Antimicrobial Stewardship and Resistance

Vocabulary flashcards covering key terms, metrics, guidelines, and priority pathogens related to global antimicrobial resistance and antimicrobial stewardship programs.

Antimicrobial Resistance (AMR)

The global health threat where microorganisms evolve resistance to antimicrobial treatments, associated with 4.95 million deaths globally in 2019, including 1.27 million deaths directly attributable to AMR.

Six Leading AMR Pathogens

The group of six bacterial pathogens causing the highest burden of resistance-associated deaths: Escherichia coli, Staphylococcus aureus, Klebsiella pneumoniae, Streptococcus pneumoniae, Acinetobacter baumannii, and Pseudomonas aeruginosa.

WHO Priority Pathogens List: Critical Group

The top priority tier of pathogens targeted for R&D of new antibiotics, comprising carbapenem-resistant Enterobacterales, third-generation cephalosporin-resistant Enterobacterales, carbapenem-resistant Acinetobacter baumannii, and rifampicin-resistant Mycobacterium tuberculosis.

WHO Priority Pathogens List: High Group

Pathogens categorized as high priority for new antibiotic R&D, including fluoroquinolone-resistant Salmonella Typhi, fluoroquinolone-resistant Shigella spp., vancomycin-resistant Enterococcus faecium, carbapenem-resistant Pseudomonas aeruginosa, fluoroquinolone-resistant non-typhoidal Salmonella, third-generation cephalosporin- and/or fluoroquinolone-resistant Neisseria gonorrhoeae, and methicillin-resistant Staphylococcus aureus.

WHO Priority Pathogens List: Medium Group

Pathogens categorized as medium priority for new antibiotic R&D, including macrolide-resistant Group A Streptococci, macrolide-resistant Streptococcus pneumoniae, ampicillin-resistant Haemophilus influenzae, and penicillin-resistant Group B Streptococci.

Defined Daily Dose (DDD)

A standard metric defined by the World Health Organization (WHO) as the assumed average maintenance dose per day for a drug used for its main indication in a $70\,\text{kg}$ adult.

Defined Daily Dose (DDD) Calculation Formula

The standard formula for calculating DDDs: $\text{No. of DDD} = \frac{\text{no. of tablets or vials used} \times \text{grams per tablet or vial}}{\text{WHO defined DDD for that antimicrobial}}$.

Point Prevalence Survey (PPS)

A cross-sectional audit method performed on a single day in each ward to collect data on patient antimicrobial prescribing, indication, dose, duration, and microbiological results.

Quality Indicators (QIs) of Antimicrobial Use

The core requirements for rational antimicrobial prescribing, consisting of Right Drug, Right Patient (clinical and microbiological indication), Right Dose (weight and renal function), Right Route (IV, IM, oral, topical), and Right Duration.

Global Action Plan Objective 1

Improve awareness and understanding of antimicrobial resistance through effective communication, education, and training.

Global Action Plan Objective 2

Strengthen the knowledge and evidence base through surveillance and research.

Global Action Plan Objective 3

Reduce the incidence of infection through effective sanitation, hygiene, and infection prevention measures.

Global Action Plan Objective 4

Optimize the use of antimicrobial medicines in human and animal health.

Global Action Plan Objective 5

Develop the economic case for sustainable investment that takes account of the needs of all countries, and increase investment in new medicines, diagnostic tools, vaccines, and other interventions.

Community-Acquired Infection Threshold

An infection originating prior to hospital admission or defined as presenting within less than $48\,\text{hrs}$ of hospital admission.

Hospital-Acquired Infection Threshold

An infection developing after hospital admission, specifically defined as occurring greater than $48\,\text{hrs}$ after admission.

Antimicrobial Prescription Chart Review Schedule

The mandatory review intervals on standard hospital antimicrobial prescription charts to evaluate patient progress and culture results on Day 3, Day 5, and Day 7.

Days of Therapy (DOT)

A clinical metric of antimicrobial consumption that measures the number of days a patient receives a specific antimicrobial agent, independent of the dose administered.

Antibiotic Consumption Data

Quantitative monitoring of antimicrobial usage levels over time within a hospital, department, or unit to evaluate ASP interventions.

Antimicrobial Stewardship (AMS)

A systematic multidisciplinary framework involving doctors, pharmacists, nurses, and management to optimize antimicrobial prescribing, minimize resistance, and enhance patient safety.