.

Antibiotic

A substance produced by one organism that selectively destroys or inhibits the growth of another organism.

Minimum Inhibitory Concentration (MIC)

The lowest concentration of an antimicrobial that completely prevents visible growth of a microorganism after overnight incubation in a lab setting.

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Spectrum of Activity

The range of microorganisms an antimicrobial is effective against.

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Clinical Breakpoints

Clinical breakpoints consider real-world factors and clinical data to make better use of in vitro MIC data.

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Empirical Prescribing

Using antimicrobials to treat an infection without knowing the exact cause.

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Antimicrobial Resistance

The ability of microbes to survive and grow despite the presence of an antimicrobial.

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Antimicrobial Spectrum of Activity

The classification of an antimicrobial based on the types of bacteria it can kill. 'Broad spectrum' antimicrobials can target a wide range of bacteria, while 'narrow spectrum' antimicrobials target a limited range of bacteria. This classification is important because it helps doctors choose the best antibiotic for a particular infection.

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Gram-Positive Bacteria

A type of bacteria with a thick cell wall but no outer membrane; it's stained purple by Gram staining.

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Gram-Negative Bacteria

A type of bacteria with a thin cell wall and an outer membrane containing lipopolysaccharide; it's stained pink by Gram staining.

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Bactericidal Antimicrobials

Antimicrobials that kill bacteria directly by damaging their cell walls or other essential structures. These drugs work best when the concentration is high enough.

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Bacteriostatic Antimicrobials

Antimicrobials that stop bacteria from dividing or multiplying. These drugs work by interfering with essential processes like protein synthesis. They require the concentration to be above the minimum inhibitory concentration (MIC).

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Concentration-dependent Antimicrobials

Antimicrobials that depend on achieving high concentrations to be effective. The higher the concentration, the greater the kill.

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Time-dependent Antimicrobials

Antimicrobials that require prolonged exposure to be effective. Time spent at the minimum inhibitory concentration (MIC) is key.

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Antimicrobial Resistance (AMR)

The ability of bacteria to resist the effects of antibiotics, reducing their effectiveness.

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Responsible Antimicrobial Use

The use of antibiotic drugs in a way that minimizes the development of resistance, maximizing their effectiveness.

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Empirical Prescribing in Veterinary Medicine

The use of antimicrobials to treat infections without specific identification of the causative organism.

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Critically Important Antimicrobials

Antimicrobials that are crucial for treating serious infections in humans, and are at high risk of resistance if overused.

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Cross-species AMR-gene Transfer

The transfer of antibiotic resistance genes between different bacterial species, including those from animals to humans.

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Narrowest spectrum of antibacterial

The practice of using the narrowest spectrum of antibacterial drugs possible to treat an infection.

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Antibacterial - is it necessary?

Determining if bacteria are present and if an antibacterial drug will likely improve the patient's outcome.

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Identify the culprit bacteria

Identifying the likely bacteria causing an infection by considering factors like Gram staining, oxygen needs (aerobic/anaerobic), and the possibility of multiple bacteria.

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Antimicrobial Sensitivity

Testing the bacteria's sensitivity to different antibacterial drugs. This may involve taking a sample for culture and sensitivity testing.

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Antimicrobial action

A drug's ability to kill bacteria (bactericidal) or prevent their growth (bacteriostatic).

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Practice Protocol

This is a practical guide created to help veterinarians make informed decisions about using antimicrobials efficiently and responsibly.

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Record and justify protocol deviations

This step emphasizes the importance of keeping detailed records to explain why specific actions are taken in relation to antimicrobial use.

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Report suspected treatment failures

This involves reporting any suspected treatment failures early, as it could indicate the development of resistance.

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Work to avoid need for antimicrobials

This highlights the importance of preventing the need for antimicrobials in the first place, for example, through preventative measures like herd health plans.

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Study Notes

Antimicrobials 1

  • Antimicrobials are substances that destroy or inhibit microorganisms (e.g., bacteria, viruses, protozoa).

  • Antibacterial agents are substances that specifically destroy or inhibit bacteria.

  • Antibiotics are substances produced by one organism that selectively destroy or inhibit the growth of another.

  • A significant misunderstanding is that some antimicrobials are "stronger" than others, as there is no such thing as a "strong" antimicrobial.

  • Each antimicrobial has a specific spectrum of activity against specific classes of microbes.

  • The recommended dose should always be prescribed, as under-dosing can drive the development of antimicrobial resistance.

  • The patient should complete the full course of antimicrobials even if the clinical signs have resolved to completely eradicate the infection.

Minimum Inhibitory Concentration (MIC)

  • The MIC is the lowest concentration of an antimicrobial drug that will inhibit visible growth of a microorganism after overnight incubation in vitro.

  • Clinical breakpoints are a modification of the MIC that take into account clinical data, including species, condition, route of administration, and antimicrobial mode of action (MoA).

Spectrum of Activity

  • Antimicrobials are described as broad-spectrum or narrow-spectrum based on the class(es) of organism they affect, for example, bacteria, protozoa, and viruses.

  • More commonly, broad-spectrum or narrow-spectrum refers to whether the antibacterial drug is effective against Gram-positive and/or Gram-negative bacteria.

Bactericidal vs Bacteriostatic

  • Bactericidal antibacterials kill bacteria.

  • Bacteriostatic antibacterials stop bacterial division.

Time-dependent Antimicrobials

  • The efficacy of a time-dependent antimicrobial is dependent on the exposure time above the minimum inhibitory concentration (MIC).

  • Increasing the dose will not enhance the effect.

Concentration-dependent Antimicrobials

  • The efficacy is dependent on the drug concentration above the MIC.

  • Increasing the dose reduces the bacterial count more rapidly.

Learning Objective 3 (Time-dependent vs Concentration-dependent)

  • Time-dependent drugs need to be above the MIC for a prolonged period.

  • Concentration-dependent drugs achieve maximum effect with high concentrations for a short time.

Learning Objective 4: Empirical Prescribing

  • Empirical prescribing means treating a disease based on the most likely cause in the absence of definitive tests.

Learning Objective 5: Antimicrobial Resistance and Responsible Use

  • Antimicrobial resistance (AMR) is a major threat to human health and global health.

  • Prescribing critically important antimicrobials should be avoided, with alternative treatments considered.

  • Use of a step-wise approach helps responsible use.

  • Avoid antibiotics if possible, selecting the correct antimicrobial, developing local protocols, monitoring local sensitivity, justifying deviations from protocols, and reporting suspected treatment failures are all part of responsible use.

Empirical Prescribing Steps

  • Does the patient need an antimicrobial?

  • Will prescribing an antimicrobial drug improve the prognosis?

  • What are the likely causative organisms?

  • Is there a risk of antimicrobial resistance (AMR)?

  • Consider taking microbiological samples before prescribing.

  • What is the narrowest spectrum of antimicrobial likely to be effective?

  • Benefits and harms for individual patients?

  • Consider other factors.

  • Present options to the client.

Responsible Use of Antimicrobials (7-Point Plan)

  • Work with clients to avoid need for antimicrobials.

  • Avoid inappropriate use (assess presence of bacteria and prognosis improvement).

  • Choose the right drug for the right bug (identify likely causative organisms, consider if Gram +/-, aerobic/anaerobic).

  • Monitor antimicrobial sensitivity (if possible, take sample and send for culture/sensitivity check; monitor local trends in sensitivity)

  • Minimise use (only use when necessary; consider reduction in morbidity/mortality; develop practice protocols).

  • Record and justify protocol deviations (keep good clinical records; explain chosen course of action).

  • Report suspected treatment failures to the VMD (this may be an early sign of resistance development).

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Antimicrobials Lecture 1 Slides PDF

Description

This quiz covers essential concepts related to antimicrobials, including their definitions, classifications, and the importance of dosage. Understand the difference between bactericidal and bacteriostatic actions, along with the significance of Minimum Inhibitory Concentration (MIC) in antimicrobial therapy.

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