Antibiotic therapy

Question 1

Name the beta lactams

Answer 1

Penicillins, cephalosporins, monobactams, carbapenems

Question 2

Beta lactams method of action

Answer 2

Inhibition of cell wall synthesis, by binding to penicillin binding proteins (PBP) and inactivating transpeptidase enzymes involved in cross linking peptidoglycans.

Question 3

Augmentin

Answer 3

Amoxicillin + clavulonic acid

Question 4

Zosyn (Tazocin)

Answer 4

Piperacillin + tazobactam (antipseudomonal penicillin)

Question 5

Aminopenicillins

Answer 5

Amoxicillin, ampicillin

Question 6

Macrolides

Answer 6

Erythromycin, Clarithromycin, azithromycin

Question 7

Tetracyclines

Answer 7

Tetracycline, doxycycline, minocycline

Question 8

Responsible for red man syndrome

Answer 8

Vancomycin

Question 9

C.difficile treatment

Answer 9

First episode = metronidazole (10-14 days), second/severe episode = oral vancomycin

Question 10

Bacterial meningitis treatment

Answer 10

Meningococcal - Penicillinw G or cefotaxime/ceftriaxone (if immediate hypersensitivity to penicillin/cephalosporins then chloramphenicol).
Pneumococcal, H.influenzae or unknown etiology - cefotaxime or ceftriaxone (if allergy then chloramphenicol)
Listeria - amoxicillin

Question 11

Empirical therapy for pneumonia

Answer 11

Or Clarithromycin or doxycyclineAmoxicillin

Question 12

Empirical therapy for UTI

Answer 12

Trimethoprim (oral), nitrofurantoin or amoxicillin

Question 13

Quinolones

Answer 13

Ciprofloxacin, levofloxacin

Question 14

Treatment for MRSA

Answer 14

MRSA pneumonia - glycopeptide (vancomycin)
MRSA bronchiectasis - tetracycline or clindamycin
MRSA skin/soft tissue infection - tetracycline +/- rifampicin and fucidic acid.
MRSA UTI - tetracycline
MRSA septicaemia - glycopeptide

Summary: tetracycline or a glycopeptide (vancomycin)

Question 15

Purulent conjunctivitis

Answer 15

Chloramphenicol eye drops

Question 16

Gastroenteritis

Answer 16

Self limiting, antibiotics not necessary

Question 17

Salmonella

Answer 17

Only treat invasive/severe infection - ciprofloxacin or cefotaxime

Question 18

Bacterial vaginosis

Answer 18

Oral or topical metronidazole (5 days) or topical clindamycin

Question 19

Uncomplicated gonorrhea

Answer 19

Azithromycin single dose + contact tracing recommended

Question 20

Osteomyelitis

Answer 20

Flucloxicillin (of MRSA suspected then vancomycin)

Question 21

Septic arthritis

Answer 21

Flucloxacillin (if MRSA suspected then vancomycin)

Question 22

Community acquired pneumonia (low severity)

Answer 22

Amoxicillin (7 days), alternatives - doxycycline, clarithromycin

Question 23

Strep threat treatment

Answer 23

Phenoxymethylpenicillin

Question 24

Acute COPD exacerbation

Answer 24

Amoxicillin or doxycycline or Clarithromycin

Question 25

Otitis media in children

Answer 25

Amoxicillin (erythromycin if penicillin allergy)

Question 26

Cellulitis treatment

Answer 26

Flucloxacillin (Clarithromycin if penicillin allergy)

Question 27

Vancomycin

Answer 27

Glycopeptide active against Grame +ve- bloodstream MRSA infections. Directly inhibits cell wall synthesis.