Antibiotics In Infections

Question 1

Septic Arthritis treatment

• risk for gram -ve
• risk for MRSA

Answer 1

No other risk factors
o Flucloxacillin (Penicillase resistant B-lactam antibiotic specific for Staph aureus )
o If allergic Clindamycin

• Risk for Gram negatives
  o add 3rd generation cephalosporin eg. Cefuroxime
• Risk for MRSA
  o Vancomycin

Question 2

Open fracture antibiotics

1. grade 1 and 2
2. grade 3

Answer 2

Grade I and II
o 1st generation cephalosporin

Grade III
o 1st generation cephalosporin
o aminoglycoside traditionally recommended, but beware of nephrotoxicity in polytrauma
patients

With farm injury / bowel contamination
o add Penicillin for clostridia

Question 3

surgery prophylaxis

Answer 3

Cefazolin

longer half-life and higher serum concentration

First generation cephalosporins are routinely used as for prophylaxis in orthopaedic surgery as they are:
 cheap
 well tolerated with < 10% cross-reactivity with penicillin allergies
 gives good cover for the most likely organisms (Gram positive cocci, Staph aureus etc. )

Question 4

Vancomycin is the treatment of choice for…

Answer 4

Vancomycin is also the antibiotic of choice for the treatment of methicillin-resistant
Staphylococcus aureus and coagulase-negative Staphylococcus species.