blood infections

Question 1

what type of drug do you give for community acquired septicaemia ? + examples

Answer 1

broad spectrum anti-psuedomonal penicillin

e.g. piperacillin with tazobactam
e.g. ticaricillin with clavulanic acid

Question 2

treatment of CA septicaemia if MRSA suspected

Answer 2

broad spectrum anti-psuedominal penicillin e.g. pipericillin with tazobactam, ticaricillin with clauvulanic acid

PLUS vancomyin (or teicoplanin)

Question 3

treatment of CA septicaemia if anaerobic infection suspected

Answer 3

broad spectrum cephalosporin + metronidazole.

Question 4

treatment of CA septicaemia if other resistant microorganism suspected

Answer 4

a more broad spectrum beta lactic abx e.g. meropenem

Question 5

treatment of hospital acquired septicaemia

Answer 5

• broad spectrum anti psuedomonal beta lactic abx (e.g. piperacillin with tazobactam, ticarcillin with clauvulanic acid, ceftazidime, imipenem with cilastatin, meropenem

Question 6

HA septicaemia treatment if MRSA suspected

Answer 6

BS antipseudomonal beta lactam abx (e.g. piperacillin with tazobactam, ticarcillin with clavulanic acid, ceftazidime, imipenem with cilastatin, or meropenem)
MRSA suspected, add vancomycin or teicoplanin

Question 7

HA septicaemia if anaerobic infection suspected

Answer 7

add metronidazole to BS cephalosporin

Question 8

treatment of septicaemia related to vascular catheter

Answer 8

vancomycin or tecioplanin
if gram negative sepsis suspected, esp in immunocompromised, add BS antipseudomonal beta lactam
consider removing vascular catheter, esp if infection cause by Staph. aureus, pseudonyms or Candida

Question 9

treatment of meningococcal septicaemia

Answer 9

single dose of benzylpenicillin before urgent transfer to hospital as long as this does not delay transfer
cefotaxime alternative in penicillin allergy (or ceftriaxone)
chloramphenicol if Hx immediate hypersensitivity to penicillin or cephalosporins

Question 10

to eliminate nasopharyngeal carriage of meningococcal septicaemia the following may be used (3)

Answer 10

ciprofloxacin
rifampicin
ceftriaxone

Question 11

pt has suspected meningococcal septicaemia. what should you give before urgent transfer to hospital as long as this does not delay transfer

Answer 11

single dose of benzylpenicillin

Question 12

pt has suspected meningococcal septicaemia. 1st line before urgent transfer to hospital if normally single dose of benzylpenicillin sodium, but the pt family reports they are allergic to penicillin. what are the alternatives

Answer 12

cefotaxime (or ceftriaxone) alternatives if penicillin allergy
chloramphenicol if history of immediate hypersensitivity reaction to penicillin or cephalosporins