antibiotic matching

Question 1

what is pre test probability used for?

Answer 1

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

Question 2

what are the most common differential diagnoses for urinary infections?

Answer 2

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

Question 3

what are the most common differential diagnoses for abdo infections?

Answer 3

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

Question 4

what are the most common differential diagnoses for respiratory infections?

Answer 4

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

Question 5

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

Answer 5

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

Question 6

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

Answer 6

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

Question 7

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

Answer 7

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

Question 8

what needs to be considered when taking a history?

Answer 8

recent antibiotic use

Question 9

what cultures can be done?

Answer 9

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

Question 10

what is diagnostic iteration?

Answer 10

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

Question 11

what group of ABs includes azithromycin, clarithromycin and erythromycin?

Answer 11

macrolides

Question 12

what is used in the case of a mild infection ?

Answer 12

amoxicillin

if penicillin allergy then use clarithromycin or doxycycline

Question 13

in a medium infection what ABs are used?

Answer 13

amoxicillin and clarithromycin

if penicillin allergy - levofloxacin or doxycycline

Question 14

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

Answer 14

co-amoxiclav IV and clarithromycin

if allergic to penicillin then used levofloxacin PO

Question 15

what is the common pathogen of post viral pneumonia?

Answer 15

S aureus

Question 16

what is MRSA resistant to ?

Answer 16

beta lactams

Question 17

what are the characteristics for amoxicillin?

Answer 17

IV and PO available

can be considered for cystitis and systemic infections

Question 18

what are the characteristics for flucloxacillin?

Answer 18

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

Question 19

what are the characteristics for erythromycin?

Answer 19

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

Question 20

what are the characteristics for levofloxacin?

Answer 20

IV and PO available

can be considered for cystitis and systemic infections

Question 21

what are the characteristics for trimethoprim?

Answer 21

IV and PO available

can be considered for cystitis and systemic infections

Question 22

what are the characteristics for doxycycline?

Answer 22

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

Question 23

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

Answer 23

vancomycin or doxycycline

Question 24

what can amoxicillin be used for?

Answer 24

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

Question 25

what are macrolides appropriate for?

Answer 25

the gram negative rods with no cell wall - chlamydia, legionella and mycoplasma pneumoniaes

Question 26

in what global challenge situation should microbiology be consulted?

Answer 26

when there are CPEs present - carbapenemase producing enterobacteriacae

Question 27

what are the three mutations that are challenging in E coli?

Answer 27

penicillinase, CPEs, ESBLs - extended spectrum beta lactamase

Question 28

what are teicoplanib and vancomycin are what types of AB and what does this imply?

Answer 28

they are both glycopeptide antibiotics and therefore can be interchanged

Question 29

what are broad spectrum antibiotics?

Answer 29

they are antibiotics or combinations of that provide cover for gram positive, negative and anaerobes such as co-amoxiclav

Question 30

what are gram positive antibiotics and give five examples?

Answer 30

they are antibiotics that are used to cover gram positive pathogens only 
teicoplanin/vancomycin
amoxicillin/penicillin
linezolid
macrolides e.g. carithromycin
flucloxacillin

Question 31

what are gram negative antibiotics and gives three examples?

Answer 31

antibiotics that are mostly used to cover gram negative bacteria
gentamicin
ciprofloxacin
aztreonam

Question 32

what are antibiotics that are commonly used to treat cystitis?

Answer 32

those that are used to treat e. coli
nitrofurantoin 
trimethoprim 
fosfomycin
pivmecillinam 
cephalexin