Antibiotic Man (2018) - Hospital and Primary Care Flashcards
Meningitis
Ceftriaxone (IV) + Dexamethasone (IV)
Aciclovir (IV)- if encephalitis suspected
Amoxicillin (IV)- if immunocompromised
Epiglottitis
Ceftriaxone (IV)
Community Acquired Pneumonia (CAP)
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)
Hospital Acquired Pneumonia (HAP)
Non-severe: Amoxicillin (IV) + Metronidazole (IV)
Severe: Amoxicillin (IV) + Metronidazole (IV) + Gentamicin (IV)
Penicillin allergic:
Switch Amoxicillin for Co-trimoxazole
Acute exacerbation of COPD
- Amoxicillin
- Doxycycline
Only give if:
- increased sputum purulence
- consolidations on CXR
- signs of pneumonia
Acute cough/ bronchitis
N/A, unless elderly and frail:
- Amoxicillin
- Doxycycline
Native Valve Endocarditis
Take blood cultures
Start empirical therapy
Subacute/ indolent: Amoxicillin (IV) + Gentamicin (IV)
Acute/ severe: Flucloxicillin (IV)
Severe + potential resisetant pathogens: Vancomycin (IV) + Meropenem (IV)
Prosthetic Valve Endocarditis
Vancomycin (IV) + Rifampicin (PO) + Gentimicin (IV)
C. difficile Infection
Non-severe: Metronidazole (PO)
Severe: Vancomycin (PO) + Metronidazole (PO)
Peritonitis / Biliary tract infection / Intra-abdominal infection
Amoxicillin (IV) + Gentamicin (IV) + Metronidazole (IV)
Penicillin allergic: Switch Amoxicillin with Vancomycin
Step down to: Co-trimoxazole + Metronidazole
Acute Gastroenteritis
N/A
Acute pancreatitis
N/A, unlikely to help
Proven Spontaneous Bacterial Peritonitis
Mild: Co-trimoxazole (PO)
Severe: Piperacillin (IV) / Tazobactam (IV)
Infection of catheterised adult
Do not treat unless signs and symptoms of infection.
Do not use urinalysis.
If you must: treat as complicated UTI
Complicated UTI
Amoxicillin (IV) + Gentamicin (IV)
Penicillin allergic: Switch Amoxicillin with Co-trimaxazole (IV)
Step down to: Co-trimaxazole (IV)
Pylonephritis (Hopsital)
Pyelonephritis is a kidney infection that occurs when bacteria from a urinary tract infection spreads to the kidney.
Amoxicillin (IV) + Gentamicin (IV)
Penicillin allergic: Switch Amoxicillin with Co-trimaxazole (IV)
Step down to: Co-trimaxazole (IV)
Uncomplicated Female UTI
Nitrofurantoin or Trimethoprim
Urosepsis
Urosepsis is sepsis with a source localised to the urinary tract (or male genital tract, e.g. prostate)
Amoxicillin (IV) + Gentamicin (IV)
Penicillin allergic: Switch Amoxicillin with Co-trimaxazole (IV)
Step down to: Co-trimaxazole (IV)
Uncatheterised Male UTI
Nitrofurantoin or Trimethoprim