Antibiotics

Question 1

Dose amoxicillin

Answer 1

Oral 1g tds

IV 1g tds

Question 2

Dose co-trimox

Answer 2

Oral and IV 960mg BD

Question 3

dose co amox

Answer 3

Oral 625mg TDS

IV 1.2g TDS

Question 4

dose clarithromycin

Answer 4

Oral and IV 500mg BD

Question 5

dose metronidazole

Answer 5

Oral 400mg TDS

IV 500mg TDS

Question 6

dose flucloxacillin

Answer 6

Oral and IV 1g QDS

Question 7

Abx meningitis

Answer 7

ceftriaxone IV 2g BD and dexamethasone 10mg QDS

Add Amoxicillin IV 2g 4hrly if >60 or immunocompromised

Question 8

Encephalitis Rx

Answer 8

Aciclovir IV 10mg/kg tds

Question 9

Abx epiglottitis/supraglottitis

Answer 9

Ceftriaxone IV 2g OD

Question 10

Abx CAP

Answer 10

0-2 = Amoxicillin 1g tds IV/PO
If pencillin allergic Doxy PO 200mg day 1 then 100mg OD or IV Clarithromycin if NBM. Total 5d
3-5 = Co-amox IV 1.2g tds and doxy PO 100mg BD
If penicillin allergic IV Levofloxacin 500mg BD
ICU/HDU or NBM co amox IV 1.2g tds + Clarithromycin IV 500mg bd. Total 7d.

Question 11

ABx HAP

Answer 11

non severe = PO amoxicillin 1g tds (PA - Doxy 100mg BD) for 5d
Severe = IV amoxicillin and gentamicin (PA - IV co-trimox + gent). Step down - PO cotrimox. Total 7d.

Question 12

Abx Aspiration pneumonia

Answer 12

Non severe = PO amox and metronidazole (PA doxy + met) total 5d
Severe = IV amox met and gent (PA replace amox with PO doxy or Iv clarithro)
Step down PO amox and met (PA doxy and met) Total 7d

Question 13

COPD exacerbation Abx

Answer 13

amoxicillin 500mg tds or
doxycycline 200mg day 1 then 100mg od
total 5d

Question 14

Native valve endocarditis (subacute) Abx

Answer 14

Amox IV 2g 4hrly + Gent 1mg/kg bd

Question 15

Native valve endocarditis acute sepsis abx

Answer 15

fluclox IV 2g 6hrly (4hrly if >85kg)

Question 16

Prosthetic valve endocarditis or suspected MRSA

Answer 16

Vanc IV and Gent IV 1mg/kg BD

Add rifampicin PO 600mg BD after therapeutic vanc dose reached

Question 17

C diff treatment

Answer 17

Non severe = metronidazole PO 400mg tds for 10d

Severe = vanc 125mg qds PO/NG +/- metronidazole for 10d

Question 18

Recurrent C diff

Answer 18

can try more vanc
fidaxomicin
faecal transplant

Question 19

intra abdo sepsis

Answer 19

iv amox met and gent
step down cotrimox and met
PA - iv vanc met gent
total 7d

Question 20

proven SBP

Answer 20

mild = cotrimox PO (incidental on tap)
severe - piperacillin/tazobactam IV 4.5g tds
then step down to cotrimox
5-7d

Question 21

complicated uti/pyelonephritis/urosepsis

Answer 21

IV amox and gent (PA IV cotrimox and gent)
step down cotrimox
total 7d

Question 22

uncomplicated female lower uti

Answer 22

nitrofurantoin 100mg MR BD or 50mg QDS
or trimethoprim 200mg BD
3d

Question 23

uncatheterised male uti

Answer 23

nitrofurantoin 100mg MR BD or 50mg QDS
or trimethoprim 200mg BD
7d

Question 24

acute bacterial prostatitis

epididymoorchitis

Answer 24

ofloxacin 400mg OD or ciprofloxacin 500mg BD
for 28d
Trimethoprim if high CDI risk

Question 25

cellulitis

Answer 25

fluclox 1g qds IV/po 7d

PA doxy 100mg bd PO

Question 26

diabetic foot infection

Answer 26

mild = fluclox 1g qds or doxy 100mg bd
moderate = fluclox 1g qds and met 400mg tds
or doxy 100mg bd + met

Question 27

open fracture prophylaxis

Answer 27

Iv coamox 1.2g tds

or iv cotrimox 960mg bd + met 500mg tds

Question 28

acute septic arthritis/osteomyelitis

Answer 28

IV fluclox 2g qds

Question 29

sepsis unknown origin

Answer 29

amox met gent

PA = vanc met gent

Question 30

indications to continue iv therapy

Answer 30

continuing sepsis - 2 of - temp (high or low), tachycardai, tachypnoea, WCC >12 or <4
febrile with neutropenia or immunosuppressed
specific infections need IV
no oral route available
IV antibiotic not on IVOST protocol
Post op not tolerate 1L fluids

Question 31

IVOST amox and gent

Answer 31

Cotrimox

Question 32

IVOST met

Answer 32

met 400mg TDS

Question 33

IVOST benzylpenicillin

Answer 33

Pen V 1g bd or 500mg qds

Question 34

IVOST co amox 1.2g

Answer 34

co amox 625mg tds

Question 35

IVOST co amox and doxy or clarithro

Answer 35

doxy 100mg bd

Question 36

IVOST levofloxacin

Answer 36

doxy 100mg bd

Question 37

drugs which stay the same IVOST

Answer 37

amox
clarithro
fluclox
cotrimox