Antibiotics

Question 1

Meningitis

>2m

<2m

Answer 1

• >2m
  
  • Third gen cephalosporin
  • Add vancomycin if MRSA suspected
• <2m
  
  • Ben pen + 3rd gen cephalosporin

Question 2

Orbital/periorbital cellulitis

Answer 2

• Orbital cellulitis
  
  • Flucloxacillin and third gen cephalosporin
  • Add metronidazole if not responding
• Periorbital cellulitis
  
  • Amoxyclav

Question 3

Diarrhoea ABx

Answer 3

• Salmonella only
• Third gen cephalosporin
• Only if isolated in infant < 3m or in immumocompromised

Question 4

UTI

>6m not sick

<6m or sick or acute pyelonephritis

Answer 4

• >6m not sick
  
  • Trimethoprim
• <6m or sick or acute pyelonephritis
  
  • Benpen + gentamicin IV 7.5mg/kg

Question 5

Resp

1. Epiglotitis
2. Otitis media
3. Pneumonia
4. Tonsilitis

Answer 5

1. Epiglotitis
   
   • Ceftriaxone
2. Otitis media
   
   • No antibiotics for 48 hours if > 6 months
   • Otherwise amoxycillin
3. Pnemonia
   
   • Mild = amoxycillin (outpatient)
   • Moderate = benpen (inpatient)
   • Severe = flucloxacillin + third gen cephalosporin
   • Consider adding Azithromycin for M. pneuomoniae and other atypicals
4. Tonsilitis
   
   • No antibiotics (particularly if < 4 years)
   • Or PenV oral

Question 6

Cellulitis

Necrotising fasciitis

Answer 6

• Cellulitis
  
  • Cephalexin - mild (outpatient)
  • Flucloxacillin - moderate-severe (inpatient)
• Necrotising fasciitis (GAS, Staph A, S. Pneu)
  
  • Vancomycin + meropenem + clindamycin
  • Consider IVIG

Question 7

Septicaemia

< 2m

> 2m

Answer 7

• Under 2 months
  
  • BenPen + third gen cephalosporin
  • If suspect abdominal source (not community acquired)
    
    • Amoxycillin + gentamicin + metronidazole
• Over 2 months
  
  • With unknown CSF
    
    • Flucloxacillin + third gen cephalosporin
  • Normal CSF
    
    • Flucloxacillin + third gentamicin
  • If neutropenic give Tazocin + amikacin