Antimicrobial Therapy Flashcards
What is the most common cause of GI infection in the UK?
Campylobacter
What is the standard treatment of sepsis
Co-amoxiclav + gentamicin (broad spectrum)
What are platelet levels in sepsis?
Low
What scan would you use to see an (GI) abscess?
CT
How would you treat a large GI abscess e.g. from appendicitis?
1) Washout and drainage of pus and dead tissue in theatre
2) Send pus to lab to culture bacteria e.g. E.coli
3) Treat with antibiotics e.g. co-amoxiclav
What bacteria is a common cause of intra-abdominal sepsis?
E.coli
What infection has a 100% mortality if untreated?
Endocarditis
How do you treat with antibiotics?
Start with broad spectrum/empirical antibiotics and then narrow down the therapy after getting microbiology results
What should you write on a drug chart when giving an antibiotic?
Indication and stop date
How do you give antibiotics as part of surgical prophylaxis?
Only a few doses before, maybe during if long surgery and 48h after
What is a common antibiotic-associated infection?
C.difficile
What are the 3 possible results of antimicrobial susceptibility disc testing?
1) R = resistant
2) I = intermediate but mainly resistant
3) S = sensitive
What is MIC?
Minimum inhibitory concentration = the lowest concentration of the antibiotic being tested that inhibits growth of the organism in a broth
What is MBC?
Minimum bactericidal concentration = the lowest concentration of the antibiotic that kills the organism
What are the 7 main classes of antibiotics?
1) Beta lactams (penicillins, cephalosporins and carbapenems)
2) Macrolides
3) Tetracyclines
4) Trimethoprim and co-trimoxazole
5) Quinolones
6) Aminoglycosides
7) Glycopeptides
Why are cephalosporins used less now?
They are implicated in C difficile
What is the first line antibiotic in chest infection (gram negative)?
Amoxicillin
Which antibiotics are frequently given for UTIs?
- Cefalexin (cephalosporin)
- Trimethoprim
What type of bacteria is flucloxacillin commonly used again?
Staphylococcus
What are the 3 macrolides?
1) Clarithromycin
2) Erythromycin
3) Azithromycin
What are macrolides esp. clarithromycin used for?
Used in penicillin-allergic patients against gram positive bacteria (staphylococci or streptococci) in e.g. SSTIs, throat infections, atypical pneumonia
When are the tetracyclines used e.g. doxycycline?
- Penicillin allergic patients who suffer side effects with macrolides
- Broad spectrum
- Respiratory tract and SSTIs
- Atypical CAP
- Resistance is common
What is co-trimoxazole used for?
- Infections in immunocompromised patients e.g. prophylaxis and treatment of PJP
What are quinolones (ciprofloxacin) used for?
- Against gram-negative bacteria
- Newer ones more useful against gram-negative e.g. S.pneumoniae
