Antibiotic Man

Question 1

Tx for Meningitis

Answer 1

Ceftriaxone IV 2g bd

plus

Dexamethasone IV 10mg qds

Question 2

Tx for Meningitis if encephalitis is suspected

Answer 2

Aciclovir IV 10mg/kg

Question 3

Tx for Meningitis if over 60 or immunocompromised

Answer 3

Ceftriaxone IV 2g bd

plus

Dexamethasone IV 10mg qds

ADD

Amoxicillin IV 2g 4 hourly

Question 4

Tx for epiglottitis

Answer 4

Ceftriaxone IV 2g od

Question 5

CAP Tx for CAP 0-2

Answer 5

Amoxicillin 1g tds PO/IV = 5 days

Question 6

CAP Tx for CAP 0-2 if pen. allergic

Answer 6

Doxycyline PO 200mg on day 1

then 100mg od

or IV Clarithromycin

Question 7

CAP Tx for CAP 3-5

Answer 7

Co-amoxiclav IV 1.2g tds

AND

Doxycycline PO 100mg bd

for 7 days

Question 8

CAP Tx for CAP 3-5 if pen. allergic

Answer 8

IV Levofloxacin 500mg bd

Question 9

CAP Tx for CAP 3-5 and in ICU

Answer 9

Co-amoxiclav IV 1.2g tds

AND

Clarithromyin IV 500mg bd

Question 10

Tx for non-severe HAP

Answer 10

PO Amoxicillin

5 days

Question 11

Tx for non-severe HAP if pen. allergic

Answer 11

Doxycycline 100mg bd

Question 12

Tx for severe HAP

Answer 12

IV Amoxicillin + Gentamicin

7 days

Question 13

Tx for severe HAP if pen. allergic

Answer 13

IV Co-trimoxazole + Gentamicin

Question 14

Tx for non-severe aspiration pneumonia

Answer 14

PO Amoxicillin + Metronidazole

5 days

Question 15

Tx for non-severe aspiration pneumonia if pen. allergic

Answer 15

PO Doxycycline 100mg bd + Metronidazole

5 days

Question 16

Tx for severe aspiration pneumonia

Answer 16

IV Amoxicillin + Gentamicin + Metronidazole

Question 17

Tx for severe aspiration pneumonia if pen. allergic

Answer 17

Replace Amoxicillin with PO Doxycycline or IV Clarithromycin

Question 18

Step down Tx for severe aspiration pneumonia

Answer 18

PO amoxicillin + metronidazole

Total = 7 days

Question 19

Tx of acute exacerbation of COPD - 1st and 2nd line

Answer 19

Only give antibiotics if increased sputum purulence
or consolidation on CXR

1st line = Amoxicillin 500mg tds

2nd line = Doxycycline 200mg on day 1 then 100mg od

Total = 5 days

Question 20

Protocol for suspected endocarditis

Answer 20

• take appropriate blood cultures
• start empirical therapy and refer to ID/Microbiology
• check endocarditis specific guidance/guidelines

Question 21

Tx for native value (subacute) endocarditis

Answer 21

Amoxicillin IV 1g 4 hourly

AND

Gentamicin 1mg/kg bd

Question 22

Tx for native value severe sepsis (acute) endocarditis

Answer 22

Flucloxacillin IV 2g 6 hourly

Question 23

Tx for prosthetic value or suspected MRSA endocarditis

Answer 23

Vancomycin IV

AND

Gentamicin IV 1mg/kg

And

Rifampicin PO 600mg bd

Question 24

C Diff Tx - non severe

Answer 24

Metronidazole PO 400mg tds

10 days

Question 25

C Diff Tx - severe

Answer 25

Vancomycin 125mg qds PO

+/-

IV Metronidazole

10 days

Question 26

Tx for Peritonitis/Biliary Tract/Intra-abdominal

Answer 26

IV Amoxicillin + Metronidazole + Gentamicin

Total = 7 days

Question 27

Step down Tx for Peritonitis/Biliary Tract/Intra-abdominal

Answer 27

PO Co-Trimoxazole + Metronidazole

Question 28

Tx for Peritonitis/Biliary Tract/Intra-abdominal if pen. allergic

Answer 28

IV Vancomycin + Metronidazole + Gentamicin

Question 29

Guidelines for Catheterised patient with UTI or UTI in older adults

Answer 29

do not use urinalysis

do not Tx unless clinical signs/Sx of infection

if definite infection Tx as per complication UTI

Question 30

Tx for complicated UTI/Pyelonephritis/Urosepsis

Answer 30

IV Amoxicillin + Gentamicin

Total = 7 days

Question 31

Step down Tx for complicated UTI/Pyelonephritis/Urosepsis

Answer 31

PO Co-trimoxazole

Question 32

Tx for complicated UTI/Pyelonephritis/Urosepsis if pen. allergic

Answer 32

IV Co-trimoxazole + Gentamicin

Question 33

Tx for uncomplicated female lower UTI

Answer 33

Nitrofurantoin 500mg qds

OR

Trimethoprim 200mg bd

Total = 3 days

Question 34

Tx for uncathetherised Male UTI

Answer 34

Nitrofurantoin 500mg qds

OR

Trimethoprim 200mg bd

Total = 7 days

Question 35

Tx for Cellulitis

Answer 35

Flucloxacillin 1g qds

Total = 7 days

Question 36

Tx for Cellulitis if pen. allergic

Answer 36

Doxycycline 100mg bd PO

Question 37

Open fracture prophylaxis

Answer 37

IV Co-Amoxiclav 1.2g tds

or IV Co-Amoxiclav 960mg bd + Metronidazole 500mg tds

Question 38

what time frame should open fracture prophylaxis be started within

Answer 38

within 3 hours for max 72 hours

Question 39

mild diabetic foot infection Tx

Answer 39

Flucloxacillin 1g qds or Doxycycline 100mg bd

Question 40

moderate diabetic foot infection Tx

Answer 40

Flucloxacillin 1g qds + Metronidazole 400mg tds

OR

Doxycycline 100mg bd + Metronidazole 400mg tds

Question 41

Tx for acute septic arthritis/osteomyelitis

Answer 41

IV Flucloxacillin 2g qds

Question 42

Tx for severe systemic infection w/ unknown source

Answer 42

IV Amox. + Metronidazole + Gent

Question 43

Tx for severe systemic infection w/ unknown source if IVDU

Answer 43

IV Amox. + Metronidazole + Gent + Flucloxacillin

to cover S. aureus

Question 44

Tx for severe systemic infection w/ unknown source and pen. allergic

Answer 44

IV Vancomycin + Metronidazole + Gent

Question 45

if neutropenic sepsis is suspected, what Ix should be done

Answer 45

Blood cultures
Stool Cultures 
MSU
Sputum culture
CXR
Swab skin lesions 
Swab Hickman line exit site
Throat swab

Question 46

Tx for Neutropenia + Sepsis + News less or equal to 6

standard risk patients

Answer 46

Piperacillin/Tazobactam

(if pen allergic = Teicoplanin + Aztreonam)

(if anaphylaxis or angioedema = Tecioplanin + Ciprofloxacin)

Question 47

Tx for Neutropenia + Sepsis + News more than or equal to 7

high risk patients

Answer 47

Piperacillin/Tazobactam + Gentamicin

(if pen allergic = Teicoplanin + Aztreonam + Gentamicin)

(if anaphylaxis or angioedema = Tecioplanin + Ciprofloxacin + Gentamicin)