Antibiotics guidelines 2020 updated

Question 1

Respiratory infections. State the appropriate antibiotic treatment
Exacerbation of chronic bronchitis [3]
Uncomplicated CAP [2]

Answer 1

Exacerbations of chronic bronchitis:

• Amoxicillin
• tetracycline eg doxy
• clarithromycin

Uncomplicated community-acquired pneumonia:

• Amoxicillin
• Doxycycline or clarithromycin in penicillin allergic

Question 2

Mx: Pneumonia possibly caused by atypical pathogens

Answer 2

Pneumonia possibly caused by atypical pathogens: Clarithromycin

Question 3

Mx: Hospital acquired pneumonia [4]

Answer 3

Within 5 days of admission: co-amoxiclav or cefuroxime

More than 5 days after admission: piperacillin with tazobactam

OR a broad-spectrum cephalosporin (e.g. ceftazidime)

OR a quinolone (e.g. ciprofloxacin)

Question 4

Urinary tract infections:
LUTI [3]
Acute pyelonephritis [2]

Answer 4

Lower urinary tract infection:

• Trimethoprim
• or nitrofurantoin
• Alternative: amoxicillin or cephalosporin

Acute pyelonephritis:

• Broad-spectrum cephalosporin
• or quinolone

Question 5

Urinary tract infections:

Acute prostatitis [2]

Answer 5

Quinolone or trimethoprim

Question 6

Skin infections: Impetigo mx

Answer 6

Topical fusidic acid, oral flucloxacillin or erythromycin if widespread

Question 7

Skin infections:
Cellulitis [2]
Cellulitis near the eyes or nose [2]

Answer 7

Cellulitis

• Flucloxacillin
• (clarithromycin, erythromycin or doxycycline if penicillin-allergic)

Near eyes or nose

• Co-amoxiclav
• (clarithromycin, + metronidazole if penicillin-allergic)

Question 8

Skin infections: erysipelas [2]

Answer 8

• Flucloxacillin*

- clarithromycin, erythromycin or doxycycline if penicillin-allergic)

Question 9

Skin infections: animal or human bite [2]

Answer 9

• Co-amoxiclav

- doxycycline + metronidazole if penicillin-allergic

Question 10

Skin infections: mastitis during breast feeding

Answer 10

Flucloxacillin

Question 11

ENT infections:

• Throat infections [2]
• Sinusitis [3]

Answer 11

Throat infections:

• Phenoxymethylpenicillin
• (erythromycin alone if penicillin-allergic)

Sinusitis

• Amoxicillin
• or doxycycline
• or erythromycin

Question 12

ENT infections:
Otitis media [2]
Otitis externa [2]

Answer 12

Otitis media:

• Amoxicillin
• (erythromycin if penicillin-allergic)

Otitis externa:

• Flucloxacillin
• (erythromycin if penicillin-allergic)

Question 13

GI infections:
Clostridium difficile [2]
Campylobacter 
Salmonella non-typhoid
Shigellosis

Answer 13

Clostridium difficile:

• First episode: metronidazole
• Second or subsequent episode of infection: vancomycin

Campylobacter enteritis: Clarithromycin

Salmonella (non-typhoid): Ciprofloxacin

Shigellosis: Ciprofloxacin