pharmacist in infection

What is the WHO definition of Antimicrobial Resistance (AMR)?

AMR occurs when bacteria, viruses, fungi, and parasites change over time and no longer respond to medicines, making infections harder to treat and increasing the risk of disease spread, severe illness, and death.

What is the core definition of Antimicrobial Stewardship (AMS)?

An organisational or healthcare system-wide approach to promoting and monitoring judicious use of antimicrobials to preserve their future effectiveness.

Name three specific roles a pharmacist plays in AMS beyond clinical checking.

• Patient counselling

• public health promotion

• hand hygiene promotion

• vaccination support

• surveillance/audits

• promoting IV to oral switch.

When clinically checking an antibiotic, what are the three fundamental "D"s to check?

Drug, Dose, Duration.

What two critical clinical questions should you ask when verifying an antibiotic's suitability?

What is the likely pathogen?

Will this antibiotic cover it and will it get to the site of infection?

What type of bacteria (Gram-positive or Gram-negative) is most commonly implicated in community-acquired cellulitis?

Gram-positive bacteria (e.g., Staphylococcus aureus, Streptococcus pyogenes).

When taking an antibiotic allergy history, what key details must you ascertain about the "reaction"?

• what antibiotic

• when was antibiotic taken (recent or childhood)

• what was indication of antibiotic

• what was reaction (e.g., localised rash vs. generalised itchy rash or anaphylaxis)

• how long after taking antibiotic did reaction occur

What does OPAT stand for, and what is its primary benefit for the healthcare system?

Outpatient Antimicrobial Therapy. Benefits include freeing up hospital beds, reducing HCAI risk, and improving patient flow.

What does TDM stand for, and what is its primary goal?

Therapeutic Drug Monitoring. The goal is to maintain a constant drug concentration in the bloodstream to optimise efficacy and minimise toxicity.

Name two antibiotics that MUST have drug level monitoring (TDM).

Vancomycin and Gentamicin.

For which type of patients is pharmacokinetics (PK) most variable, often requiring TDM?

Critically unwell, obese, and obstetric (pregnant) patients .

Which antibiotic is commonly associated with causing a metallic taste?

Metronidazole.

Which antibiotic class is most associated with photosensitivity?

Tetracyclines (e.g., Doxycycline) and Fluoroquinolones (e.g., Ciprofloxacin).

What does ESBL stand for, and why is it clinically significant?

Extended-Spectrum Beta-Lactamase. It's an enzyme that makes bacteria resistant to many penicillin and cephalosporin antibiotics, limiting treatment options

What are two key patient factors to assess for OPAT suitability?

• Suitability of home environment.

• Understanding and compliance / reliable IV access.

What is the significance of promoting an "IV to Oral" switch?

• It improves patient comfort and mobility

• reduces the risk of line-related complications and HCAIs

• facilitates earlier discharge

• often more cost-effective.

what are the benefits of IV to oral switch

1. length of stay reduced

2. adverse events reduced

3. patient experience improved

4. nursing time is released to care for patients

5. carbon footprint reduced

6. errors of dose calculation and dilution reduced

7. healthcare associated infection reduced