antibiotic matching Flashcards

1
Q

what is pre test probability used for?

A

to inform the history and examination, to dictate tests and act as a starting point to match the symptoms with the diagnosis

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2
Q

what are the most common differential diagnoses for urinary infections?

A

pyelonephritis, catheter associated UTIs, cystitis, prostatitis, renal abscesses

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3
Q

what are the most common differential diagnoses for abdo infections?

A

dental, abdo, biliary tract infections, H pylori, C difficile, spontaneous bacterial peritonitis, gastroenteritis and appendicitis

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4
Q

what are the most common differential diagnoses for respiratory infections?

A

ventilator associated, post viral, hospital acquired or community acquired pneumonia or TB

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5
Q

what are the most common differential diagnoses for orthopaedic or skin and soft tissue infections?

A

cellulitis, orbital cellulitis, osteomyelitis, septic arthritis, infected ulcer, necrotising fasciitis, diabetic foot infection, prosthetic joint infection, pilonidal abscess, fourniers gangrene

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6
Q

what are the most common differential diagnoses for vascular and CNS infection?

A

infected DVT, endocarditis, mycotic aneurysm, encephalitis, bacterial and TB meningitis, brain abscess, central venous catheter infections

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7
Q

how do you progress from a differential to a working diagnosis?

A

history, exam, lab and radiological tests, trial without and trial of therapy, pretest probability

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8
Q

what needs to be considered when taking a history?

A

recent antibiotic use

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9
Q

what cultures can be done?

A

urine, blood, bacterial (ascitic), abdo fluid, joint fluid, wound swab, sputum, bone sample, biopsy

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10
Q

what is diagnostic iteration?

A

it is a procedure in which repetition of operations or tests yields results that are successively closer to desired result - gives a high diagnostic probability

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11
Q

what group of ABs includes azithromycin, clarithromycin and erythromycin?

A

macrolides

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12
Q

what is used in the case of a mild infection ?

A

amoxicillin

if penicillin allergy then use clarithromycin or doxycycline

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13
Q

in a medium infection what ABs are used?

A

amoxicillin and clarithromycin

if penicillin allergy - levofloxacin or doxycycline

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14
Q

if there is a high severity infection what ABs are used?

A

co-amoxiclav IV and clarithromycin

if allergic to penicillin then used levofloxacin PO

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15
Q

what is the common pathogen of post viral pneumonia?

A

S aureus

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16
Q

what is MRSA resistant to ?

A

beta lactams

17
Q

what are the characteristics for amoxicillin?

A

IV and PO available

can be considered for cystitis and systemic infections

18
Q

what are the characteristics for flucloxacillin?

A

IV and PO available
can be considered for systemic infections
unsure around cystitis

19
Q

what are the characteristics for erythromycin?

A

IV and PO available
can be considered for systemic infections
unsure around cystitis

20
Q

what are the characteristics for levofloxacin?

A

IV and PO available

can be considered for cystitis and systemic infections

21
Q

what are the characteristics for trimethoprim?

A

IV and PO available

can be considered for cystitis and systemic infections

22
Q

what are the characteristics for doxycycline?

A

IV not available but PO is available. considered for systemic infection but not for cystitis

23
Q

what are appropriate antibiotics for the gram positives S aureus and strep pneumoniae?

A

vancomycin or doxycycline

24
Q

what can amoxicillin be used for?

A

the gram negative coccus moraxellas catharalis and gram negative rods haemophilus influenzae

25
what are macrolides appropriate for?
the gram negative rods with no cell wall - chlamydia, legionella and mycoplasma pneumoniaes
26
in what global challenge situation should microbiology be consulted?
when there are CPEs present - carbapenemase producing enterobacteriacae
27
what are the three mutations that are challenging in E coli?
penicillinase, CPEs, ESBLs - extended spectrum beta lactamase
28
what are teicoplanib and vancomycin are what types of AB and what does this imply?
they are both glycopeptide antibiotics and therefore can be interchanged
29
what are broad spectrum antibiotics?
they are antibiotics or combinations of that provide cover for gram positive, negative and anaerobes such as co-amoxiclav
30
what are gram positive antibiotics and give five examples?
``` they are antibiotics that are used to cover gram positive pathogens only teicoplanin/vancomycin amoxicillin/penicillin linezolid macrolides e.g. carithromycin flucloxacillin ```
31
what are gram negative antibiotics and gives three examples?
antibiotics that are mostly used to cover gram negative bacteria gentamicin ciprofloxacin aztreonam
32
what are antibiotics that are commonly used to treat cystitis?
``` those that are used to treat e. coli nitrofurantoin trimethoprim fosfomycin pivmecillinam cephalexin ```