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Sepsis > Antibiotics > Flashcards

Antibiotics Flashcards

1
Q

Adverse drug reaction

A

response to drug which is unintended and which occurs at doses normally used for prophylaxis or therapy - not allergic reaction

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2
Q

If you have a true penicillin allergy, you will not be able to take what other classes of antibiotics? (3)

A

cephalosporins,
carbapenems,
aztreonam,
all have beta lactam ring

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3
Q 
CNS bacterial infection could be which of the following bugs: 
E.coli, 
H. influenzae, 
Strep pneumonia, 
s.aureus, 
c.difficile, 
legionella, 
s.epidermis
A

Strep pneumonia

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4
Q 
Resp infection could be which of the following bugs: 
E.coli, 
H. influenzae, 
Strep pneumonia, 
s.aureus, 
c.difficile, 
legionella, 
s.epidermis
A

H. influenzae,
strep pneumonia,
legionella

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5
Q 
Gut infection could be which of the following bugs:
E.coli, 
H. influenzae, 
Strep pneumonia, 
s.aureus, 
c.difficile, 
legionella, 
s.epidermis
A

c.diff

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6
Q 
Urinary infection could be which of the following bugs:
E.coli, 
H. influenzae, 
Strep pneumonia, 
s.aureus, 
c.difficile, 
legionella, 
s.epidermis
A

E.coli

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7
Q 
Skin infection could be which of the following bugs: 
E.coli, 
H. influenzae, 
Strep pneumonia, 
s.aureus, 
c.difficile, 
legionella, 
s.epidermis
A

S.aureus

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8
Q

Staph epidermis usually never really causes infection except for when?

A

When prosthetic material

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9
Q

What antibiotic for strep pneumonia in CNS?

A

a cephalosporin
OR,
amoxicillin at high dose

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10
Q

What antibiotic for haemophilus influenzae in lungs?

A

Mild: amoxicillin if allergic IV levofloxacin,
Severe: Co-amoxiclav + PO doxycycline, if allergic IV levofloxacin

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11
Q

What antibiotic for c.diff infection in gut?

A

1st line: oral vancomycin,

metronidazole if no vancomycin

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12
Q

What antibiotic for uncomplicated e.coli infection in urinary tract?

A

1st line nitrofurantoin,

2nd trimethoprim

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13
Q

What antibiotics for staph aureus

A

flucloxacillin

or doxycycline

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14
Q

UTI catheterised patient investigation

A

urine culture,

blood culture if seems septic,

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15
Q

UTI catheterised patient management (initial therapy with and w/o penicillin allergy, step down therapy)

A

currently IV amoxicillin & gentamicin,
Penicillin allergy: co-trimoxazole + gentamicin,
Step down therapy: PO co-trimoxazole

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16
Q

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?

A

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.

17
Q

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?

A

IV gentamicin carries risks of nephrotoxicity and ototoxicity,
Also IV carries risk of infection of staph aureus from cannula.

18
Q

Coag negative Staph epidermidis treatment?

A

IV vancomycin (fluclox doesn’t work against coagulase negative staph)

19
Q

Moraxella catarrhalis associated with who in CAP

A

COPD exacerbations in particular

20
Q

Perforated diverticulum with signs of sepsis - pathogens & antibiotics

A

Pathogens: polmicrobial coliforms, anaerobes & eneteroccocci,
Antibiotics: IV amoxicillin + metronidazole + gentamicin

21
Q

Profuse diarrhoea, abdo pain, vomiting. Recent treatment with co-amoxyclav for resistant UTI. Likely pathogen and antibiotics?

A

Pathogen: likely c.difficile after a 4c antibiotic,
Antibiotics: 1st line oral vancomycin, 2nd line metronidazole

22
Q

Presentation RUQ pain, fevers, N&V. RUQ and positive murphy’s sign. Likely diagnosis, pathogen and antibiotics?

A

Diagnosis: cholangitis, cholecystitis
Likely pathogens: coliforms, anaerobes and enterococci,
Antibiotics: IV amoxicillin + metronidazole + gentamicin

23
Q

Endocarditis native valve acute: bug and management

A

Staph aurues, take 2 sets blood cultures & start antibiotics within 1 hour, flucloxacillin IV

24
Q

Endocarditis native valve subacute: bugs and management

A

Strep viridans, enterococci,
3 sets blood cultures 6 hours apart,
Amoxicillin IV + gentamicin

25
Q

Prosthetic valve: bug & management

A

Coagulase negative staph: staph epidermidis,

Vancomycin IV & gentamicin

26
Q

Step down therapy for peritonitis/biliary tract/intra abdo infection?

A

Oral co-trimoxazole and metronidazole

27
Q

Gentamicin concern?

A

Nephrotoxicity

28
Q

Gentamicin management of concerns with using this drug?

A

Limit duration: 72 hours then approval required, only 24 hours if renal concern,
Monitor renal function daily

29
Q

Ciprofloxacin side effects? (4)

A

C.diff,
Tendonitis,
Interacts with epileptic drugs so lowers seizure threshold,
QT interval

Sepsis (8 decks)

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