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The Holy Grail (Treatments) > Antibiotic Man (2018) - Hospital and Primary Care > Flashcards

Antibiotic Man (2018) - Hospital and Primary Care Flashcards

1
Q

Meningitis

A

Ceftriaxone (IV) + Dexamethasone (IV)

Aciclovir (IV)- if encephalitis suspected
Amoxicillin (IV)- if immunocompromised

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2
Q

Epiglottitis

A

Ceftriaxone (IV)

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3
Q

Community Acquired Pneumonia (CAP)

A

Mild: Amoxicillin (IV)
Severe: Co-amoxiclav (IV) + Doxycycline (PO)
ICU/HDU: Co-amoxiclav (IV) + Clarithromycin (IV)

Penicillin allergic:
Switch Amoxicillin for Doxycycline (PO)
Switch Co-amociclav for Levofloxacin (IV)

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4
Q

Hospital Acquired Pneumonia (HAP)

A

Non-severe: Amoxicillin (IV) + Metronidazole (IV)
Severe: Amoxicillin (IV) + Metronidazole (IV) + Gentamicin (IV)

Penicillin allergic:
Switch Amoxicillin for Co-trimoxazole

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5
Q

Acute exacerbation of COPD

A
  1. Amoxicillin
  2. Doxycycline

Only give if:

  • increased sputum purulence
  • consolidations on CXR
  • signs of pneumonia
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6
Q

Acute cough/ bronchitis

A

N/A, unless elderly and frail:

  1. Amoxicillin
  2. Doxycycline
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7
Q

Native Valve Endocarditis

A

Take blood cultures
Start empirical therapy

Subacute/ indolent: Amoxicillin (IV) + Gentamicin (IV)
Acute/ severe: Flucloxicillin (IV)
Severe + potential resisetant pathogens: Vancomycin (IV) + Meropenem (IV)

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8
Q

Prosthetic Valve Endocarditis

A

Vancomycin (IV) + Rifampicin (PO) + Gentimicin (IV)

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9
Q

C. difficile Infection

A

Non-severe: Metronidazole (PO)

Severe: Vancomycin (PO) + Metronidazole (PO)

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10
Q

Peritonitis / Biliary tract infection / Intra-abdominal infection

A

Amoxicillin (IV) + Gentamicin (IV) + Metronidazole (IV)

Penicillin allergic: Switch Amoxicillin with Vancomycin

Step down to: Co-trimoxazole + Metronidazole

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11
Q

Acute Gastroenteritis

A

N/A

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12
Q

Acute pancreatitis

A

N/A, unlikely to help

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13
Q

Proven Spontaneous Bacterial Peritonitis

A

Mild: Co-trimoxazole (PO)
Severe: Piperacillin (IV) / Tazobactam (IV)

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14
Q

Infection of catheterised adult

A

Do not treat unless signs and symptoms of infection.
Do not use urinalysis.
If you must: treat as complicated UTI

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15
Q

Complicated UTI

A

Amoxicillin (IV) + Gentamicin (IV)

Penicillin allergic: Switch Amoxicillin with Co-trimaxazole (IV)

Step down to: Co-trimaxazole (IV)

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16
Q

Pylonephritis

Pyelonephritis is a kidney infection that occurs when bacteria from a urinary tract infection spreads to the kidney.

A

Amoxicillin (IV) + Gentamicin (IV)

Penicillin allergic: Switch Amoxicillin with Co-trimaxazole (IV)

Step down to: Co-trimaxazole (IV)

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17
Q

Uncomplicated Female UTI

A

Nitrofurantoin or Trimethoprim

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18
Q

Urosepsis

Urosepsis is sepsis with a source localised to the urinary tract (or male genital tract, e.g. prostate)

A

Amoxicillin (IV) + Gentamicin (IV)

Penicillin allergic: Switch Amoxicillin with Co-trimaxazole (IV)

Step down to: Co-trimaxazole (IV)

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19
Q

Uncatheterised Male UTI

A

Nitrofurantoin or Trimethoprim

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20
Q

Cellulitis

A

Flucloxacillin
Penicillin allergic: Doxycycline (PO)

If risk of MRSA: Doxycycline

21
Q

Acute Septic Arthritis

A

Flucloxacillin (IV)

22
Q

Osteomyelitis

A

Flucloxacillin (IV)

23
Q

Diabetic Foot Infection

A

Mild: Flucloxacillin or Doxycycline
Moderate: Flucloxacillin + Metronidazole or Doxycycline + Metronidazole

24
Q

Open Fracture Prophylaxis

A

Co-amoxiclav (IV) + Metronidazole or
Co-trimoxazole (IV) + Metronidazole

Start within 3 hours

25
Q

Unknown source

A

Amoxicillin (IV) + Gentamicin (IV) + Metronidazole (IV)

Penicillin allergy: Switch Amoxicillin with Vancomycin

If Staphlococci: Add Flucloxacillin + Vancomycin

26
Q

Conjunctivitis

A

Usually self-limiting. Chloramphenicol

27
Q

Ophthalmic shingles

A

Aciclovir

28
Q

Tonsillitis

A

Most are viral. If Fever PAIN score is >4 and severe then treat with:

Penicillin
Penicillin allergy: Clarithromycin

29
Q

Pharyngitis

A

Most are viral. If Fever PAIN score is >4 and severe then treat with:

Penicillin
Penicillin allergy: Clarithromycin

30
Q

Sore throat

A

Most are viral. If Fever PAIN score is >4 and severe then treat with:

Penicillin V
Penicillin allergy: Clarithromycin

31
Q

Sinusitis

A

If >7 days

  1. Penicillin V
  2. Doxycycline
32
Q

Otitis Media

A

Most cases will resolve without antibiotics. Consider antibiotics if otorrhoea (discharge) is present:

  1. Amoxicillin
  2. Clarithromycin
33
Q

Otitis Externa

A

Mild: Acetic acid
Moderate: Sofradex or Otomize. Basically Dexamethasone and an antibiotic.
Severe: ENT referral

Sofradex: Dexamethasone (corticosteroid), framycetin and gramicidin (antibiotics).
Otomize: Dexamethasone, neomycin (antibiotic) and acetic acid.

34
Q

Oral thrush

A
  1. Miconazole gel

2. Fluconazole

35
Q

Diverticulitis

A

Uncomplicated acute diverticulitis may respond to analgesia and dietary modification.
If needed use: Metronidazole 400mg + Co-trimoxazole

36
Q

UTI or bacteriuria in pregnancy

A

1st-2nd trimester: Nitrofurantoin
3rd trimester: Trimethoprim

2nd line: Cefalexin

37
Q

Prostatitis

A

Ofloxacin or Ciprofloxacin

High risk of C. difficile: Trimethoprim

38
Q

Epididymo-orchitis

A

Send MSSU, gonorrhoea & chlamydia tests.

If STI likely (<35 or new partner in last 3mth): Doxycycline
If UTI likely (>35 and no new partner): Ofloxacin or Ciprofloxacin

39
Q

Uncomplicated Chlamydia

A

Azithromycin or Doxycycline

40
Q

Pelvic Inflammatory Disease

A

Metronidazole + Ofloxacin

41
Q

Trichomoniasis

Trichomoniasis (or “trich”) is a very common sexually transmitted disease (STD). It is caused by infection with a protozoan parasite called Trichomonas vaginalis.

A

Metronidazole

42
Q

Bacterial vaginosis

A

Metronidazole

43
Q

Tinea pedis

A

Topical 1% Terbinafine

44
Q

Dermatophyte nail infection

A

Confirm with nail clippings

Terbinafine
Fingers: 6-12 weeks
Toes: 3-6 months

45
Q

Diabetic Foot Infection

A

Mild: Flucloxacillin or Doxycycline
Moderate: Flucloxacillin + Metronidazole or Doxycycline + Metronidazole

46
Q

Impetigo

A

Localised lesions: Topical Fusidic Acid
Non localised: 1. Flucloxacillin
2. Clarithromycin

47
Q

Chickenpox

A

Aciclovir

48
Q

Shingles

A

Aciclovir or Valaciclovir

49
Q

Bites (assuming from animals etc)

A
  1. Co-amoxiclav

2. Metronidazole + Doxycycline

The Holy Grail (Treatments) (13 decks)

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