Antibiotics

Question 1

How is croup treated?

Answer 1

1st line = single dose of oral dexamethosone, alternatives = oral prednisolone or nebulised budesonide to reduce severity. Nebulised adrenaline can be given in an emergency as it acts more quickly than steroids

Question 2

How is bronchiolitis managed?

Answer 2

Reassurance and observation, supplementary O2 if saturations are low, avoid overfeeding

Question 3

How is paediatric pneumonia managed?

Answer 3

Amoxicillin = 1st line (S. pneumoniae)
Co-amoxiclav (H. influenzae), erythromycin (mycoplasma pneumoniae), clarithromycin (allergy) are alternatives for 5 days

Question 4

How is acute epiglottitis managed?

Answer 4

DO NOT EXAMINE! Give oxygen, call the anaesthetist and ENT for intubation and airway management. Once they are stabilised, give IV ceftriaxone or dexamethosome

Question 5

How is an infective exacerbation of CF managed?

Answer 5

S. aureus - flucloxicillin
Pseudomonas aeruginosa - tobramycin, ciprofloxacin
H. influenzae - co amoxiclav

Question 6

How is paediatric gastroenteritis managed?

Answer 6

Isolate, oral rehydration therapy/IV fluids depending on tolerance of oral intake. Once fluid intake is tolerated, light foods can be started. Antibiotics or antiemetics aren’t recommended

Question 7

How are UTIs managed in children?

Answer 7

<3 months - urgent referral to a paediatrician, IV ceftriaxone, septic screen
>3m with an upper UTI - cephalexin, co-amoxiclav
>3m with a lower UTI - trimethoprim, nitro

Question 8

How is meningitis managed in children <3m?

Answer 8

Cefotaxime and amoxicillin to cover listeria. IV dexamethasone can also be given to reduce risk of long term complications (not if systemic disease!)

Question 9

How is meningitis managed in children >3m?

Answer 9

Ceftriaxone. IV dexamethasone can also be given to reduce risk of long term complications (not if systemic disease!)

Question 10

How is meningitis managed in the community?

Answer 10

IM benzylpenicillin and call an ambulance immediately

Question 11

How is viral HSV meningitis managed?

Answer 11

Aciclovir

Question 12

How are contacts of meningitis managed?

Answer 12

Ciprofloxacin

Question 13

How is encephalitis managed?

Answer 13

Aciclovir for HSV or VCZ encephalitis, and supportive treatment. Ganciclovir is used to treat cytomegalovirus.

Question 14

How is septic arthritis managed?

Answer 14

Flucloxicillin for 4-6 weeks (and rifampicin added in the first 2 weeks?)

Question 15

How is osteomyelitis managed

Answer 15

IV flucloxicillin for 6 weeks, with rifampicin added in the first 2 weeks

Question 16

How is MRSA treated?

Answer 16

Vancomycin

Question 17

How is periorbital cellulitis managed?

Answer 17

Fluids, analgesia, empirical co-amoxiclav for 7 days

Question 17

How is orbital cellulitis managed?

Answer 17

Fluids, analgesia, IV co-amoxiclav

Question 18

How is cellulitis managed?

Answer 18

Flucloxacillin for 5-7 days

Question 19

How is otitis media managed?

Answer 19

Often self resolving, regular analgesia, antibiotics can reduce pain but not length of illness - amoxicillin is first line

Question 20

How is measles managed?

Answer 20

Self resolving, antipyretics

Question 21

How is scarlet fever managed?

Answer 21

10 days PO penicillin V, supportive care (antipyretics, antihistamines like loratadine or cetirizine for itching)

Question 22

How is rubella managed?

Answer 22

Self limiting, NSAIDS for pain

Question 23

How is parvovirus B19 (slapped cheek) managed?

Answer 23

Self limiting, fluids, NSAIDS, antipyretics

Question 24

How is chicken pox managed?

Answer 24

Self limiting, calamine lotion can soothe itchiness, antipyretics, aciclovir if immunocompromised/neonates/risk of complications

Question 24

How is roseola infantum managed?

Answer 24

Self limiting, antipyretics, fluids

Question 25

How is diphtheria managed?

Answer 25

Single dose of antitoxin as soon as diphtheria is suspected, antibiotics (IM benzylpenicillin, oral erythromycin/other macrolide), respiratory and cardiac monitoring

Question 26

How is staphylococcal scalded skin syndrome treated?

Answer 26

IV antibiotics, management of fluid balance followed by a switch to oral abx. If severe, may require ITU. Pain relief and greasy moisturisers to stop sore skin sticking to clothes

Question 27

How is whooping cough managed?

Answer 27

Oral clarithromycin/azithromycin for 14 days if diagnosed within 21 days (doesn’t alter disease course but does reduce risk of spread)

Question 27

How is minor polio managed?

Answer 27

Oral rehydration, IV fluids if volume depletion is present, monitoring for acute flaccid paralysis or progression of paralytic poliomyelitis. If paralysed, physiotherapy and respiratory monitoring, vaccinations etc

Question 28

How is TB managed?

Answer 28

Rifampicin, isoniazid (full 6m), pyrazinamide ethambutol (first 2m)

Question 29

How is bullous impetigo managed?

Answer 29

Oral flucloxacillin

Question 30

How is non-bullous impetigo managed?

Answer 30

Antiseptic cream like hydrogen peroxide, and flucloxicillin if this fails. Avoiding spread with good hand hygiene, avoiding sharing towels/cutlery etc

Question 31

How is neonatal sepsis managed?

Answer 31

IV benzylpenicillin and gentamicin, oxygen, fluids

Question 32

What is the management for neonatal sepsis?

Answer 32

IV benzylpenicillin and gentamicin - CRP should be measured 18-24 hours after presentation to ensure they child is improving. Oxygen, fluids and electrolytes should also be given depending on the status of the baby.