Antibiotics Flashcards
Meningitis prophylaxis for close contacts? (7 days)
Ciprofloxacin (single dose)
Chlamydia (and in pregnancy)
Doxycycline (7 days)
(azithyromycin in pregnancy)
Gonorrhoea
IM ceftriaxone (single dose)
(If sensitivities are known = ciprofloxacin
Meningitis? (3mnths and above)
<3mnths - cefotaxime (sheff accept for all)
>3mnths - ceftriaxone
UTI (complicated)
All males + pregnant females + catheterised.
=> Cefalexin (7 days)
UTI (uncomplicated)
All females (not pregnant)
=> Nitrofurantoin / trimethoprim (3 days)
Contraindication for nitrofurantoin?
Avoid inthird trimester- risk ofneonatal haemolysis.
Contraindication for trimethoprim?
Avoid in first trimester -folate antagonist.
It is not known to be harmful later in pregnancy but is generally avoided unless necessary.
Treatment for upper UTI?
Cefalexinandco-amoxiclav - for 7-10 days
Inpregnant women, cefalexin is the first-line oral antibiotic, and cefuroxime is the first-line IV antibiotic.
Sepsis 6?
Serum lactate, blood cultures, urine output monitoring, oxygen, empirical broad-spectrum antibiotics & IV fluids
H.pylori
Amoxicillin, clarithromycin + PPI (omeprazole)
Change amoxicillin to metronidazole if there is a penicillin/B lactam allergy
Treatment for Impetigo
Flucloxacillin
(or clarithromycin in penicillin allergy)
Caused by S.aureus
C.difficile?
- oral vancomycin
- IV metronidazole
Cellulitis?
Flucloxacillin (S.pyogenes)
MRSA (S.aureus)
Resistant to methicillin/flucloxacillin
=> use VANCOMYCIN
Mild CAP treatment?
(SCORE 0-1 ON CURB-65)
5 days of oral antibiotics:
- Amoxicillin
(clarithromycin - in penicillin allergy)
- Doxycycline
Moderate CAP treatment?
(SCORE 2 ON CURB-65)
Amoxicillin plus clarithromycin
IV antibioticsand stepped down to oral antibiotics as the condition improves.
Respiratory support(oxygen or intubation and ventilation)
PCP in HIV patients?
Pneumocystis jiroveciipneumonia (PCP), afungal pneumonia, occurs inimmunocompromisedpatients
- DRY COUGH WITHOUT SPUTUM PRODUCTION
- SOB
- NIGHT SWEATS
=> Co-trimoxazole(trimethoprim/sulfamethoxazole) treats PCP
Patients with a low CD4 count are prescribedprophylactic co-trimoxazole to protect against PCP
Giardiasis?
Metronidazole 5-7 days
infection caused by the protozoan Giardia lamblia
UNITS OF ALCOHOL equation
(% strength) x (amount of liquid in L)
How many grams of pure alcohol are in 1 UNIT OF ALCOHOL?
1 unit = 8g pure alcohol
How many calories in alcohol?
7 CALORIES (per gram)
Acute otitis media?
Amoxicillinfor 5-7 days (first-line)
Co-amoxiclavis a second-line option if the infection is not responding to amoxicillin.
- Clarithromycin(if penicillin allergic)
- Erythromycin(in pregnant women allergic to penicillin)
Treatment for strep throat (group A strep - S pyogenes)
Amoxicillin (or clarithromycin in penicillin allergy)
Whooping cough treatment
Clarithromycin
(bordatella pertussis)
Treatment of atypical pneumonia? i.e. legionella
Macrolide –> clarithromycin
Treatment for PCP pneumonia? (HIV - pneumocystis jirovecii)
Co-trimoxazole
(combination of trimethoprim and sulphamethoxazole which have anti-fungal activity against P. jirovecii in addition to antibacterial action
Moderate vs SEVERE CAP treatment?
MODERATE:
IV or PO - Amoxicillin, plus clarithromycin
SEVERE:
IV co-amoxiclav, plus clarithromycin
(broad spectrum cover!!)
Treatment of atypical pneumonia? (general options)
The so called ‘atypical’ pathogens that can cause pneumonia are not sensitive to amoxicillin and must be treated with macrolides (erythromycin, clarythromicin), fluoroquinolones (ciprofloxacin, levofloxacin) or tetracyclines (doxycycline). In the case of Legionella the first line is clarythromycin.
Severe CAP treatment?
3+ score on CURB-65
Co-axoxiclav, plus clarithromycin
