Antibiotic Guidelines

Question 1

Exacerbations of Chronic Bronchitis

Answer 1

Amoxicillin or tetracycline or clarithromycin

Question 2

Uncomplicated community-acquired pneumonia

Answer 2

1. Amoxicillin
2. If penicillin allergic = Doxycycline or clarithromycin
3. Flucloxacillin if staphylococci suspected e.g. In influenza

Question 3

Pneumonia possibly caused by atypical pathogens

Answer 3

Clarithromycin

Question 4

Hospital-acquired pneumonia

Answer 4

Within 5 days of admission: co-amoxiclav or cefuroxime

More than 5 days after admission: Tazocin OR a broad-spectrum cephalosporin (e.g. ceftazidime) OR a quinolone (e.g. ciprofloxacin)

Question 5

Lower urinary tract infection

Answer 5

Trimethoprim or nitrofurantoin. Alternative: amoxicillin or cephalosporin

Question 6

Acute pyelonephritis

Answer 6

Broad-spectrum cephalosporin or quinolone

Question 7

Acute prostatitis

Answer 7

Quinolone or trimethoprim

Question 8

Impetigo

Answer 8

Topical fusidic acid, oral flucloxacillin or erythromycin if widespread

Question 9

Cellulitis

Answer 9

• Flucloxacillin
• Penicillin - Clarithromycin or clindomycin

Question 10

Erysipelas

Answer 10

Phenoxymethylpenicillin

Erythromycin if penicillin-allergic

Question 11

Animal or human bite

Answer 11

Co-amoxiclav

Doxycycline + metronidazole if penicillin-allergic

Question 12

Mastitis during breast-feeding

Answer 12

Flucloxacillin

Question 13

Throat infections

Answer 13

Phenoxymethylpenicillin

Erythromycin alone if penicillin-allergic

Question 14

Sinusitis

Answer 14

Amoxicillin or doxycycline or erythromycin

Question 15

Otitis media

Answer 15

Amoxicillin (erythromycin if penicillin-allergic)

Question 16

Otitis externa

Answer 16

Flucloxacillin (erythromycin if penicillin-allergic)

NOTE A mild moderate topical antibiotic with a corticosteroid is used in mild to moderate cases.

Question 17

Periapical or periodontal abscess

Answer 17

Amoxicillin

Question 18

Gingivitis: acute necrotising ulcerative

Answer 18

Metronidazole

Question 19

Gonorrhoea

Answer 19

Intramuscular ceftriaxone + oral azithromycin

Question 20

Chlamydia

Answer 20

Doxycycline or azithromycin

Question 21

Pelvic inflammatory disease

Answer 21

Oral ofloxacin + oral metronidazole

or

Intramuscular ceftriaxone + oral doxycycline + oral metronidazole

Question 22

Syphilis

Answer 22

Benzathine benzylpenicillin

or

doxycycline

or

erythromycin

Question 23

Bacterial vaginosis

Answer 23

Oral or topical metronidazole or topical clindamycin

Question 24

Clostridium difficile

Answer 24

First episode: metronidazole
Second or subsequent episode of infection: vancomycin

Question 25

Campylobacter enteritis

Answer 25

Clarithromycin

Question 26

Salmonella (non-typhoid)

Answer 26

Ciprofloxacin

Question 27

Shigellosis

Answer 27

Ciprofloxacin