Antibiotics Flashcards
Adverse drug reaction
response to drug which is unintended and which occurs at doses normally used for prophylaxis or therapy - not allergic reaction
If you have a true penicillin allergy, you will not be able to take what other classes of antibiotics? (3)
cephalosporins,
carbapenems,
aztreonam,
all have beta lactam ring
CNS bacterial infection could be which of the following bugs: E.coli, H. influenzae, Strep pneumonia, s.aureus, c.difficile, legionella, s.epidermis
Strep pneumonia
Resp infection could be which of the following bugs: E.coli, H. influenzae, Strep pneumonia, s.aureus, c.difficile, legionella, s.epidermis
H. influenzae,
strep pneumonia,
legionella
Gut infection could be which of the following bugs: E.coli, H. influenzae, Strep pneumonia, s.aureus, c.difficile, legionella, s.epidermis
c.diff
Urinary infection could be which of the following bugs: E.coli, H. influenzae, Strep pneumonia, s.aureus, c.difficile, legionella, s.epidermis
E.coli
Skin infection could be which of the following bugs: E.coli, H. influenzae, Strep pneumonia, s.aureus, c.difficile, legionella, s.epidermis
S.aureus
Staph epidermis usually never really causes infection except for when?
When prosthetic material
What antibiotic for strep pneumonia in CNS?
a cephalosporin
OR,
amoxicillin at high dose
What antibiotic for haemophilus influenzae in lungs?
Mild: amoxicillin if allergic IV levofloxacin,
Severe: Co-amoxiclav + PO doxycycline, if allergic IV levofloxacin
What antibiotic for c.diff infection in gut?
1st line: oral vancomycin,
metronidazole if no vancomycin
What antibiotic for uncomplicated e.coli infection in urinary tract?
1st line nitrofurantoin,
2nd trimethoprim
What antibiotics for staph aureus
flucloxacillin
or doxycycline
UTI catheterised patient investigation
urine culture,
blood culture if seems septic,
UTI catheterised patient management (initial therapy with and w/o penicillin allergy, step down therapy)
currently IV amoxicillin & gentamicin,
Penicillin allergy: co-trimoxazole + gentamicin,
Step down therapy: PO co-trimoxazole
UTI catheterised patient improves with IV amoxicillin & gentamicin, e.coli report comes back resistant to amox. Why is step down therapy co-trimoxazole and not nitrofurantoin?
Nitrofurantoin is only active once concentrated in bladder, not effective in bloodstreem/kidneys so once complicated e.g. fever, sepsis, vomiting, flank pain then nitrofurantoin doesn’t work.
UTI catheterised patient improves with IV amoxicillin & gentamicin, e.coli report comes back resistant to amox. Why is step down therapy co-trimoxazole and not to continue IV gentamicin?
IV gentamicin carries risks of nephrotoxicity and ototoxicity,
Also IV carries risk of infection of staph aureus from cannula.
Coag negative Staph epidermidis treatment?
IV vancomycin (fluclox doesn’t work against coagulase negative staph)
Moraxella catarrhalis associated with who in CAP
COPD exacerbations in particular
Perforated diverticulum with signs of sepsis - pathogens & antibiotics
Pathogens: polmicrobial coliforms, anaerobes & eneteroccocci,
Antibiotics: IV amoxicillin + metronidazole + gentamicin
Profuse diarrhoea, abdo pain, vomiting. Recent treatment with co-amoxyclav for resistant UTI. Likely pathogen and antibiotics?
Pathogen: likely c.difficile after a 4c antibiotic,
Antibiotics: 1st line oral vancomycin, 2nd line metronidazole
Presentation RUQ pain, fevers, N&V. RUQ and positive murphy’s sign. Likely diagnosis, pathogen and antibiotics?
Diagnosis: cholangitis, cholecystitis
Likely pathogens: coliforms, anaerobes and enterococci,
Antibiotics: IV amoxicillin + metronidazole + gentamicin
Endocarditis native valve acute: bug and management
Staph aurues, take 2 sets blood cultures & start antibiotics within 1 hour, flucloxacillin IV
Endocarditis native valve subacute: bugs and management
Strep viridans, enterococci,
3 sets blood cultures 6 hours apart,
Amoxicillin IV + gentamicin
