Antibiotic treatment 2

Question 1

Treatment for Bacterial vaginosis?

Answer 1

1) Oral metronidazole: 5–7 days

2) Alternatively, topical metronidazole for 5 days or topical clindamycin for 7 days

Question 2

Treatment for Uncomplicated genital chlamydial infection non-gonococcal urethritis, and non-specific genital infection?

Answer 2

1) Contact tracing recommended.
2) Azithromycin or doxycycline: azithromycin as a single dose or doxycycline for 7 days
↳ Alternatively, erythromycin- 14 days

Question 3

Treatment of uncomplicated gonorrhoea?

Answer 3

1) Contact tracing recommended

2) Azithromycin + i/m ceftriaxone- A single-dose of each antibacterial

Question 4

Treatment for Pelvic inflammatory disease

Answer 4

1) Contact tracing recommended

2) Doxycycline + metronidazole + single-dose of i/m ceftriaxone - 14 days

Question 5

Treatment for Early syphilis (infection of less than 2 years)

Answer 5

1) Contact tracing recommended.

2) Benzathine benzylpenicillin as a single dose ( if latent > 2 years, give once weekly for 2 weeks)

Question 6

Treatment for asymptomatic contacts of patients with infectious syphilis

Answer 6

Doxycycline- Suggested duration of treatment 14 days

Question 7

Treatment for osteomyelitis?

Answer 7

1) Flucloxacillin- consider adding fusidic acid or rifampicin for initial 2 weeks
2) 6 weeks for acute infection
↳ if allergic use clindamycin

Question 8

Treatment for Septic arthritis?

Answer 8

1) Flucloxacillin- 4–6 weeks

2) If penicillin-allergic clindamycin

Question 9

Antibacterial therapy should only be offered to patients with acute sinusitis if they meet what criteria?

Answer 9

1) systemically very unwell
2) Signs and symptoms of a more serious illness
3) High-risk of complications e.g. comorbidities,
4) bacterial sinusitis

Question 10

Patients presenting with symptoms of sinusitis for around 10 days or more with no improvement might be given what?

Answer 10

Back-up antibiotic prescription, which can be used if symptoms do not improve within 7 days or if they worsen significantly at any time

Question 11

what the first line therapy for sinusitis ?

Answer 11

1) First line:Non-life threatening : phenoxymethylpenicillin
2) more serious illness/ complications: co-amoxiclav
↳ if penicillin allergic: Doxycycline or clarithromycin (erythromycin in pregnancy).

Question 12

what is Bronchiectasis ?

Answer 12

1) progressive condition, caused by chronic inflammatory damage to the airways and is characterised by thick-walled, dilated bronchi
2) Acute symptoms : sustained deterioration of symptoms from their baseline, worsening local symptoms, wheeze, breathlessness or haemoptysis and fever or pleurisy.

Question 13

what is the treatment for Bronchiectasis ?

Answer 13

1) sputum sample culture and susceptibility testing- Antibacterial therapy to all patients with an acute exacerbation.
2) Oral first line: Amoxicillin, clarithromycin, or doxycycline- duration of 7–14 days.

Question 14

what is the recommended antibacterial treatment for an acute exacerbation of COPD?

Answer 14

1) Duration of treatment is 5 days

2) Oral first line: Amoxicillin, clarithromycin, or doxycycline.

Question 15

1) Acute cough is usually self-limiting and often resolves within how many weeks without antibacterials?
2) what advice should patients be given?

Answer 15

1) 3–4 weeks

2) self limiting- try honey and over-the-counter cough medicines

Question 16

which individuals are considered to be at a higher risk of complications if they present with an acute cough?

Answer 16

1) pre-existing co-morbidity
2) young children who were born prematurely
3) over 65 years of age
↳Immediate or back-up antibacterial treatment should be considered in these patients

Question 17

what is the choice of antibacterial therapy for an acute cough?

Answer 17

1) Doxycycline- 5 days

2) Alternative first line choices: amoxicillin, clarithromycin, or erythromycin.

Question 18

what is the treatment for community-acquired pneumonia?

1) low-severity
2) Moderate-severity

Answer 18

1) Amoxicillin (or ampicillin)- 7 days

2) Amoxicillin + clarithromycin (or azithromycin or erythromycin) or doxycycline alone- 7 days

Question 19

what is the treatment for Community-acquired pneumonia: high-severity?

Answer 19

1) Benzylpenicillin + clarithromycin (or azithromycin or erythromycin) -7-10 days
2) or benzylpenicillin sodium + doxycycline -7-10 days

Question 20

what is the treatment for pneumonia possibly caused by atypical pathogens?

Answer 20

Clarithromycin (or azithromycin or erythromycin)- 7–10 days

Question 21

what is the treatment for early-onset (less than 5 days after admission to hospital) hospital-acquired pneumonia?

Answer 21

Co-amoxiclav or cefuroxime- 7 days

Question 22

what is the treatment for late onset (>5 days hospital) acquired pneumonia?

Answer 22

1) Antipseudomonal penicillin (e.g. piperacillin with tazobactam) or
2) OR a broad-spectrum cephalosporin (e.g. ceftazidime) 3) OR another antipseudomonal beta-lactam
4) OR a quinolone (e.g. ciprofloxacin)
↳ if MRSA suspected, add vancomycin.