Paper II — 2023 July (Supplementary) (2019 Scheme) — Q12
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Paper II
2023 July (Supplementary) (2019 Scheme) · 100 marks · 180 min
Question
Management of Hospital Acquired Infections.
Q124 marksShort Answers
Answer
Hospital-acquired (nosocomial) infections are a distinct pharmacological problem from community-acquired infection because hospital flora is enriched for multidrug-resistant organisms (MRSA, vancomycin-resistant enterococci, extended-spectrum beta-lactamase/carbapenemase-producing Gram-negatives, Pseudomonas) from concentrated antibiotic selection pressure and person-to-person transmission within the hospital environment.
Management principles:
Broad empirical therapy covering locally prevalent resistant organisms, guided by the hospital’s own antibiogram/local resistance surveillance, pending culture results.
De-escalation to the narrowest effective agent once an organism and its susceptibility are identified — correcting the deliberately broad empirical choice once specific information is available.
Source control — removing/addressing an infected line, catheter, or surgical site, since antimicrobials alone often cannot clear infection tied to retained infected hardware or an undrained collection.
Infection control measures — hand hygiene, contact isolation for resistant organisms, and antimicrobial stewardship programmes to prevent transmission to other patients — an institutional-level component of management as important as individual drug therapy.
