Antibiotic treatment 1

Question 1

1) Septicaemia (community-acquired)

2) Septicaemia (Hospital-acquired)

Answer 1

1) Community: B-S antipseudomonal penicillin (e.g. piperacillin with tazobactam) or a B-S cephalosporin (e.g. cefuroxime)
2) Hospital: B-S antipseudomonal beta-lactam antibacterial (piperacillin with tazobactam)

Question 2

Septicaemia related to vascular catheter

Answer 2

Vancomycin (or teicoplanin)

Question 3

Meningococcal septicaemia suspected

Answer 3

A single dose of benzylpenicillin sodium should be given before urgent transfer to hospital. so long as this does not delay the transfer. (alternative cefotaxime or chloramphenicol)

Question 4

General treatment for endocarditis?

Answer 4

1) normally a penicillin: fluclox, Amox and a low dose low-dose gentamicin
2) if penicillin allergic: vancomycin + low dose gentamicin

Question 5

outline the initial management of Meningitis

Answer 5

1) Transfer patient to hospital urgently
2) If meningococcal disease suspected, benzylpenicillin sodium should be given before transfer to hospital
3) In hospital, consider starting adjunctive dexamethasone before or with first dose of antibacterial, but no later than 12 hours after starting antibacterial

Question 6

In hospital if the if aetiology of meningitis is unknown how should the following be treated?

1) Adult and child 3 months–50 years
2) Adult over 50 years

Answer 6

1) Adult and child 3 months–50 years: cefotaxime (or ceftriaxone)
2) Adult over 50 years: cefotaxime (or ceftriaxone) + amoxicillin
↳Suggested duration of treatment at least 10 days

Question 7

what is the antibiotic treatment for meningitis caused by meningococci?

Answer 7

Benzylpenicillin or cefotaxime (or ceftriaxone)-

suggested duration of treatment 7 days.

Question 8

what is the antibiotic treatment for Meningitis caused by pneumococci/ Haemophilus influenzae?

Answer 8

1) Cefotaxime (or ceftriaxone)
2) Consider adjunctive treatment with dexamethasone, preferably starting before or with first dose of antibacterial, but no later than 12 hours after starting antibacterial

Question 9

what is the antibiotic treatment for meningitis caused by Listeria

Answer 9

1) Amoxicillin (or ampicillin) + gentamicin
2) Suggested duration of treatment 21 days.
↳Consider stopping gentamicin after 7 days.

Question 10

what are the causative organisms for otitis externa, and when would treatment be considered?

Answer 10

1) Pseudomonas aeruginosa or Staphylococcus aureus

2) Systemic antibacterial if spreading cellulitis or patient systemically unwell.

Question 11

1) what would be the antibiotic of choice for otitis externa?
2) what if pseudomonas is suspected?

Answer 11

1) Fucloxacillin
↳ allergy Clarithromycin (or azithromycin)
2) Ciprofloxacin eye drops (or an aminoglycoside)

Question 12

Antibacterial therapy should be offered to children with acute otitis media if they meet what criteria? (5)

Answer 12

1) Systemically very unwell
2) Signs and symptoms of a more serious illness
3) high-risk of serious complications due to pre-existing comorbidities
4) otorrhoea (discharge from perforation of the eardrum)
5) children under 2 years with bilateral otitis media

Question 13

whats the choice of antibacterial therapy in children for Otitis media?

Answer 13

1) First line: amoxicillin (Second line :co-amoxiclav)

2) if penicillin allergic: clarithromycin or erythromycin (preferred in pregnancy)

Question 14

should gastro-enteritis be treated with an antibiotic?

Answer 14

Frequently self-limiting and may not be bacterial.

Question 15

campylobacter enteritis is frequently self-limiting and would only usually be treated in immunocompromised or if the infection was severe. whats the drug of choice?

Answer 15

Clarithromycin (or azithromycin or erythromycin)

Question 16

Only severe or invasive infections caused by salmonella (non-typhoid) are treated. whats the antibiotic of choice?

Answer 16

Ciprofloxacin or cefotaxime

Question 17

what antibacterial is used to treat Typhoid fever?

Answer 17

Cefotaxime (or ceftriaxone)

Question 18

Clostridium difficile infection often follows antibiotic therapy , which antibiotics are known for causing c.diff?

Answer 18

1) clindamycin
2) ampicillin, amoxicillin
3) co-amoxiclav
4) second- and third-generation cephalosporins
5) quinolones

Question 19

what antibiotics are used to treat c.diff

Answer 19

1) For first episode of mild to moderate infection, oral metronidazole- treatment 10–14 days
2) other options: vancomycin, and fidaxomicin