The End of the Antibiotic Era

The end of the antibiotic era

Instructions:-

Write an essay on 1 only of the following questions. Your answer should be approximately 2000 (+/- 10%) words .

Answer all parts of your chosen question.

1. “The end of the antibiotic era” is being widely predicted.

a. What do you understand by this term?

b. What factors have led to a situation in which such an era might be seriously predicted and what would be the consequences if the prediction were to come true?

c. What measures are being or might be applied at international, national, community and hospital levels to delay or prevent such an outcome?

2. The recent hospital outbreak of Middle East respiratory syndrome-coronavirus (MERS-CoV) infections in the Republic of Korea, transmission of Ebola virus to nurses in the USA and the 2003 severe acute respiratory syndrome (SARS) outbreak in Toronto, Canada, have exposed flaws in routine IPC practice, even in wellresourced hospitals in the developed world. What measures could be introduced, more stringently applied or improved to protect HCWs and the community from spread of an unexpected, serious, exotic infectious diseases and what strategies can you suggest to improve compliance?

3. There is evidence that doctors and nurses approach and comply with routine infection prevention and control measures differently.

a. What are these differences and what do you think are the reasons for them?

b. Do you think these differences have a significant impact on patient safety and, if so, in what way?

c. What measures could be undertaken to reduce the differences and improve overall adherence to IPC policies and practice?

Readings:

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  2. 2. Jang J-H et al. Physicians and hand hygiene practice: a focus group study. J Hosp Infect 2010;76:87-89
  3. Iedema R. Creating safety by strengthening clinicians’ capacity for reflexivity. BMJ Qual Saf 2011;20 (Suppl 1) :i83ei86. doi:10.1136/bmjqs.2010.046714
  4. 2. Iedema R et al An innovative approach to strengthening health professionals’ infection control and limiting hospital-acquired infection: video-reflexive ethnography. BMJ Innovations 2015; Published online 23-7-15. doi:10.1136/bmjinnov-2014-000032
  5. . Wyer, M et al (2015). Involving patients in understanding hospital infection control using visual methods. Journal of Clinical Nursing. doi:10.1111/jocn.1277
  6. 2. Mutsonziwa GA, Green J. Colonised and isolated: a qualitative metasynthesis of patients’ experiences of being infected with multiple drug resistant organisms and subsequent isolation. Healthcare Infection, 2011, 16, 147–155 http://dx.doi.org/10.1071/HI11020
  7. Phipps L et al. Nosocomial Pneumocystis jirovecii pneumonia: lessons learned from a cluster in kidney transplant recipients. Transplantation 2011 92: 1327-1334.
  8. 2. Valade et al. Pneumocystis airborne transmission between critically ill patients and health care workers. Int Care Med 2015; 41: 1716-1718.
  9. . Paraobek CM et al. Multilocus microsatellite genotyping array for investigation of genetic epidemiology of Pneumocystis jirovecii. J Clin Microbiol 2014; 52: 1391-1399.
  10. Aminov RI. A brief history of the antibiotic era: lessons learned and challenges for the future. Front Microbiol. 2010;1:134.
  11. Shai Ashkenazi. Beginning and possibly the end of the antibiotic era. Journal of Paediatrics and Child Health 49 (2013) E179–E182
  12. Gilbert GL. Knowing when to stop antibiotics. Perspective. Med J Aust 2015; 202 (3): 121-122.
  13. 2. Dellitt TH et al. Infectious Diseases Society of America and the Society for Healthcare Epidemiology of
  14. America Guidelines for Developing an Institutional Program to Enhance Antimicrobial Stewardship. Clinical Infectious Diseases 2007; 44:159–77
  15. Charani E et al. Understanding the determinants of antimicrobial prescribing within hospitals: the role of “prescribing etiquette”. Clinical Infectious Diseases 2013;57(2):188–96
  16. Kumar et al. Duration of hypotension before initiation of effective antimicrobial therapy is the critical determinant of survival in human septic shock. Crit Care Med. 2006 Jun;34(6):1589-96
  17. Al-Tawfiq JA, Memish ZA. Managing MERS-CoV in the healthcare setting. Hosp Pract. 2015;43(3):158-163 2. Hui DS, Memish ZA, Zumla A. Severe acute respiratory syndrome vs. the Middle East respiratory syndrome. Curr Opin Pulm Med. 2014;20(3): 233-241
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