Close help

How to use this Learning Station

On this Learning Station, you can read and test your knowledge. Tap on a book to open its chapter list. In each chapter, you can take a quiz to test your knowledge.

To take tests, you must register with your email address or cell number. It is free to register and to take tests.

For help email info@bettercare.co.za or call +27 76 657 0353.

Printed books

Learning is easiest with printed books. To order printed books, email info@bettercare.co.za or call +27 76 657 0353.

Visit bettercare.co.za for information.

Test 9: Antimicrobial stewardship

  1. Antimicrobial resistance is:
    • The ability of pathogens to multiply under difficult circumstances
    • The ability of pathogens to multiply in healthcare environments
    • The ability of pathogens to grow in the presence of a drug that would normally kill them
    • The ability of pathogens to overcome the human host’s immune defences.
  2. Antimicrobial resistance:
    • Results in better outcomes for patients
    • Has decreased costs of treatment for common infections
    • Is not a common problem worldwide
    • Makes available antimicrobials less effective and infections more difficult to treat.
  3. The development of antimicrobial resistance is:
    • An entirely preventable phenomenon
    • An inevitable phenomenon as pathogens evolve and adapt to new environments
    • Unaffected by antimicrobial usage
    • Not a problem as new antimicrobials are being developed constantly.
  4. Antimicrobial resistance in healthcare facilities is spread mainly by:
    • Poor IPC practices (including poor hand hygiene compliance)
    • Use of antibiotics as growth promoters in animal farming
    • Inadequate environmental cleaning
    • Exposure of pathogens to disinfectants.
  5. Patients with antimicrobial resistant infections:
    • Are less likely to die from their infection than patients with drug-sensitive pathogens
    • Are more likely to die from their infection than patients with drug-sensitive pathogens
    • Have shorter duration of hospitalisation than patients with drug-sensitive pathogens
    • Cost less to treat than patients with drug-sensitive pathogens.
  6. Antimicrobial stewardship programmes:
    • Aim to improve patient outcomes
    • Raise awareness of the problem of antimicrobial resistance
    • Encourage rational usage of antimicrobials
    • All of the above.
  7. The most important reason to implement antimicrobial stewardship is:
    • To conserve the effectiveness of antimicrobials for the future
    • To save healthcare facilities money
    • To limit the number of antimicrobials that doctors can prescribe
    • To avoid patients developing side-effects from antimicrobials.
  8. The negative consequences of antibiotic overuse and misuse are called:
    • Consequent damage
    • Collateral damage
    • Concomitant damage
    • Consequential damage.
  9. The ideal antimicrobial stewardship committee should be made up of:
    • Clinicians (doctors and nurse practitioners) and data managers
    • Hospital management, a microbiologist and a senior doctor
    • Pharmacy, the IPC practitioner and a senior doctor
    • A manager, clinician, pharmacist, microbiologist, data manager and IPC practitioner.
  10. Information on antimicrobial usage can be used by the stewardship committee to:
    • Identify high usage drugs and clinical areas that use them most
    • Punish individual ‘high-volume’ prescribers
    • Impose penalties on the clinical areas with highest usage
    • Draw up local guidelines for antimicrobial usage.
  11. Essential resources needed for an antimicrobial stewardship programme include:
    • Significant funding or financial resources from the healthcare facility
    • An infectious diseases physician
    • A pharmacist with training in infectious diseases
    • An enthusiastic and dedicated antimicrobial stewardship programme committee.
  12. Antimicrobial stewardship programmes can save healthcare facilities money by:
    • Saving patients’ lives
    • Reducing length of hospitalisation and avoiding unnecessary drug usage
    • Preventing spread of drug-resistant pathogen
    • Preventing colonisation of staff members with resistant pathogens.
  13. The IPC practitioner contributes to antimicrobial stewardship through:
    • Multiple activities that reduce the spread of resistant pathogens
    • Reporting poor IPC practices to the healthcare facility manager
    • Performing daily ward rounds in the clinical areas
    • Advising clinicians on incorrect prescribing practices.
  14. Empiric antimicrobial therapy:
    • Is given routinely before appropriate microbiological specimens have been taken
    • Consists usually of a single antimicrobial drug that targets the most likely pathogen
    • Usually includes several anti-infective drugs that cover the most likely causative pathogens
    • Is continued even after the definitive cause of the infection is identified.
  15. Targeted antimicrobial therapy:
    • Aims to match the antimicrobial given to the specific pathogen-causing infection
    • Uses broad-spectrum antibiotics to cover all potential pathogens
    • Does not require the collection of appropriate microbiological specimens
    • Usually requires several different antimicrobials to be prescribed.
  16. Selective reporting:
    • Involves microbiologists phoning clinicians to inform them of drug-resistant pathogens
    • Presents clinicians with all possible antimicrobial treatment options for confirmed pathogens
    • Discourages prescribers from using targeted antimicrobial therapy
    • Presents clinicians with only the most narrow-spectrum antimicrobials that the pathogen is sensitive to.
  17. De-escalation of antimicrobial therapy:
    • Means changing the patient’s prescription from a narrow to a broad-spectrum antimicrobial
    • Is potentially harmful, even if the pathogen is sensitive to a narrow-spectrum antimicrobial
    • Ensures effective therapy but reduces harmful effects of broad-spectrum antimicrobials
    • Means that therapy should be stopped or discontinued.
  18. Prolonged courses of antimicrobials:
    • May encourage the development of antimicrobial resistance
    • Do not increase the risk of side-effects for patients
    • Are needed as prophylaxis for patients undergoing surgical procedures
    • Are needed for all patients with serious infections.
  19. An antimicrobial restriction policy:
    • Prevents clinicians from accessing essential antimicrobials
    • Limits access to selected antimicrobials, without prior approval from a senior person
    • Should be implemented identically at all healthcare facilities
    • Does not need clinicians with insight into antimicrobial management to be available.
  20. Antimicrobial prescription guidelines:
    • Should be based on international antimicrobial recommendations
    • Are unhelpful when implementing antimicrobial stewardship
    • Give recommendations on antimicrobial selection, dose and duration based on local data
    • Give recommendations on which brands of antimicrobials to use.