Antimicrobial prescribing Flashcards
Acute epididymitis >35 + low risk STI
Doxycyline 100mg BD 10-14 days
or
Ofloxacin 200mg BD 14 days
1st line antibiotic for pyelonephritis in a child
Oral cefalexin
Antibiotic for pyelonephritis in chid if sensitivity confirmed
Oral co-amoxiclav
1st line Lyme disease
Doxycycline 200mg OD 21 days
1st choice for persistent/severe sinusitis
Phenoxypenicillin QDS 5 days
1st choice for peristent/severe sinusitis if pen-allergic
Doxycycline/clarithromycin/erythromycin 5 days
Antibiotic treatment of sinusitis if systemically very unwell/high risk
Co-amoxiclav 5 days
Travel vaccinations available free on NHS
Cholera
Diphtheria, polio, tetanus booster
Hep A
Typhoid
Antimalarial to avoid in history of depression
Mefloquine
Antimalarial taken weekly
Mefloquine
Antimalarials CI in epilepsy
Mefloquine
Chloroquine
1st line for UTI in pregnancy
Nitrofurantoin 100mg BD 7 days (avoid at term)
2nd line for UTI in pregnancy
Amoxicillin if known sensitive 7 days /
Cefalexin 7 days
1st line for cellulitis
Flucloxacillin 500mg QDS 5-7 days
Alternative for cellulitis
Clarithromycin / Erythromycin / Doxycyline 5-7 days
/co-amox in child
1st line for cellulitis on face
Co-amoxiclav 7 days
Cellulitis on face - pen-allergic adult
Clarithromycin + metronidazole 7 days
1st line gonorrhoea
Refer GUM
IM Ceftriaxone 1g stat
Gonorrhoea - only if known to be sensitive
Refer GUM
Ciprofloxacin 500mg stat
Mycoplasma pneumonia features
Worsening flu-like + dry cough
Bilateral changes CXR
Erythema multiforme
Haemolytic anaemia
Which young people are eligible for annual flu vaccine (August 2021)
All children aged 2-15
6m-2y in clinical risk group
Potential Lyme disease + history of erythema migrans
Treat with Doxycyline/amoxicillin
1st line management of Lyme disease
Doxycyline 100mg BD 21 days
Alternative antibiotic for Lyme disease
Amoxicillin 1g TDS 21 days
Potential Lyme disease - No history of erythema migrans
Borrelia ELISA
Potential Lyme disease - No history of erythema migrans, ELISA negative
Repeat ELISA 4-6 weeks
Potential Lyme disease - no EM, ELISA negative x2 at 12 weeks (or equivocal)
Immunoblot
Acute otitis externa - 1st line
Analgesia, localised heat
Acute otitis externa - 2nd line
Acetic acid 2% spray TDS 7 days
Neomycin + steroid drops TDS 7-14 days
Acute otitis externa - cellulitis/extends beyond ear canal/systemic upset
Flucloxacillin 250-500mg QDS
Refer exclude malignant otitis externa
1st line for PID
Ceftriaxone 1g IM stat + metronidazole 400mg BD 14 days + doxycycline 100mg BD 14 days
2nd line for PID
Metronidazole 400mg BD 14 days + ofloxacin 400mg BD 14 days
or
Moxifloxacin 400mg OD 14 days
1st line for TV
Metronidazole 400mg BD 5-7 days / 2g stat
Live attenuated vaccines
BCG MMR Intranasal flu Oral rotavirus Oral polio Oral typhoid Yellow fever
1st episode genital herpes (within 5 days of onset + new lesions/systemic symptoms)
Aciclovir 400mg TDS
Valaciclovir 500mg BD
Famciclovir 250mg TDS
5 days
Herpes suppressive therapy (>6 per year)
Aciclovir 400mg BD
Aciclovir 200mg QDS
Famciclovir
Valaciclovir
Tropical disease - ulcerating skin lesion -> mucosal involvement
Leishmaniasis brasiliensis
Dengue presentation
Fever Retro-orbital headache Flushing Maculopapular rash Low PLT
1st line chlamydia
Doxycyline 100mg BD 7 days
2nd line chlamydia
Azithromycin 1g stat + 500mg OD 2 days
Farmer: small papule on hand ->2cm, flat-topped + haemorrhagic
Orf
Side effect of Atovaquone+proguanil (malarone)
GI upset
Side effect of Chloroquine anti-malarial
Headache
Side effects of Mefloquine (Lariam)
Dizziness
Neurospyschiatric
Lower seizure threshold
1st line antibiotic for acute prostatitis
Ciprofloxacin 500mg BD
Ofloxacin 200mg BD
Review after 14 days
Alternate 1st line antibiotic for acute prostatitis - if other CI
Trimethoprim 200mg BD
Review after 14 days
2nd line antibiotics for acute prostatitis
Levofloxacin
Co-trimoxazole
Review after 14 days
Farmer: Headache, fever, myalgia, subconjunctival haemorrhage, AKI
Leptospirosis
Chancroid
Painful genital ulcer
Unilateral painful LN
Recent travel
Flu -treatment for at-risk patients (prophylaxis in care home/symptom onset)
Oseltamivir 75mg BD 5 days
1st choice antibiotic for AOM
Amoxicillin 5-7 days
1st choice antibiotic for AOM - if pen-allergic
Clairthomycin / erythromycin 5-7 days
2nd choice antibiotic for AOM
Co-amoxiclav 5-7 days
Acute infective exacerbation COPD - 1st choice
Amoxicillin
Doxycyline
Clarithromycin
5 days
Acute infective exacerbation COPD - high risk of treatment failure
Co-amoxiclav
Co-trimoxazole
Levofloxacin
5 days
1st line for CAP (low severity: 0/1)
Amoxicillin 500mg TDS 5 days
Alternatives for CAP (low severity: 0/1)
Doxyxcyline, clarithromycin, Erythromycin
1st line for CAP (moderate severity in adult: 1/2)
Amoxicillin
(+ clarithromycin/erythromcyin if atypical)
5 days
1st line for high-severity CAP adults/children (3/4/5)
Co-amoxiclav
(+ clarithyromycin/erythromycin if atypical)
5 days
1st line for HAP
Co-amoxiclav 5 days + review