Antibiotic Man

Question 1

Meningitis

Answer 1

Ceftriaxone IV 2g + dexamethasone IV 10g for 4 days
Aciclovor if eonphalitis is suspected (swollen brain)
Amoxicillin every 4 hours IV if immunocompromised or >60

Question 2

Epiglottitis (inflammation of the epiglottis) /supraglottitis (inflammation of the wind pipe)

Answer 2

Ceftriaxone IV 2g

Question 3

Community Acquired Pneumonia

Answer 3

Asses CURB 65 score
0-2 - amoxycillin (doxycycline on first day if allergic to penicillin then IV or oral clarithromycin)
3-5 (severe) - co-amoxiclav + doxycycline (if penicillin allergic levoflaxin)
if in ICU co-amoxiclav + clarithromycin

Question 4

Hospital Acquired Pneumonia or Aspiration Pneumonia

Answer 4

Severe - IV amoxicillin, metronidazole, gentamicin

Non-severe- metronidazole +amoxicillin.

Question 5

Acute Exacerbation of COPD

Answer 5

Give antibiotics if increased sputum purulence
1st line amoxicillin
2nd line doxycycline (5 days)

Question 6

Acute cough/bronchitis

Answer 6

No significant benefit however considered in the frail and elderly
1st line - amoxicillin
2nd line - doxycycline

Question 7

Endocarditis

Answer 7

Sub acute - amoxicillin iv + gentamicin
acute - IV flucoxacillin
prosthetic valve/ suspected MRSA - vancomycin IV + rifampicin + gentamicin

Question 8

Clostridium Difficile Infection

Answer 8

Non-severe - oral metronidazole

severe - oral vancomycin +/- IV metronidazole

Question 9

Peritonitis/ biliary tract/ intra-abdominal

Answer 9

amoxicillin + metronzadole + gentamicin (swap amoxicillin with vancomycin if allergic)

Question 10

UTI

Answer 10

uncomplicated - nitrofurantoin or trimethoprim

complicated - IV amoxicillin + gentamicin (co-trimoxazole if penicillin allergic)

Question 11

Cellulitis

Answer 11

Flucoxicillin (if penicillin allergic use doxycycline)

Question 12

Acute septic arthritis

Answer 12

Flucloxacillin

Question 13

Diabetic foot infection

Answer 13

mild- flucloxacillin or doxycycline

moderate flucloxacillin + metronidazole

Question 14

Open fracture prophylaxis

Answer 14

IV co-amoiclav