Antibiotics

Question 1

Which antibiotics should be avoided in a penicillin allergy?

Answer 1

Penicillins
Cephalosporins (eg ceftraixone)
Carbapenems (meropenem)

Question 2

Which is the antibiotic of choice for a mild community acquired pneumonia in a penicillin allergic patient?

Answer 2

Oral as mild
Avoid penicillins and cephalosporins
Erythromycin/clarithromycin (macrolide)
Clarithro better as less nausea and only BD

Question 3

Which 3 antibiotics should be used for exacerbations of chronic bronchitis?

Answer 3

Amoxicillin, clarithromycin or tetracycline

Question 4

Which abx is recommended in CAP?

Answer 4

Amoxicillin (fluclox to eradicate staph if superimposed on flu)
Eythromycin/clari if pen allergic

Question 5

Which abx is recommended in atypical pneumonia?

Answer 5

Clarithromycin (macrolide)

Question 6

Which abx are recommended in HAP?

Answer 6

<5 days of admission: co-amoxiclav or cefuroxime
>5 days after admission: piperacillin with tazobactam OR a broad-spectrum cephalosporin (e.g. ceftazidime) OR a quinolone (e.g. ciprofloxacin)

Question 7

Name 2 abx recommended for lower UTI

Answer 7

Nitrofurantoin or

Trimethoprim

Question 8

Name 2 abx recommended for pyelonephritis

Answer 8

Broad spectrum cephalosporin (caftazidime) or

Quinolone (ciprofloxacin)

Question 9

Treatment of acute prostatitis

Answer 9

Quinolone (cipro) or

Trimethoprim

Question 10

Recommended treatment of impetigo

Answer 10

Fusidic acid (topical)
If widespread, oral flucloxicillin/erythromycin

Question 11

Recommended treatment of cellulitis

Answer 11

Flucloxicillin

Clarithromycin if pen allergic

Question 12

Recommended treatment of animal/human bites

Answer 12

Co-amoxiclav

doxycyline+metronidazole if pen allergic

Question 13

Recommended treatment of mastitis

Answer 13

Flucloxicillin

Question 14

Recommended treatment of throat infections

Answer 14

Penicillin V (phenoxymethylpenicillin)
erythromycin if pen allergic

Question 15

Recommended treatment of sinusitis/otitis media

Answer 15

Amoxicillin (erythro)

Question 16

Recommended treatment of otitis externa

Answer 16

Flucloxicillin (erythro)

Question 17

Peridontal abscess treatment

Answer 17

Amoxicillin

Ulcerating/necrotising Metronidazole

Question 18

Recommended treatment of gonorrhoea

Answer 18

IM ceftriaxone + oral azithromycin (macrolide)

Question 19

Recommended treatment of chlamydia

Answer 19

Doxycycline (tetracycline) or azithromycin (macrolide)

Question 20

Recommended treatment of PID

Answer 20

Ofloxacin (quinolone) + metronidazole OR
IM ceftriaxone (cephalosporin) + metronidazole + doxycycline (tetracycline)

Question 21

Recommended treatment of syphilis

Answer 21

Benzathine penicillin or doxycycline (tetracycline) or erythromycin (macrolide)

Question 22

Recommended treatment of BV

Answer 22

Oral/topical metronidazole or topical clindamycin

Question 23

Treatment of 1st episode of C diff

Answer 23

Metronidazole

Question 24

Treatment of recurring C diff

Answer 24

Vancomycin (glycopeptide)

Question 25

Treatment of campylobacter enteritis

Answer 25

Clarithromycin (macrolide)

Question 26

Treatment of salmonella

Answer 26

Ciprofloxacin (quinolone)

Question 27

Treatment of Shigellosis

Answer 27

Ciprofloxacin (quinolone)

Question 28

Which antibiotics are most likely to cause C diff?

Answer 28

``` Broad spectrum Cephalosporins most likely Penicillins Clindamycin Quinolones (ciprofloxacin) ```

Question 29

Treatment of C diff

Answer 29

1st line oral metronidazole for 10-14days 2nd line/if severe oral vancomycin Life threatening IV metro + vanc

Question 30

Main SE of metronidazole (and class)

Answer 30

Nitromidazole Peripheral neuropathy Interacts with alcohol

Question 31

Which abx should be avoided in pts taking statins? Why?

Answer 31

Clarithromycin | P450 enzyme inhibition, increases risk of rhabdomyolysis

Question 32

What abx is used prophylactically in sickle cell disease?

Answer 32

Phenoixymethylpenicillin | erythromycin if pen allergic

Question 33

How is blepharitis treated if simple hygiene methods fail?

Answer 33

Chloramphenicol 1% eye drops

Question 34

When should quinolones be prescribed with caution?

Answer 34

Epilepsy | Children (arthropathy)

Question 35

1st line treatment of meningitis in 20yr old

Answer 35

Cefotaxime Aciclovir Dexamethasone

Question 36

Which abx is linked with steven-johnson syndrome?

Answer 36

Sulfamethoxazole (co-trimoxazole) | All sulfonamides

Question 37

Which abx is linked with peripheral neuropathy?

Answer 37

Metronidazole

Question 38

What is the early treatment of Lyme's disease?

Answer 38

Doxycycline

Question 39

Management of neutropenic sepsis

Answer 39

Immediately start piperacillin with tazobactam (Tazocin)

Question 40

Management for an MRSA carrier?

Answer 40

Nasal mupirocin | Chlorhexidine for the skin

Question 41

Which antibiotic reacts with alcohol?

Answer 41

Metronidazole