Antibiotic Treatment Flashcards

1
Q

CURB 65

A
Confusion of recent onset
Urea >7 mmol/l 
Resp rate =/> 30 per minute
Low systolic BP (<90)
Low diastolic BP (=/<60)
Age 65 or over
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

CURB65=2

Community acquired pneumonia

A

Amoxicillin 1g tds IV/PO 5 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

CURB65=4

Community acquired pneumonia

A

Co-amoxiclav IV + 1.2g tds + Doxycycline PO 100mg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

ICU patient
CURB65=5
Community acquired pneumonia

A

Co-amoxiclav IV + 1.2g tds + Clarithromycin IV 500mg

Then step down to doxycycline 100mg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Penicillin allergic
CURB65=1
Community acquired pneumonia

A

Doxycycline 200mg on day 1 (PO)

100mg od or clarithromycin id NBM

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

CURB65=4 Penicillin allergic NBM

Community acquired pneumonia

A

IV Levofloxacin 500mg td

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

CURB65=5 Penicillin allergic

Community acquired pneumonia

A

IV Levofloxacin 500mg td

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Hospital Acquired pneumonia CURB65=4

A

IV amoxicillin + Metronidazole + Gentamicin

Step down to PO co-trimoxazole + metronidazole (Total IV/PO 7 days)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Hospital Acquired pneumonia

CURB65=2

A

PO Amoxicillin + Metronidazole (5 days)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Hospital Acquired pneumonia
CURB65=2
Penicillin allergic

A

PO Co-trimoxazole+ Metronidazole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Hospital Acquired pneumonia
CURB65=5
Penicillin allergic

A

IV Co-trimoxazole + Metronidazole +/- Gentamicin

Total IV/PO 7 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Hospital Acquired pneumonia
CURB65=5
Previous ICU admission

A

Seek advice

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Hospital Acquired pneumonia
CURB65=5
Previous MRSA

A

Seek advice

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Acute exacerbation of COPD

Increased sputum purulence

A

1st line Amoxicillin 500mg tds

2nd line Doxycycline 200mg on day one then 100mg daily (5 days)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Acute exacerbation of COPD
No increased sputum purulence
Consolidation on CXR

A

1st line Amoxicillin 500mg tds

2nd line Doxycycline 200mg on day one then 100mg daily (5 days)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Acute Cough/ Bronchitis

76 frail

A

1st line amoxicillin 500mg tds

2nd line doxycycline 200mg on day one then 100mg daily (5 days)

17
Q

Endocarditis

A

Start empirical therapy and refer to ID/microbiology

18
Q

Native valve indolent (Subacute)

A

Amoxicillin IV 2g 4 hourly + Gentamicin 1mg/kg bd (use actual body weight - max 120mg/dose)

19
Q

Native valve severe sepsis (Acute)

A

Flucloxacillin IV 2g 6 hourly (4 hourly if >85kg)

20
Q

Prosthetic valve or Suspected MRSA

A

Vancomycin IV + Rifampicin PO 600mg bd + Gentamicin IV 1mg/kg bd (use actual body weight - max 120mg/dose)

21
Q

Native valve severe sepsis + risk factors for resistant pathogens (

A

Vancomycin IV + Meropenem IV 2g tds (requires ID/Micro approval)

22
Q

Clostridium Difficile Infection risk factors

A

History of recent (<3m) or current antibiotic use
• Prolonged recent hospital stay
• Use of PPI
• Increasing age especially > 65y
• Surgical procedure (in particular bowel procedures) • Immunosuppression

23
Q

What is the severity assessment for C.Diff?

A

One or more of the following severity markers:
Temperature > 38.5°C
Ileus, colonic dilatation >6cm on AXR/CT, toxic megacolon and/or pseudomembranous colitis
WCC >15 cells x 109L
Acute rising serum creatinine >1.5 x baseline
Has persisting CDI where the patient has remained symptomatic and toxin positive despote 2 courses of appropriate therapy

24
Q

How would you treat non-severe c.diff

A

Metronidazole PO 400mg tds (10days)

25
Q

How would you treat severe c diff?

A

Vancomycin 125mg qds PO/NG (10 days) +/- IV metronidazole

26
Q

How would you treat recurrent c diff?

A

Positive CDI in previous 8 weeks- seek help

27
Q

How would you treat peritonitis/biliary tract infections/ intraabdominal infections

A

IV amoxicillin + Metronidiazole + Gentamicin

then step down to PO Co-trimoxazole + metronidiazole

28
Q

Peritonitis

Penicillin Allergic

A

IV Vancomyicn + Metronidazole + Gentamicin (then step down to PO Co-trimoxazole + metronidazole)

29
Q

Acute Gastroenteritis

A

No antibiotic treatment required

30
Q

Pancreatitis

A

Antibiotics unlikely to affect outcome

31
Q

Proven severe spontaneous bacterial peritonitis

A

Piperacillin/Tazobactam IV 4.5g tds
then step down to Co-trimoxazole PO
(5 - 7 days)

32
Q

Proven Mild spontaneous bacterial peritonitis

A

(incidental diagnosis on routine tap):
Co-trimoxazole PO
(5 - 7 days)