Antibiotics Flashcards
One broad spectrum drug or multiple narrow spectrum drugs?
Multiple narrow spectrum drugs: to reduce resistance
Exceptions to multi narrow spectrum drug rule
- anaphylaxis to narrow spectrum
- met call, high risk e.g febrile neutropenia
- critically unwell
- medical contraindication
- if no other way to cover multiple potential causative organisms
Common staph infections
- cellulitis
- impetigo
Treatment for staph
Flucloxacillin
- comes in oral and IV
MRSA risk factors
- immunocompromised, hx of recurrent infections
- non response to fluclox
Principle before antibiotics
- specimen for suspected source of infection before first dose of antibiotics
Suspected organisms in recurrent infections
- often have same sensitivities as previous
Treatment for MRSA
- vancomycin: Iv (oral only in confirmed c. Diff)
- macrolide: erythromycin oral
- trimethoprim
Strep infection
- commensal in some in pharynx
- infects ent and lungs
Treatment of strep
Penicillin
- still very bactericidal for all types of strep.
- in oral and iv form
Treatment of tonsillitis
Oral penicillin = phenoxymethicillin or penicillin V
Iv = benzylpenicillin
CAP bugs
Most common: strep
> tx is penicillin
Next common: mycoplasma pneumoniae
> tx is doxycycline (oral), azithromycin (iv)
- tx on ward: benpen and doxycycline
- tx in community is amoxicillin: breaks narrow spectrum rule…
- tx for severe pneumonia: iv ceftriaxone and iv azithromycin - when unwell
