PSA Antimicrobial Prescribing 1 — Questions and Answers
Question 1: What is antimicrobial stewardship?
- A coordinated program to optimize antibiotic use, improve outcomes, and reduce antimicrobial resistance (Correct answer)
- Keeping antibiotics in stock
- Using the newest antibiotics first
- Prescribing antibiotics for all infections
Correct answer: A coordinated program to optimize antibiotic use, improve outcomes, and reduce antimicrobial resistance
Antimicrobial stewardship programs promote appropriate antibiotic selection, dosing, and duration to maximize effectiveness while minimizing resistance development.
Question 2: Why should antibiotics not be prescribed for viral infections?
- Antibiotics only work against bacteria; using them for viral infections provides no benefit and promotes resistance (Correct answer)
- Antibiotics treat all infections
- Viruses respond slowly to antibiotics
- Only certain antibiotics work on viruses
Correct answer: Antibiotics only work against bacteria; using them for viral infections provides no benefit and promotes resistance
Antibiotics target bacterial cellular mechanisms that viruses do not have. Unnecessary antibiotic use drives the development of resistant bacteria without providing any clinical benefit.
Question 3: What factors determine antibiotic selection?
- Likely pathogen, site of infection, local resistance patterns, patient allergies, and drug pharmacokinetics (Correct answer)
- Only the cheapest option
- Whatever is most readily available
- The newest antibiotic on the market
Correct answer: Likely pathogen, site of infection, local resistance patterns, patient allergies, and drug pharmacokinetics
Rational antibiotic selection considers the probable causative organism, anatomical site, local antibiograms, patient factors (allergies, renal function), and drug properties.
Question 4: What is a narrow-spectrum vs. broad-spectrum antibiotic?
- Narrow-spectrum targets specific bacteria; broad-spectrum affects many types — narrow is preferred when the pathogen is known (Correct answer)
- Broad-spectrum is always better
- Narrow-spectrum is used for serious infections
- They are equally effective
Correct answer: Narrow-spectrum targets specific bacteria; broad-spectrum affects many types — narrow is preferred when the pathogen is known
Narrow-spectrum antibiotics (like flucloxacillin for staphylococci) target specific organisms, preserving normal flora. Broad-spectrum antibiotics are used when the pathogen is unknown.
Question 5: What is C. difficile infection and how does antibiotic use contribute?
- An intestinal infection caused when antibiotics kill normal gut bacteria, allowing C. difficile overgrowth (Correct answer)
- A virus caused by poor hygiene
- An infection unrelated to antibiotics
- A common cold complication
Correct answer: An intestinal infection caused when antibiotics kill normal gut bacteria, allowing C. difficile overgrowth
Antibiotics, especially broad-spectrum ones, can destroy normal gut flora, allowing Clostridioides difficile to proliferate and produce toxins causing severe diarrhea and colitis.
Question 6: What does 'empirical' antibiotic therapy mean?
- Starting antibiotic treatment based on clinical judgment before culture results are available (Correct answer)
- Using antibiotics experimentally
- Prescribing without any clinical basis
- Only using antibiotics proven in trials
Correct answer: Starting antibiotic treatment based on clinical judgment before culture results are available
Empirical therapy begins treatment based on the most likely pathogen and local resistance patterns while awaiting definitive culture and sensitivity results.
PSA Antimicrobial Prescribing 1
What is antimicrobial stewardship?