Antibiotic Man

Question 1

Bacterial meningitis

Answer 1

IV Ceftriaxone
IV dexamethasone
add IV amoxicillin if >60

ciprofloxacin for close contacts

Question 2

ENT - epiglottis/supraglottitis

Answer 2

IV cetriaxone

Question 3

Mild/moderate CAP (CURB65 0-2)

Answer 3

oral amoxicillin
 (if penicillin allergic, doxycycline)

Question 4

severe CAP (CURB653-5)

Answer 4

IV co-amoxiclav + oral doxycycline

if penicillin allergic IV levofloxacin

Question 5

ICU/HDU CAP

Answer 5

IV co-amoxiclav + IV clarithromycin

If penicillin allergic IV levofloxacin

Question 6

HAP non-severe

Answer 6

oral amoxicillin

Question 7

HAP severe

Answer 7

IV amoxicillin + IV gentamicin

Question 8

non-severe aspiration pneumonia

Answer 8

oral amoxicillin + metronidazole

Question 9

Severe aspiration pneumonia

Answer 9

IV amoxicillin + metronidazole + gentamicin

Question 10

acute exacerbation of COPD

Answer 10

give antibiotics if:
increases sputum purulence

1st line -amoxicillin
2nd line - doxycycline

Question 11

acute cough/acute bronchitis

Answer 11

may be considered in frail elderly but no significant benefit of antibiotics

1st line - amoxicillin
2nd line - doxycycline

Question 12

Native valve indolent endocarditis

Answer 12

IV amoxicillin and IV gentamicin - 4-6 weeks

Question 13

native valve severe sepsis endocarditis

Answer 13

IV flucloxacillin 4-6 weeks

Question 14

prosthetic valve or suspected MRSA endocarditis

Answer 14

IV vancomycin + IV gentamicin

when therapeutic Vancomycin level reached at oral rifampicin

Question 15

Non-severe C.diff

Answer 15

oral metronidazole

Question 16

severe c.diff

Answer 16

oral/NG vancomycin + IV metronidazole

Question 17

peritonitis/biliary tract/intra-abdominal infections

Answer 17

IV amoxicillin, metronidazole and gentamicin

Question 18

proven spontaneous bacterial peritonitis

Answer 18

mild - oral co-trimoxazole

severe - piperacillin/taxobactam IV

Question 19

Complicated UTI/pyelonephritis/urosepsis

Answer 19

IV amoxicillin
IV gentamicin

step down to co-trimoxazole or as per sensitivities

Question 20

uncomplicated female lower UTI

Answer 20

Nitrofurantoin or trimethoprim (3 days)

Question 21

Uncatherterised male UTI

Answer 21

nitrofurantoin or Trimethoprim (7 days)

Question 22

Cellulitis

Answer 22

Flucloxacillin (IV/PO 5-7 days)

penicillin allergic - doxycycline

Question 23

open fracture prophylaxis

Answer 23

cefuroxime IV

start within 3 hours for max 72 hours

Question 24

Diabetic foot infection

Answer 24

Mild - flucloxacillin or doxycycline

moderate - flucloxacillin + metronidazole

Question 25

Acute septic arthritis/osteomyelitits

Answer 25

IV flucloxacillin

Question 26

Severe systemic infection of unknown source

Answer 26

IV amoxicillin, metronidazole and gentamicin (if IVDU add fluclox for staph aureus cover)

if penicillin allergic - IV vancomycin, metronidazole and gentamicin