Antibiotic Man Flashcards
what are the indications for IV use?
2> outwith normal range (temp, RR, BP, WCC)
febrile with neutropenia or immunocuppression
endocarditis/ septic arthritis/ abcess/ meningitis/ osteoarthritis
oral route compromised
post surgery - unable to tolerate 1l of oral fluids
no oral formulation available
how often should you review IV therapy
every 12-24 hours
if IV gent still required after 72 hours consider switch to
aztreonam
meningitis
ceftriaxone IV and dexamethasone IV
meningitis with suspected encephalitis add
acyclovir IV
meningitis if >60yo or immunocompromised
add amoxicillin IV
epiglottitis/ supraglottitis
ceftriaxone IV
what scoring system is used in CAP
CURB65
what is CURB65
confusion urea >7 RR>20 BP <90/<60 age >65
mild/mod CAP
Amoxicillin IV/PO 5 days
mild/mod CAP pen allergy
doxy PO or IV clarithromycin if NBM
severe CAP
coamoxiclav IV and Doxy PO
severe CAP pen allergy
IV levofloxacin
severe CAP in ICU/HDU or NBM
IV coamoxiclav and clarithromycin
severe CAP in ICU/HDU or NBM pen allergy
IV levofloxacin
any patient with severe CAP should be stepped down to
Doxycycline
any patient with severe CAP should be treated for
7 days
HAP or aspiration pneumonia severe
IV amox met and gent
HAP or aspiration pneumonia severe pen allergy
IV cotrimoxazole met +/- gent
all patients with severe HAP should be stepped down to
PO cotrimoxazole and metronidazole
patients with severe HAP should be treated for
7 days
no severe hap
PO amox and met
non severe hap pen allergy
PO cotrimox and met
how long should non severe hap be treated for
5 days
acute exac of copd
1- amox
2- doxy
acute cough or bronchitis in frail elderly
1 - amox
2 - doxy
native valve indolent (subacute) endocarditis
amox and gent iv
native valve severe sepsis acute endocarditis
iv fluclox
prosthetic valve or suspected mrsa
iv vanc and gen with po rifampicin
native valve severe sepsis and risk factors for resistant pathogens
vanc and meropenem iv
non severe c diff
po metronidazole 10 days
severe c diff
vanc po 10 days +/- iv met
peritonitis/ biliary tract/ intraabdo
iv anox met and gent
peritonitis/ biliary tract/ intraabdo step down to
PO cotrimox and met
peritonitis/ biliary tract/ intraabdo pen allergy
IV vanc met and gent
proven spontaneous bacterial peritonitis mild
Po cotrimoxazole
proven spontaneous bacterial peritonitis severe
piperacillin/ tazobactam IV
proven spontaneous bacterial peritonitis severe step down to
co trimoxazole PO
uncomplicated lower UTI female
nitrofurantoin or trimethoprim 3 days
uncathetarised male uti
nitrofurantoin or trimethoprim 7 days
complicated UTI/ pyelonephritis/ urosepsis
IV amox and gent 7 days
complicated UTI/ pyelonephritis/ urosepsis pen allergy
IV cotrimox and gent 7 days
complicated UTI/ pyelonephritis/ urosepsis step down to
co trimox
cellutitis
flucolox 7 days
cellulitis pen allergy
doxy 7 days
acute septic arthritis/ osteomyelitis
iv fluclox
diabetic foot infection mild
fluclox or doxy 7 days
diabetic foot infection moderate
fluclox + met or
doxy + met
7 days
open fracture prophylaxis
IV coamoxiclav or (IV cotrimox and met) within 3 hours for max 3 days
unknown source
IV amox met and gent
consider adding fluclox or vanc if concerned about fluclox
unknown source pen allergy
IV vanc met and gent
