Antibiotic Guidelines

Question 1

Exacerbations of chronic bronchitis

Answer 1

Amoxicillin or tetracycline or clarithromycin

Question 2

Uncomplicated community-acquired pneumonia

Answer 2

Amoxicillin (Doxycycline or clarithromycin in penicillin allergic, add 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: piperacillin with tazobactam 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 (clarithromycin, erythromycin or doxycycline if penicillin-allergic)

Question 10

Cellulitis (near the eyes or nose)

Answer 10

Co-amoxiclav (clarithromycin, + metronidazole if penicillin-allergic)

Question 11

Erysipelas

Answer 11

Flucloxacillin* (clarithromycin, erythromycin or doxycycline if penicillin-allergic)

Question 12

Animal or human bite

Answer 12

Co-amoxiclav (doxycycline + metronidazole if penicillin-allergic)

Question 13

Mastitis during breast-feeding

Answer 13

Flucloxacillin

Question 14

Throat infections

Answer 14

Phenoxymethylpenicillin (erythromycin alone if penicillin-allergic)

Question 15

Sinusitis

Answer 15

Amoxicillin or doxycycline or erythromycin

Question 16

Otitis media

Answer 16

Amoxicillin (erythromycin if penicillin-allergic)

Question 17

Otitis externa**

Answer 17

Flucloxacillin (erythromycin if penicillin-allergic)

Question 18

Periapical or periodontal abscess

Answer 18

Amoxicillin

Question 19

Gingivitis: acute necrotising ulcerative

Answer 19

Metronidazole

Question 20

Gonorrhoea

Answer 20

Intramuscular ceftriaxone

Question 21

Chlamydia

Answer 21

Doxycycline or azithromycin

Question 22

Pelvic inflammatory disease

Answer 22

Oral ofloxacin + oral metronidazole or intramuscular ceftriaxone + oral doxycycline + oral metronidazole

Question 23

Syphilis

Answer 23

Benzathine benzylpenicillin or doxycycline or erythromycin

Question 24

Bacterial vaginosis

Answer 24

Oral or topical metronidazole or topical clindamycin

Question 25

Clostridium difficile

Answer 25

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

Question 26

Campylobacter enteritis

Answer 26

Clarithromycin or (azithromycin or ciprofloxacin)

Question 27

Salmonella (non-typhoid)

Answer 27

Ciprofloxacin

Question 28

Shigellosis

Answer 28

Ciprofloxacin

Question 29

Legionella

Answer 29

Erythromycin / clarithromycin

Question 30

Bacterial tonsillitis

Answer 30

Penicillin V (also called phenoxymethylpenicillin) for a 10 day course is typically first line. Alternatives antibiotics and for a broader spectrum of activity: Co-amoxiclav Clarithromycin Doxycycline

Question 31

Otitis Media (bacterial)

Answer 31

Amoxicillin Alternatives in penicillin allergy: Clarithromycin Erythromycin Second line if not responding to amoxicillin after 2 days: Co-amoxiclav

Question 32

Sinusitis (bacterial)

Answer 32

Penicillin V (also called phenoxymethylpenicillin) for a 5 day course is typically first line. Alternatives in penicillin allergy: Clarithromycin Erythromycin (pregnancy) Doxycycline Second line if not responding after 2 days: Co-amoxiclav

Question 33

Intra abdominal infection

Answer 33

Co-amoxiclav alone Amoxicillin plus gentamicin plus metronidazole Ciprofloxacin plus metronidazole (penicillin allergy) Vancomycin plus gentamicin plus metronidazole (penicillin allergy)

Question 34

Spontaneous Bacterial Peritonitis

Answer 34

Piperacillin/Tazobactam (Tazocin) is often first line Cephalosporins such as cefotaxime are also often used Levofloxacin plus metronidazole is an common alternative in penicillin allergy

Question 35

Septic arthritis

Answer 35

Flucloxacillin plus rifampicin is often first line Vancomycin plus rifampicin for penicillin allergy, MRSA or prosthetic joint Clindamycin is an alternative

Question 36

Giardiasis

Answer 36

Metronidazole

Question 37

Shigella

Answer 37

Azithromycin or ciprofloxacin.

Question 38

Meningococcal meningitis

Answer 38

Benzylpenicillin

Question 39

Listeria meningitis

Answer 39

Amoxicillin

Question 40

Post exposure prophylaxis for meningococcal meningitis

Answer 40

ciprofloxacin