Antibiotics 3 Flashcards
What are the possible bacterial causes of:
Purulent discharge from urethra.
Dysuria
?
Chlamydia trachomatis
Neisseria gonorrhoeae
Mycoplasma genitalum
What are the possible investigations for STDs?
Mid Stream Urine
First Void Urine for PCR testing
Urethral swap of discharge
Which antibiotics are neisseria gonnorrhoeae commonly resistant to?
Resistance is now widespread to:
Amoxycillin, penicillin
1st and 2nd gen cephalosporins
Tetracyclines
Quinolones
How is neisseria gonnorhea treated?
Empirical mostly and guided by lab susceptibility testing.
What must be considered when treating neisseria gonnorrhoaea?
Considering whether
infection was acquired locally or overseas.
In metro or country area
What is used for neisseria gonorrhoeae in rural and remote areas?
Amoxycillin and probenicid (because multiresistance is not common here)
What is used for neisseria gonorrhoeae in metro areas?
Ciproflaxacin was used in the past but due to quinolone resistance the empirical choice is to use IMI ceftriaxone
What treatments are used for gono+C.tracho?
If lab tests not available: both ceftriaxone + azithromycin
If PCR tests available:
po azithromycin single dose and IMI ceftriaxone
How are macrolides used for Chlamydia trachomatis?
Commonly used as single dose treatment (1 gm)
What are some examples of macrolides?
Erythromycin
Roxithromycin
Clarithromycin
Azithromycin (used for chlamydia)
What other uses are macrolides used for?
“atypical” pneumonia
Enteric infections
Typhoid fever
What was previous treatment for chlamydia trachomatis infection?
Doxycycline twice daily for 7 days
Why don’t beta lactams work against atypical pneumoniaeae causes?
They don’t have large cell walls (gram negative)
They could be viral causes
What should be used for atypical pneumonia if beta-lactams don’t work?
Azithromycin (a macrolide)
What are likely pathogens that cause ulceration of foot?
Enterobacteriaceae
Pseudomonas aeruginosa
Staph aureus
Beta-haemolytic streps
Alpha-haemolytic streps
Peptococcus species
Peptostreptococcus species
What antibiotics are used to treat early diabetic foot infections?
Augmentum (Gram pos staph/strep)
Clindamycin + ciprofloxacin
Cephalexin (1st gen cephalosporin) + Metronidazole
What is augmentin good for treating?
Enterobacteriaceae
Not P.aeruginosa
Anaerobes
What is clindamycin good for treating?
Gram positive
anaerobes
What is ciprofloxacin good for treating?
Broad gram negative
Including susceptible P. aeruginosa
What antibiotics are used to treat diabetic foot infections that have gone deeper or reached the bone?
Tazocin IV (piperacillin + tazobactam)
Meropenem IV (a carbapenem)
What is metronidazole good for treating?
Only active against anaerobes
What is the best of the anaerobic antibiotics?
Metronidazole
What is tazocin IV good for treating?
Enterobacteriaceae
Susceptible P. aeruginosa
Gram Pos
Anaerobes
What is meropenem IV used for?
It is very broad spectrum
used for gram pos, gram neg, and anaerobes
