Antibiotic Man Hosp and Community

Question 1

What is important to assess before choosing antibiotic treatment in community care for community/hospital acquired pneumonia?

Answer 1

CURB65 Score

Question 2

What is important to assess before choosing antibiotic treatment in hospital for hospital for community/hospital acquired pneumonia?

Answer 2

CURB65 Score

Question 3

If someone presents in community care with hospital acquired pneumonia what is the minimum CURB65 score required for hospital admission?

Answer 3

3 because 3-5 is severe HAP which requires IV antibiotic treatment

Question 4

What is a CURB65 score?

Answer 4

1 point for each:
C= Confusion
U= Urea; >7mmol/l
R= Resp rate; >30/minute
B= BP; <90mmHg (systolic) or <60mmHg (diastolic)
65= >65 years old

Question 5

What does each CURB65 score indicate (in terms of treatment in primary care) for CAP?

Answer 5

0= Usually treat at home
1= Usually treat at home
2=Consider hospital referral
3-4= Urgent hospital admission AND give amoxicillin 1g oral or benzylpenicllin 1.2gIV before transfer

NB: Obviosuly withhold the penicllin treatment if they’re known to be allergic

Question 6

What does each CURB65 Score indicate (in terms of treatment in hospital) for HAP?

Answer 6

0-2= non-severe; PO Amoxicillin + Metronidazole (5 days)
3-5= severe; IV Amoxicillin + Metronidazole + Gentamicin then step down to PO Co-trimoxazole + Metronidazole (Total IV+PO treatment = 7 days)
(penicillin allergic give IV Co-trimoxazole + Metronidazole +/- Gentamicin)

Question 7

How are mild/moderate CAP patients treated in hospital?

Answer 7

Amoxicillin IV/PO for 5 days

If penicillin allergic: Doxycycline PO

Question 8

How are severe CAP patients treated in hospital?

Answer 8

Co-amoxiclav IV + Doxycyline PO

If penicillin allergic IV Levofloxacin

Question 9

How are non-severe HAP patients treated in hospital?

Answer 9

PO Amoxicillin + Metronidazole for 5 days

Question 10

How are severe HAP patients treated in hospital?

Answer 10

IV Amoxicillin + Metronidazole + Gentamicin
Step down to PO Co-trimoxazole + Metronidazole (Total IV+ PO = 7 days)

If penicillin allergic IV Co-trimoxazole + Metronidazole +/- Gentamicin

Question 11

How to treat CAP in community?

Answer 11

Amoxicillin 3x a day for 5 days
OR
Doxycycline for 5 days

Question 12

In terms of antibiotics AND ANTIBIOTICS ONLY how would you treat an acute exacerbation of COPD?

Answer 12

Give antibiotics if increased sputum purulence then give antibiotics
If not; check CXR for pneumonia or consolidation as 1/both of these would indicate antibiotics

Which antibiotics?
1st Line= Amoxicillin
2nd Line= Doxycycline

Question 13

‘Antibiotics are helpful in the treatment of acute gastroenteritis.’
TRUE/FALSE

Answer 13

False

Question 14

‘Antibiotics are helpful in the treatment of acute pancreatitis.’
TRUE/FALSE

Answer 14

False

Question 15

Peritonitis, biliary tract and ‘intra-abdominal’ bacterial infections have the same antibiotic treatment advice in Tayside; what is it?

Answer 15

IV Amoxicillin + Mtronidazole + Gentamicin
then step down to
PO Co-trimoxazole + Metronidazole

If penicillin allergic replace Amoxicillin with Vancomycin