Antimicrobial Therapy

Module details

Title

Antimicrobial Therapy

Type

Specialist

Module code

SLS221

Credits

10

Requirement

Compulsory

Aim of this module

This module will provide the trainee with detailed knowledge and understanding of the structure, function, mode of action and resistance mechanisms of antimicrobial agents. In the work-based module they will be expected to apply this knowledge as they gain experience of the use and monitoring of antimicrobial therapy and the impact on patient care in a variety of clinical settings. This module provides the trainee with experience in the assessment of efficacy of antimicrobial therapies. The trainee will have opportunity to review and discuss clinical situations in which antibiotic, antiviral and antifungal agents are commonly prescribed, clinical situations that involve the prophylactic and therapeutic use of immunoglobulins and vaccines, and the importance of the quality management system in the laboratory (and point-of-care) investigation of the pathogens related to this module.

Competencies

#	Learning outcome	Competency	Action
# 1	Learning outcome 1	Competency Interpret request forms and select the most appropriate method to establish or monitor the effectiveness of antimicrobial therapy.	Action View
# 2	Learning outcome 1	Competency Select appropriate antimicrobial agents.	Action View
# 3	Learning outcome 2	Competency Monitor and assess the efficacy of antimicrobial therapies.	Action View
# 4	Learning outcome 2	Competency Perform routine clinical investigation of situations associated with both successful and unsuccessful use of: antibiotics antiviral agents antifungal agents antiparasitic agents.	Action View
# 5	Learning outcome 2	Competency Perform therapeutic antibiotic assays.	Action View
# 6	Learning outcome 2	Competency Prescribe immunoglobulin therapy.	Action View
# 7	Learning outcome 3	Competency Contribute to activities relating to UK vaccination scheduling.	Action View
# 8	Learning outcome 4,5	Competency Perform quality assurance and quality control tasks within the laboratory in the investigation of antibiotic, antiviral and antifungal susceptibility tests.	Action View
# 9	Learning outcome 4,5	Competency Perform quality assurance and quality control tasks within the laboratory in the investigation of therapeutic drug assays for commonly prescribed antibiotics.	Action View
# 10	Learning outcome 3	Competency Interpret and report results from antimicrobial susceptibility testing and give advice on further patient management.	Action View
# 11	Learning outcome 3	Competency Interpret and report results from therapeutic antibiotic assays and give advice on further patient management.	Action View

Assessments

You must complete:

• 2 case-based discussion(s)
• 2 of the following DOPS/ OCEs:

Set up and read five E tests on a range of organisms. Interpret and report the MICs for suitable clinical situations	DOPS
Set up and read anti fungal susceptibility tests by E test. Interpret and report the MICs for suitable clinical situations	DOPS
Set up and read five disc diffusion assays on a range of organisms. Interpret and report the results for suitable clinical situations	DOPS
Perform and interpret a molecular assay that detects antimicrobial resistance	DOPS
Interpret the results of therapeutic drug monitoring e.g. aminoglycosides, glycopeptides, azoles etc.	DOPS
Perform and interpret approriate investigations for the identification of key healthcare associated organisms, such as multi reistant enterobacteriaceae	DOPS
Participate in antimicrobial ward rounds where patient management and antimicrobial options are discussed	OCE
Participate in clinical meetings where antimicrobial management is discussed	OCE
Under supervision obtain a patient history from a normal volunteer or typical patient referred to your service and present the findings to a colleague or peer	OCE

Learning outcomes

1. Assess and select appropriate agents and methods for use, together with the methods used in monitoring these therapies.
2. Perform the range of methodologies used in assessing the efficacy of antimicrobial therapies.
3. Interpret and report laboratory results that influence the choice of an antimicrobial agent and its ongoing efficacy.
4. Work in partnership with other clinical specialisms in the use and monitoring of antimicrobial agents.
5. Perform quality assurance and control tasks within the laboratory in the investigation of antibiotic, antiviral and antifungal susceptibility tests.

Learning outcomes

1. Explain the structure and mode of action of a broad range of antimicrobial agents, including antibiotics, antivirals and antifungals.
2. Explain and critically evaluate with reference to the evidence base the clinical management and prescribing strategies associated with antimicrobial therapies in a variety of clinical settings.
3. Discuss the prophylactic and therapeutic use of immunoglobulins and vaccines.
4. Describe the application and performance of a range of techniques used in the assessment, surveillance and monitoring of antimicrobial therapy, including identification of antimicrobial resistance.
5. Discuss and evaluate the role of the clinical microbiology laboratory in the provision of information for antimicrobial treatment of infections.
6. Explain and critically evaluate the role of national bodies (e.g. National Institute for Health and Clinical Excellence) and professional guidelines associated with the use of antimicrobials and treatment of infection.
7. Discuss the partnership between the clinical microbiology laboratory and other clinical specialism in the use and monitoring of antimicrobial agents and how this contributes to patient care.

Indicative content

• Structure, function and method of action of commonly prescribed antimicrobial agents
• Clinical approach to antimicrobial therapy in acute, chronic and community medicine
• Antibiotic resistance: definition, assessment and risk to human health
• Current guidelines relating to antimicrobials and their use in clinical practice
• Role of the laboratory in optimising antimicrobial therapy
• Emerging antimicrobial agents
• The design and production of vaccines
• Prophylactic and therapeutic use of immunoglobulins and vaccines
• Antimicrobial resistance: definition, mechanisms, surveillance, assessment and risk to human health
• Diagnostic tools used for antimicrobial susceptibility testing and screening for resistance mechanisms of bacteria, viruses, fungi and parasites (e.g. culture, immunoassay, molecular techniques, automation)

Activities

• Produce a report outlining the classes of antimicrobial agents in use in your hospital(s) in relation to local policies.
• Participate in multidisciplinary review meetings at which patients being treated with antimicrobial agents are discussed. Prepare a portfolio of relevant clinical cases and describe the clinical outcome and learning points, including the impact of investigations on patient treatments and care, and factors that will affect your future practice.
• Participate in ward rounds. Prepare a portfolio of relevant clinical cases and describe the clinical outcome and learning points.
• Identify a patient undergoing treatment with antimicrobial agents and follow their progress from referral, through investigation and treatment, Reflect on the multidisciplinary aspects of treatment care and the role of Infection Sciences in improving patient care and experience.
• Produce a case report outlining clinical situations associated with the successful and unsuccessful use of antibiotics.
• Produce a case report outlining clinical situations associated with the successful and unsuccessful use of antiviral agents.
• Produce a case report outlining clinical situations associated with the successful and unsuccessful use of antifungal agents.
• Prepare a portfolio of local practice of the clinical criteria that informed a decision to prescribe immunoglobulin therapy.
• Discuss the challenge to health of resistance to antimicrobial therapy. Demonstrate what is being done locally to reduce this risk.