Bacterial Infections

Question 1

Community acquired pneumonia:
Mild
Mod
Severe
Atypical

Answer 1

Mild: Amoxicillin 500mg tds PO 7d
or Clarithromycin 500mg bd PO 7d or Doxy if pen allergic

Mod: Amoxicillin 500mg tds
And Clarithromycin 500mg bd PO/IV 7d (clarithro alone if pen allergic)

Severe: Co-Amos 1.2g tds IV / cefuroxime 1.5g tds IV
And Clarithromycin 500mg bd IV 7-10d
Add Flucox if staph suspected

Atypical:
Chamydia: tetracycline
PCP: Co-trimoxazole
Legionella: Clarithro + Rifampicin

Question 2

Hosp acquired pneumonia:
Mild
Severe

Answer 2

Mild (<5d):
Co-amoxicillin 625mg tds PO 7d or cefuroxime

Severe (>5d):
Tazocin 7d
\+/- Vanc for MRSA
\+/- Gent for Pseudomonas
\+/- cipro

Question 3

Aspiration Pneumonia

Answer 3

Co-Amos 625mg PO tds 7d

Question 4

Exacerbation COPD

Answer 4

(Increased sputum purulence/vol, dyspnoea, consolidation on CXR)

Amoxicillin 500mg PO tds 7d
Or
Doxycycline 200mg STAT + 100mg bd 7d

Question 5

Infective endocarditis (empiric):
Acute severe
Subacute

Answer 5

Acute severe: Flucox + Gent IV

Subacute: Benpen + Gent IV

Question 6

Meningitis:
Community
<50
>50
Viral suspected

Answer 6

Community: Benpen 1.2g IV/IM
<50: Ceftriaxone 2g IVI/IM bd
>50: Ceftriaxone + ampicillin 2g IVI/4h
Viral: Aciclovir

Give Dex 0.15mg/kg/6h with 1st dose abx unless septic shock or meningococcal sepsis

Question 7

UTI:
Pyelonephritis
Lower UTI
Prostatitis

Answer 7

Pyelonephritis: Cefotaxime 1g IV BD 10d, cephalosporin or quinolone

Lower UTI:

1st: trimethoprim 200mg BD / Nitrofurantoin 50mg QDS (avoid in reduced GFR) 3-6d
2nd: Cefalexin 1g/12h / Amoxicillin 500mg tds

Prostatitis:
Ciprofloxacin 500mg BD 28d or trimethoprim

Question 8

GI sepsis

Answer 8

Cefuroxime + Metronidazole

Question 9

C.diff

Answer 9

1st: Metronidazole PO
2nd: Vancomycin PO

Question 10

Sepsis

Answer 10

Tazocin

+/- Vancomycin if MRI suspected

+/- Gentamicin for gram -ves

Ceftriaxone + Metronidazole if anaerobe

Question 11

Cellulitis:
Empiric
Known strep

Answer 11

Empiric: Flucoxacillin 500mg qds

Known strep: Pen V or Ben Pen

Question 12

Exacerbation of chronic bronchitis

Answer 12

Amoxicillin or tetracycline or clarithromycin

Question 13

Empitigo

Answer 13

Topical fusidic acid, oral flucloxacillin or erythromycin if widespread

Question 14

Erysipelas

Answer 14

Phenoxymethylpenicillin (erythromycin if penicillin-allergic)

Question 15

Human or animal bite

Answer 15

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

Question 16

Throat infection

Answer 16

Phenoxymethylpenicillin (erythromycin alone if penicillin-allergic)

Question 17

Sinusitis

Answer 17

Amoxicillin or doxycycline or erythromycin

Question 18

Otitis media

Answer 18

Amoxicillin (erythromycin if penicillin-allergic)

Question 19

Otitis externa

Answer 19

Flucloxacillin (erythromycin if penicillin-allergic)