BACTERIAL INFECTIONS Flashcards
1
Q
What is 1st line abx for c. diff?
A
ORAL vancomycin for 10 days
2
Q
What is 2st line abx for c. diff?
A
oral Fidaxomicin
3
Q
How is vancomycin monitored?
A
Initial doses should be based on body-weight
After -based on levels
Taken 2nd day treatment
4
Q
What is vanc level?
A
Trough levels
10–20 mg/litre
15-20 (cover susceptible pathogens)
5
Q
What are 3 risk factors that can increase risk of c. diff?
A
Elderly
PPI
Hospitals
6
Q
What 4 abx can cause c. diff?
A
Clindamycin
Quinolones
Penicillin (amox, ampicillin)
3rd/4th gen cephalosporins
7
Q
What abx to give for further episode of c. diff which lasts less than 12 weeks?
A
Fidoxomicin
8
Q
What abx to give for further episode of c. diff which lasts MORE than 12 weeks?
A
Fidoxomicin OR oral vanc
9
Q
What abx to give in life threatening c diff?
A
Oral vanc + IV metronidazole
10
Q
What 4 pathogens are endocarditis caused by?
A
HACEK. staphylococci, streptococci, enterococci
11
Q
What is 1st line treatment for endocarditis if native valve?
A
Blind therapy-
if native valve - amoxicillin or ampicillin
+/- low dose of gentamicin
12
Q
What is 1st line treatment for endocarditis if penicillin allergy?
A
If penicillin-allergic, or if MRSA suspected, or severe sepsis,
–> vancomycin + low-dose gentamicin
13
Q
What is 1st line abx treatment if prosthetic valve affected by endocarditis?
A
Vancomycin + rifampicin
+ LOW dose gentamicin
14
Q
What abx to give if endocarditis caused by MRSA?
A
Vancomycin
15
Q
What abx to give if endocarditis caused by staphylococci?
A
Flucloxacillin
16
Q
What abx to give if endocarditis caused by streptococci?
A
Benzylpenicillin
17
Q
What are causative agents of cough + pneumonia?
A
S pneumoniae
H influenzae
18
Q
What is 1st line abx for low severity CAP infection?
A
Amox 500- 1g TDS
5 days
19
Q
What is 1st line abx for LOW or moderate severity respiratory infection if PENICILLIN ALLERGY?
A
Either:
Clarithromycin/ doxycycline or erythromycin (preg)
20
Q
What is 1st line abx for moderate severity CAP infections?
A
Amoxicillin
21
Q
What is 1st line abx for HIGH severity CAP infection?
A
Co-amoxiclav + clarithromycin
OR
erythromycin (pregnant)
22
Q
What is 2nd line abx for HIGH severity CAP infection if PENICILLIN allergy?
A
Levofloxacin
23
Q
What is 1st line abx for respiratory infection at hospital- non severe + not at higher risk of resistance?
A
Co amoxiclav
24
Q
What is 1st line abx for respiratory infection at hospital- non severe + not at higher risk of resistance IF ALLERGY?
A
Doxy or
Cefalexin
25
What 2 abx are added if respiratory infection caused by atypical abx?
Clarithromycin or Doxycycline
26
What is causative agent of meningitis?
N meningitidis
Strep. P
27
What is 1st line abx for meningitis?
Benzylpenicillin
28
What is 1st line abx for meningitis if penicillin allergy?
Cefotaxime
29
What is 1st line abx for meningitis if immediate hypersensitivity to penicillins or cephalosporins?
Chloramphenicol
30
What is the cause of impetigo or cellulitis?
Staph Aureus
31
What is 1st line treatment for local non- bullous impetigo?
1. Hydrogen peroxide cream
2. Fusidic acid (if above unsuitable)
32
What treatment to give if impetigo is resistant?
Mupirocin
33
What is 1st line treatment for widespread non-bullous impetigo?
flucloxacillin
OR
Fusidic acid
34
What is 1st line treatment for bullous + non bullous if HIGH RISK?
Flucloxacillin
35
What is 1st line treatment for bullous + non bullous if HIGH RISK + penicillin allergy?
Clarithromycin OR erythromycin
36
What is 1st line abx treatment for cellulitis?
Flucloxicillin ORAL/ IV
37
What is abx treatment for cellulitis if flucloxicillin unsuitable but not due to allergy?
Co- amoxiclav or doxycycline
38
What is 1st line abx treatment for cellulitis near eyes/nose?
Co-amoxiclav ORAL/iv
39
What is 1st line abx treatment for cellulitis near eyes/nose + penicillin allergy?
Clarithromycin + metronidazole
40
What is 1st line abx treatment for animal/human BITES?
Co-amoxiclav oral/ IV - 5 days treatment
41
What is 2nd line abxs for animal or human bites?
Doxy (broad) + metro (anaerobic)
42
What is duration of prophylaxis for animal bites?
3 days
43
What is 1st line abx for animal scratches?
Flucloxacillin
44
What is 1st line abx for lyme disease?
doxycycline
45
What is 2nd line abx + dose for lyme disease?
Amoxicillin 1000mg TDS - 21 days
46
What is doxycycline dose + duration for lyme disease?
doxycycline 100mg BD
21 days
47
What is diabetic foot infection 1st line abx if not severe?
flucloxacillin
pen allergy - clarit/ erythro/ doxy
48
What is diabetic foot infection 1st line abx if severe with abcess or osteomyelitis?
flucloxacillin OR co-amox + gentamicin
49
What is diabetic foot infection 1st line abx if severe with abcess or osteomyelitis if penicillin allergy?
co-trimoxazole + gentamicin
50
What is 1st line abx as standby for traveller's diarrhoea?
azithromycin
51
What is treatment for traveller's diarrhoea?
bismuth subsalicylate
52
What are 2 musculoskeletal infections?
Osteomyelitis
Septic arthritis
53
What is 1st line abx treatment for musculoskeletal infections e.g. Osteomyelitis?
Flucloxacillin
54
What is given as 1st line for Osteomyelitis if penicillin allergy?
Clindamycin
55
What is given as 1st line for Osteomyelitis if MRSA suspected?
Vancomycin
56
What to add on with fluclox to patient if they have had osteomyelitis?
Think of adding:
Fusidic acid or rifampicin for initial 2 weeks.
total duration 6 weeks
57
What to give to patient if they have had septic arthritis caused by gram -ve bacteria or gonococcal arthritis?
Cefotaxime OR ceftriaxone
for
4-6 weeks
58
What type of bacteria cause dental infections?
Anaerobes
59
What are 5 examples of dental infections?
Gingivitis (ANUG)
Periapical abscess
Periodontal abscess
Periodontitis
Pericoronitis
60
What is 1st line treatment for Pericoronitis/ANUG ?
Metronidazole 400-500mg TDS
61
How long is abx treatment for Pericoronitis/ANUG?
3 days
62
What is 2nd line abx treatment for Pericoronitis/ANUG ?
Amoxicillin
63
What is 1st line abx treatment for periapical periodontal abscess?
phenoxymethylpenicillin OR
Amoxicillin
64
What is alternative abx treatment for periapical periodontal abscess if penicillin allergy?
clarithromycin
65
What is abx add on-treatment for periapical periodontal abscess if sign of infection spreading?
Add in metronidazole
66
What is otitis externa causes? (2)
Staph Aureus
Pseudonomas aeruginosa
67
What is otitis media cause (3)?
H. influenza
S. pneumoniae or S. pyogenes
68
What is sinusitis cause?
S. pneumoniae
S. aureus
H influenza
69
What is 1 causative agent of sore throat?
S. pyogenes
70
What is 1st line abx otitis externa if systemically unwell?
Flucloxacillin
71
What is 1st line treatment for otitis externa?
acetic acid - earcalm
72
What is 2nd line treatment for otitis externa?
Topical neomycin sulfate with steroid
73
What is abx tx for otitis externa if penicillin allergy?
Clarithro
Erythro (preg) OR azithro
74
What is 2 options of abx tx for otitis externa if PSEUDOMONAS suspected?
Cipro
Aminoglycosides
75
What is 1st line for otitis media?
Amoxicillin OR
co- amoxiclav (after 2-3 days of above not working)
76
What is 1st line for sinusitis?
Phenoxymethylpenicillin OR
co-amoxiclav
77
What is 1st line for sore throat?
Phenoxymethylpenicillin
78
What is duration of tx for sore throat with 1st line abx?
5-10 DAYS
79
What is duration of tx for sore throat with 2nd line abx- penicillin allergy?
clarithro - 5 days
80
What are 3 scarlet fever symptoms?
Flu like - high temp, swollen glands
rash - small, raised bumps
white coating tongue
81
What is chlamydia causative agent?
C. trechomatis
82
What is causative agent of UTI?
E coli
83
What is 1st line tx for chlamydia?
Doxycycline
84
What is alternative tx for chlamydia?
Azithromycin
85
What is azithromycin dose for chlamydia tx (alternative opt)?
1 g OD for 1 day,
then 500 mg once daily for 2 days.
86
What is 1st line abx tx for bacterial vaginosis?
Oral metronidazole
87
What is metronidazole dose in bacterial vaginosis options?
metronidazole 2g single dose
OR
400-500mg BD for 5 to 7 days
88
What is another topical option for tx of bacterial vaginosis?
Topical clindamycin or Metronidazole
89
How long is topical clindamycin tx for BV?
7 days
90
How long is topical metronidaxole tx for BV?
5 days
91
What is 1st line abx tx for lower UTI in females including duration?
Nitrofurantoin OR trimethoprim
3 days
92
What is 1st line abx tx for lower UTI in males including duration?
Nitrofurantoin OR trimethoprim
7 days
93
What egfr can you use nitrofurantoin?
> 45/ml/min
94
2nd line abx tx for UTI in females if not improved in >48hrs?
Fosfomycin, pivmecillinam
95
What is 1st line abx tx for lower UTI in pregnant women + duration?
Nitrofurantoin for 7 days
100mg BD
96
What is 2nd line abx tx for lower UTI in pregnant women if nitro doesn't work + duration?
Amoxicillin (only if culture susceptible)
or cefalexin.
97
When to give amoxicillin in UTI in pregnant women?
only if culture susceptible
98
What is blood infection called?
Sepsis/ septicaemia
99
What are the 5 signs of sepsis?
Slurred speech/ confusion
Extremem shivering/ muscle pain
Passing NO urine
Severe breathlessness
It feels like going to die
Skin mottled
100
What is the 2 1st line abxs for CAP?
Antipseudomonal penicillin
e.g. piperacillin/ticarcillin
OR
Cephalosporins
101
What is the 1st line abx for HAP?
Co amoxiclav
clarithromycin - 2nd line for children if above doesnt work
102
What is the 2st line abxs for HAP for adults?
Doxy, cefalexin, co-trimoxazole, levofloxacin
103
What to add if MRSA suspected with HAP?
add in vancomycin
104
What is TB caused by?
mycobacterium TB + spread via cough + sneeze
105
What is the 4 abx involved in tx of TB?
Rifampicin
Isoniazid
Pyrazinamide
Ethambutol
106
How long is initial phase of TB tx?
2 months
107
How long is continual phase of TB tx?
4 months
108
What is the 5 symptoms of TB?
Cough lasting 3+ weeks
Weight loss
Night sweats/fever
Loss appetite
Neck swelling
109
What is one of the TB meds that colour urine red?
Rifampicin
110
What should isoniazid be taken with?
Pyridoxine (B6)
111
What is a counselling point for ethambutol?
Report visual deterioration
112
What is a counselling point for pyrazinamide?
Report signs of liver disorder
113
Why is isoniazid taken with pyridoxine?
Can cause peripheral neuropathy
114
What are 2 counselling points for isoniazid?
Report sign of liver disorder
Avoid tyramine + histamine rich foods
115
What is rifampicin + what does it interact with?
Enzyme inducer
hormonal contraceptives
116
What happens when rifampicin + oestrogen interact?
Reduces oral contraceptive efficacy
117
What are the 3 classes of antifungals?
Triazoles
Imidazole
Echinocandin
118
List 4 triazole antifungals?
Fluconazole
Itraconazole
Posaconazole
Voriconazole
119
What triazole interacts with antacids to reduce its absorption?
Itraconazole
120
Which anti-fungal drug is the only enzyme inducer?
Griseofulvin
121
What thing improves itraconazole bioavailability?
carbonated drinks, such as cola.
122
What is a known SE with fluconazole?
Rash - discontinue tx
123
What are 2 cautions of itraconazole?
Heart failure
Hepatotoxicity
124
What are 2 SEs of voriconazole?
Photo-toxicity
Hepatotoxicity
125
List 3 echinocandin antifungal drugs?
Anidulafungin
caspofungin
micafungin
126
List 5 imidazole anti-fungals?
Clotrimazole
Econazole
Ketoconazole
Miconazole
Tioconazole
127
Which Imidazole anti-fungal is hepatotoxic?
Ketoconazole
128
What imidazole anti-fungal drug is used for thrush?
Clotrimazole
129
What are 3 other antfungals?
Griseofulvin
Flucytosine
Terbinafine
130
What is a choice antifungal drug for nail fungal infection?
Terbinafine
131
What is a risk of Terbinafine?
Hepatotoxicity- esp oral
132
What is 1st line abx treatment for Endocarditis (native valve) caused by staphylococci?
Flucloxacillin (4 weeks, 6 if lung absess or osteomyelitis)
133
What is 1st line abx treatment for Endocarditis (native valve) caused by staphylococci?
Flucloxacillin (4 weeks, 6 if lung absess or osteomyelitis)
134
What is 1st line for acute pyelonephritis?
Cefalexin or cipro
If sensitivity known- co amox or trimethoprim
135
What to give children 3 months-59 years old if aetiology unknown for meningitis?
Cefotaxime (OR ceftriaxone) + amoxicillin
Add vancomycin if prolonged or multiple use of other antibacterials in last 3 months
136
Duration treatment for meningitis if unknown aetiology ?
Suggested duration of treatment at least 10 days
