Antibiotics!

[mustang sally]

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If you were going to a hospital sponsored lecture about antibiotics/antimicrobial stewardship (given by pharmacists), what topics would you be most interested in? Thanks in advance for your responses.

 

[Goro]

Dealing with patient demands for antibiotics when the infection is viral
The development of MDR bugs and how to deal witht hem
Whatever new antibiotics are on the horizon

 

[Taddy Mason]

Proper use of Abx for UTI prophylaxis in peds.

 

[oOKawaiiOo]

Proper use of Abx for UTI prophylaxis in peds.

The most common cause of UTI in Peds is E.coli. Since the bowel sits right behind the bladder, constipation also increases the risks of developing a UTI. You can also check for reflux via VCUG.

For recurrent UTI? It's macrodantin 50 mg

Or

take tablets of PAC (in cranberry)

Disclaimer - I'm just a 1st year medical student 😉

 

[Stagg737]

Mostly issues with resistance and potential changes in treatment protocol for areas where resistant strains have become prevalent.

In terms of stewardship, if I'm interpreting that right I'm assuming that means antibiotics prescribed by a pharmacist when a patient hasn't seen a physician? If so, how frequently are they prescribing those meds? Do they use the same protocols as hospitals and physicians?

 

[Taddy Mason]

The most common cause of UTI in Peds is E.coli. Since the bowel sits right behind the bladder, constipation also increases the risks of developing a UTI. You can also check for reflux via VCUG.

For recurrent UTI? It's macrodantin 50 mg

Or

take tablets of PAC (in cranberry)

Disclaimer - I'm just a 1st year medical student 😉

3rd year that just finished peds - many of my attendings liberally prescribed Abx for UTI prophylaxis following only 1-2 (un)complicated UTIs without any evidence of urological dysfunction and with very minimal hygiene and toileting counseling.

 

[CherryRedDracul]

Proper use of Abx for UTI prophylaxis in peds.

Or just dealing with treating with UTIs vs asymptomatic bacteriuria vs pyuria in the setting of a chronic indwelling catheter. Lots of physicians still get this all wrong.

 

[Pinocytosis]

Dealing with patient demands for antibiotics when the infection is viral
The development of MDR bugs and how to deal witht hem
Whatever new antibiotics are on the horizon

This.

To add, I'd be interested in the financial aspects to abx creation (cost, how to make them more affordable, etc.).

Also, something about the global impact. We (US) can create perfect guidelines on how to treat infections, dramatically reduce incidence of prescribing the wrong abx, and dramatically reduce MDR prevalence/incidence. But.... will other countries abide? Are the 1.357 billion people in China expected to use these guidelines? 1.252 billion people in India?

 

[futuremdforme]

Demand when infection is viral for sure. Talk about how to handle it as a GP vs in a walk-in or Emerg.

 

[mustang sally]

Mostly issues with resistance and potential changes in treatment protocol for areas where resistant strains have become prevalent.

In terms of stewardship, if I'm interpreting that right I'm assuming that means antibiotics prescribed by a pharmacist when a patient hasn't seen a physician? If so, how frequently are they prescribing those meds? Do they use the same protocols as hospitals and physicians?

I am not familiar with any model (in the US, anyway) where a pharmacist can prescribe antibiotics.

Stewardship programs have different strategies depending on the hospital. Ours is pretty basic...we encourage the rational empiric use of antibiotics with narrowing based on culture results, IV to PO switches, renal adjustment of medications, and things of that nature.