Quiz
Answer Sheet
Question 1.
Antibiotics are a
False: Antibiotics are used to treat bacterial infections. They are a type of
group of drugs used to treat
antimicrobial, which are a group of drugs used to treat infections caused by fungi
infections caused by a range of
(antifungals), viruses (antivirals), parasites (antiparasitics), and bacteria
microbes, including fungi,
(antibiotics). During Antibiotic Awareness Week the focus is on antibiotic use, as
bacteria, viruses and parasites.
these are the most commonly used antimicrobial, and a key driver of resistance.
Question 2.
False: Alexander Fleming has been acknowledged as the man who discovered
Alexander Fleming
was the person who discovered
penicillin in 1928. It took 14 years to bring penicillin to patient care. In 1945 Fleming
bacteria.
was awarded the Nobel Prize for his role in the discovery of penicillin. In his
acceptance speech, Fleming warned of the potential for resistance to penicillin to
develop.
Question 3.
Up to 40% of
True: Results of the 2014 National Antimicrobial Prescribing Survey (NAPS)
antibiotic prescribing for surgical
showed that 40% of prescriptions for surgical prophylaxis were continued beyond
prophylaxis in Australia may be
24 hours (less than 5% is considered best practice). Learn more about the NAPS
inappropriate.
http://www.safetyandquality.gov.au/national-priorities/amr-and-au-surveillanceproject/national-antimicrobial-prescribing-survey-naps/
Question 4.
Common reasons
True: Results of the 2014 National Antimicrobial Prescribing Survey (NAPS)
for inappropriate prescribing of
showed that common reasons for inappropriate prescribing of antibiotics are
antibiotics are the unnecessary
unnecessary use for the given indication or the required spectrum of activity. Learn
use for a given indication, or for
more about the NAPS http://www.safetyandquality.gov.au/national-priorities/amr-
the required spectrum of activity.
and-au-surveillance-project/national-antimicrobial-prescribing-survey-naps/
Question 5.
False: Gram-negative bacteria have now emerged that are resistant to most types
Infections caused
by carbapenem resistant
of antibiotics, including a key “last resort” class of antibiotic, the carbapenems,
Enterobacteriaceae (CRE) are
meaning they are difficult to treat. These organisms are referred to as carbapenem
easily treated with broad
resistant Enterobacteriaceae (CRE). Carbapenem resistant Enterobacteriaceae is
spectrum antibiotics.
of particular concern because Enterobacteriaceae cause resistant infections
associated with high mortality. Learn more about the Commission’s work on the
development of recommendations for the management of CRE
http://www.safetyandquality.gov.au/our-work/healthcare-associated-infection/mrgnguide/
Question 6.
Documenting the
False: Documenting the indication for therapy is an important aspect of safe
indication for antibiotic therapy is
prescribing of any medicine. Documenting the indication, intended duration and
not really necessary when daily
review date at the commencement of therapy can also help ensure timely review of
patient rounds are conducted.
the patient’s progress, response to therapy and the decision to change or stop
therapy. Despite the importance of documenting indication as part of safe antibiotic
Quiz
Answer Sheet
prescribing, results from the 2014 National Antimicrobial Prescribing Survey (NAPS)
show that out of 19,944 individual prescriptions reviewed, 26% did not have the
indication for therapy documented in the hospital medical record. Best practice is
considered to be >95%. Learn more about the NAPS
http://www.safetyandquality.gov.au/national-priorities/amr-and-au-surveillanceproject/national-antimicrobial-prescribing-survey-naps/
Question 7.
If microbiology
True: Timely review of the patient’s progress, response to therapy and results of
tests are ordered for a suspected
culture and antibiotic susceptibility tests, within 24 hours of results being available,
bacterial infection, the
can guide decision making about antibiotic treatment, and enable consideration
responsible clinician should
about whether changing or stopping antibiotics is appropriate. Changes might
review the results within 24 hours
include switching treatment from broad spectrum to narrow-spectrum, changing the
of results being available.
route of administration from intravenous to oral, or stopping treatment altogether.
Review of treatment is one of nine quality statements included in the AMS Clinical
Care Standard. Learn more: http://www.safetyandquality.gov.au/our-work/clinicalcare-standards/antimicrobial-stewardship-clinical-care-standard/
Question 8.
The term ‘antibiotic
False: The term ‘antibiotic resistance’ is used to describe bacteria that have
resistance’ is used to describe
developed the ability to resist antibiotics that have been in use. Learn more by
what happens when a person’s
reading the report: National surveillance and reporting of antimicrobial resistance
immune system begins resist the
and antibiotic usage for human health in Australia. Access at
antibiotic when it is given to them.
http://www.safetyandquality.gov.au/publications/national-surveillance-and-reportingof-antimicrobial-resistance-and-antibiotic-usage-for-human-health-in-australia/
Question 9.
The group of
True: The largest group of antibiotics are the beta-lactam antibiotics; this group
antibiotics known as beta-lactam
includes penicillins, cephalosporins, carbapenems. Other antibiotic groups include
antibiotics, includes penicillins,
aminoglycosides and quinolones. Learn more by watching the Antimicrobial
cephalosporins, and
Pharmacotherapy presentation, available on the Commission website
carbapenems.
www.safetyandquality.gov.au/aaw
Question 10.
In Australia, only
False: Results from the 2014 National Antimicrobial Prescribing Survey (NAPS)
10% of hospitalised patients are
NAPS survey show that around 30-40% of hospitalised patients are prescribed
prescribed antibiotics.
antibiotics. Learn more about the NAPS
http://www.safetyandquality.gov.au/national-priorities/amr-and-au-surveillanceproject/national-antimicrobial-prescribing-survey-naps/
Question 11.
Taking blood from
False: Avoid collecting blood cultures via indwelling or central or peripheral lines
indwelling central or peripheral
wherever possible. Use of indwelling lines reduces the specificity of a positive
lines is the best way to collect
result. It also places lines at risk of contamination and subsequent line related
blood for culture.
infection. When obtaining specimens for blood culture, the following points are
Quiz
Answer Sheet
important to avoid contamination:

Use aseptic technique during collection. Perform appropriate skin preparation
using an alcohol based antiseptic, avoid re-touching skin site prior to
venipuncture.

Avoid collecting blood cultures via indwelling central or peripheral lines where
possible. Use of indwelling lines reduces the specificity of a positive result. It
also places lines at risk of contamination and subsequent line-related infection.

Collect at least two blood culture sets (four bottles) in an adult from two
separate venipuncture sites - this helps to achieve acceptable sensitivity and
enables confirmation of infection due to organisms that may potentially
contaminate blood cultures. The two sets can be taken sequentially without
delay.
Reference: Ferguson, J. The role of the clinical microbiology service. In Duguid, M.
and Cruickshank, M. (eds) Antimicrobial Stewardship in Australian Hospitals, 2011.
Access at: http://www.safetyandquality.gov.au/our-work/healthcare-associatedinfection/antimicrobial-stewardship/
Question 12.
The most recent
True: It is a requirement of NSQHS Standard 3 that health services provide access
version of Therapeutic Guidelines:
to the most current version of Therapeutic Guidelines: Antibiotic. Information about
Antibiotic was published in
Therapeutic Guidelines: Antibiotic can be accessed at www.tg.org.au
November, 2014.
Question 13.
Selection of
True: Contrary to popular belief, selection of antibiotic resistant organisms increases
antibiotic resistant organisms
with longer courses of antibiotics, as does risk of other unwanted effects including
increases with longer courses of
increased length of hospital stay.
antibiotic therapy.
Reference: Turnidge, J. Point of care interventions. In Duguid, M. and Cruickshank,
M. (eds) Antimicrobial Stewardship in Australian Hospitals. Sydney: 2011. Access
at: http://www.safetyandquality.gov.au/our-work/healthcare-associatedinfection/antimicrobial-stewardship/
Question 14.
It is a requirement
True: From 1 January 2013, all hospitals and day procedure services in Australia
for accreditation that all hospitals
have been required to have an antimicrobial stewardship (AMS) program in place.
and health services that prescribe
Learn more about National Safety and Quality Health Service Standards - Standard
or use antibiotics have an
3: Preventing and controlling healthcare associated infections. Access at
antimicrobial stewardship
http://www.safetyandquality.gov.au/our-work/accreditation-and-the-nsqhs-
program in place.
standards/resources-to-implement-the-nsqhs-standards/#NSQHS-Standards
Question 15.
True: Informing patient and/or their carers about when, how and for how long to
When a patient is
Quiz
Answer Sheet
prescribed antibiotics, it is
take antibiotics, if they are prescribed, may help improve compliance to prescribed
important patients and carers are
antibiotic treatment. The NSW Clinical Excellence Commission resource Receiving
informed about when, how and for
Antibiotics in Hospital provides basic information to health consumers about
how long to take them, as well as
receiving antibiotics in a hospital environment. Visit
potential side effects.
http://www.cec.health.nsw.gov.au/programs/quah/antibiotic-awareness-week
Question 16.
False: Data from the 2014 National Antimicrobial Utilisation Surveillance Program
Australian
hospitals dispense lower volumes
(NAUSP) show that Australian hospitals dispense higher volumes of antibiotics than
of antibiotics than any other
Denmark, the Netherlands and Sweden. Access the 2014 NAUSP report at
country in the world.
http://www.safetyandquality.gov.au/publications/antimicrobial-use-in-australianhospitals-2014-report-of-the-national-antimicrobial-utilisation-surveillance-program/
Question 17.
Some bacterial
True: Bacterial culture and antibiotic susceptibility results are usually available 24 to
culture and antibiotic
48 hours after specimen collection. Timely review of these results can often guide
susceptibility results can be
early decision to de-escalate therapy, change treatment, or cease antibiotics
available 24 – 48 hours after
altogether.
specimen collection.
Question 18.
If severe or life
True: Sepsis is a medical emergency. The accepted principles of treatment include
threatening infection is
prompt administration of antibiotics (target to administer within one hour of
suspected, it is important to
suspecting sepsis). Mortality from sepsis increases by 7.6% for every hour
commence antibiotic therapy
antibiotics are delayed. Antibiotic therapy within one hour of presentation is
immediately without waiting for
associated with 80% survival rate to discharge (NSW Clinical Excellence
results of microbiology tests.
Commission “Sepsis Kills”). Further information about the Sepsis Kills program is
available at: http://www.cec.health.nsw.gov.au/programs/sepsis.
Question 19.
There are many
False: Antibiotic resistance is increasing at a pace that exceeds the pharmaceutical
new antibiotics being developed
industry’s capacity to develop new antimicrobial drugs. Learn more by reading the
for use in the future to help
National Antimicrobial Resistance Strategy. Access at: www.health.gov.au/amr
address the problem of antibiotic
resistance.
Question 20.
Australia has yet to
False: In June 2015 the Australian Government released the first National
develop a national strategy to
Antimicrobial Resistance Strategy to guide the response to the threat of antibiotic
address antimicrobial resistance.
misuse and resistance. The strategy was developed in partnership with industry and
government, and will guide action by governments, health professionals,
veterinarians, farmers and communities to reduce the emergence of resistant
bacteria. Access at: www.health.gov.au/amr