Antibiotics Passmed 2023

Question 1

Exacerbations of chronic bronchitis

Answer 1

Amoxicillin or tetracycline or clarithromycin

Question 2

Uncomplicated community-acquired pneumonia

Answer 2

Amoxicillin (Doxycycline or clarithromycin in penicillin allergic, add flucloxacillin if staphylococci suspected e.g. In influenza)

Question 3

Pneumonia possibly caused by atypical pathogens

Answer 3

Clarithromycin

Question 4

Hospital-acquired pneumonia

Answer 4

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 5

Lower urinary tract infection

Answer 5

Trimethoprim or nitrofurantoin. Alternative: amoxicillin or cephalosporin

Question 6

Acute pyelonephritis

Answer 6

Broad-spectrum cephalosporin or quinolone (i.e. cefalexin or ciprofloxacin: BNF)

Question 7

Acute prostatitis

Answer 7

Quinolone or trimethoprim

Question 8

Impetigo

Answer 8

Topical hydrogen peroxide, oral flucloxacillin or erythromycin if widespread

Question 9

Cellulitis

Answer 9

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

Question 10

Cellulitis (near the eyes or nose)

Answer 10

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

Question 11

Erysipelas

Answer 11

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

*phenoxymethylpenicillin was previously the recommended antibiotic until the 2019 NICE guidelines

Question 12

Animal or human bite

Answer 12

Co-amoxiclav (doxycycline + metronidazole if penicillin-allergic)

Question 13

Mastitis during breast-feeding

Answer 13

Flucloxacillin

Question 14

Throat infections

Answer 14

Phenoxymethylpenicillin (erythromycin alone if penicillin-allergic)

Question 15

Sinusitis

Answer 15

Phenoxymethylpenicillin

Question 16

Otitis media

Answer 16

Amoxicillin (erythromycin if penicillin-allergic)

Question 17

Otitis externa**

Answer 17

Flucloxacillin (erythromycin if penicillin-allergic)

**a combined topical antibiotic and corticosteroid is generally used for mild/moderate cases of otitis externa e.g. ciprofloxacin + dexamethasone.

2% acetic acid can be used for very mild otits externa

Malignant otitis externa: IV pseudomonal cover e.g. ciprofloxacin, meropenem,

Question 18

Periapical or periodontal abscess

Answer 18

Amoxicillin

Question 19

Gingivitis: acute necrotising ulcerative

Answer 19

Metronidazole

Question 20

Gonorrhoea

Answer 20

Intramuscular ceftriaxone

Question 21

Chlamydia

Answer 21

Doxycycline or azithromycin

Question 22

Pelvic inflammatory disease

Answer 22

Oral ofloxacin + oral metronidazole or intramuscular ceftriaxone + oral doxycycline + oral metronidazole

Question 23

Syphilis

Answer 23

Benzathine benzylpenicillin or doxycycline or erythromycin

Question 24

Bacterial vaginosis

Answer 24

Oral or topical metronidazole or topical clindamycin

Question 25

Clostridioides difficile

Answer 25

First episode: oral vancomycin Second or subsequent episode of infection: oral fidaxomicin

Question 26

Campylobacter enteritis

Answer 26

Clarithromycin

Question 27

Salmonella (non-typhoid)

Answer 27

Ciprofloxacin

Question 28

Shigellosis

Answer 28

Ciprofloxacin