Antibiotic Use in the ED

Question 1

Abx’s which Inhibit nucleic acid synthesis and how:

Answer 1

Sulphonamides – inhibits dihydropteroate synthetase (pre-DHFR step)

Trimethoprim – inhibits dihydrofolate reductase (DHFR)

Quinolones – inhibit DNA gyrase

Nitroimidazoles – Nucleic acid analogues

Question 2

Abx’s which Inhibit cell wall synthesis:

Answer 2

Penicillins

Cephalosporins

Vancomycin

Question 3

Abx’s which Inhibit protein synthesis

Answer 3

Aminoglycosides

Tetracyclines

Macrolides

Chloramphenicol

Question 4

Every prescription needs…

Before prescribing, always assess for…

Answer 4

generic drug name, dose (including units), frequency, duration

medication allergies, warn about SE, and be aware of drug interactions

Question 5

Abx’s used for Meningitis

Community acquired?

Brain abscess? ceftriaxone 2g IV q12h +/- metronidazole 500mg IV q12h

Answer 5

Community acquired: ceftriaxone, +/- vancomycin, +/- ampicillin

**Brain abscess: ** ceftriaxone, +/- metronidazole

Question 6

Sinusitis

Abx for Acute?

Abx for Chronic?

Answer 6

Acute (<3 weeks): no ABX recommended

Chronic (>3 weeks): TMP-SMZ + amoxicillin/clavulanic acid, azithromycin, quinolone