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Pre-Registration Revision > BNF Chapter 5: Infections > Flashcards

BNF Chapter 5: Infections Flashcards

1
Q

What are some examples of aminoglycoside antibiotics?

A

Gentamicin
Streptomycin
Amikacin
Neomycin
Tobramycin

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2
Q

Which aminoglycoside is the aminoglycoside of choice in the UK?

A

Gentamicin

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3
Q

Gentamicin

-Widely used for the treatment of serious infections
-Active against gram-positive and gram-negative organisms
-Broad spectrum but inactive against anaerobes and poor activity against haemolytic streptococci and pneumococci.
-When used to treat an undiagnosed serious infection, usually given alongside a penicillin or metronidazole (or both)
-Loading and maintenance doses calculated based on patient’s weight and _ function- treatment should not exceed 7 days.

A

Renal

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4
Q

What is the dosing of gentamicin based on?

A

Patient weight and renal function

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5
Q

When would Amikacin be used?

A

Treatment of serious infections caused by gentamicin-resistant gram-negative bacilli

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6
Q

Why is a once-daily dose of aminoglycoside preferred over multiple-daily doses?

A

More convenient, provides adequate serum concentrations.

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7
Q

When would a once-daily dose regimen of aminoglycoside antibiotics be contraindicated?

A

-Patients with endocarditis due to gram-positive bacteria
-HACEK endocarditis
-Burns of over 20% of total body area
-Creatinine clearance of less than 20mL/minute
-Pregnancy

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8
Q

Serum Concentrations
- Avoids both excessive and subtherapeutic concentrations
-Aminoglycosides have a narrow therapeutic index and are very harmful in toxicity
-Serum concentrations MUST be determined in the elderly, obese patients, cystic fibrosis patients, in renal impairment and if high doses are being given.

A
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9
Q

What three things must a clinician consider before selecting antibacterial therapy?

A

The patient
The known or likely causative organism
Risk of bacterial resistance

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10
Q

After how long should IV antibiotics be reviewed and stepped down to oral when possible?

A

48 hours

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11
Q

Sepsis- Early Management

  • High risk patients suspected of sepsis should be given a broad spectrum antibacterial at the maximum recommended dose without delay (ideally within the first hour)
    -Source of infection needs to be identified- then treat in-line with local guidance
    -Need for IV fluids, inotropes, vasopressors and oxygen should also be assessed without day.
A

.

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12
Q

What antibacterial should be given as prophylaxsis for secondary cases of Invasive group A streptococcal infections?

A

Phenoxymethylpenicillin

-Erythromycin or azithromycin if patients have a penicillin allergy

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13
Q

What antibacterial should be given for the prevention of secondary cases of Meningococcal meningitis?

A

Ciprofloxacin OR Rifampicin OR I/M Ceftriaxone

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14
Q

What is the first-line prophylaxis for the prevention of secondary disease related to Haemophilus Influenzae type b infection?

A

Rifampicin

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15
Q

What antibacterial should be given as prophylaxis for patients with pneumococcal infection when they have asplenia or sick-cell disease?

A

Phenoxymethylpenicillin
-Erythromycin if penicillin allergy

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16
Q

What should be used as antibacterial prophylaxis for gastro-intestinal operations on the stomach or oesophagus?

A

Single dose IV gentamicin or IV cefuroxime or IV co-amoxiclav - given up to 30 minutes before procedure

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17
Q

What prophylactic antibacterial should be given for a percutaneous endoscopic gastrostomy or jejunostomy?

A

Single dose of IV co-amoxiclav OR IV cefuroxime- up to 30 mins before procedure

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18
Q

What is the first-line treatment for Aspergillosis (a type of fungal infection)?

A

Voriconazole

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19
Q

What is the first-line antifungal for treating vaginal candidiasis?

A

Fluconazole by mouth

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20
Q

What antibiotics can be used first-line for community-acquired septicaemia?

A

A broad-spectrum antipseudomonal penicillin (e.g. piperacillin with tazobactam) OR a broad-spectrum cephalosporin (e.g. cefuroxime)

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21
Q

What antibiotics can be used for hospital-acquired septicaemia?

A

A broad-spectrum antipseudomonal beta-lactam antibacterial (e.g. piperacillin with tazobactam)

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22
Q

If an anaerobic infection is suspected for septicaemia, which antibiotic should be added to broad-spectrum cephalosporin?

A

Metronidazole

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23
Q

What are carbapenems?

A

Beta-lactam antibacterials with broad-spectrum of activity which includes many gram-positive and gram-negative bacteria.

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24
Q

What are Imipenem and Meropenem used to treat?

A

Severe and complicated infections, including hospital-acquired pneumonia, intra-abdominal infections, skin and soft tissue infections, and urinary tract infections

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25
Q

What are cephalosporins?

A

Broad-spectrum antibiotics which are used for the treatment of septicaemia, pneumonia, meningitis, biliary-tract infections, peritonitis and UTIs.

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26
Q

What is the main side-effect of cephalosporins?

A

Hypersensitivity

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27
Q

What are some examples of cephalosporins?

A

Cefalexin
Cefradine
Ceftriaxone

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28
Q

Threadworms

  • All members of the family require treatment
    -Mebendazole is first-line for treatment in patients over 6 months; single dose. Re-infection is very coomon, a second dose can be given after 2 weeks.
A

.

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29
Q

Tapeworm Infections

-Niclosamide is used for tapeworm infections
-Side-effects include GI upset, lightheadesness and pruritis

A

.

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30
Q

Herpes Simplex Infections

-HSV-1 is usually responsible for infections of the mouth, genital infection is usually due to HSV-1 or HSV-2.
-Topical antiviral treatment not generally recommended for oral herpes
-Treat primary or recurrent genital herpes with an antiviral drug.

A
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31
Q

Varicella-zoster Infections

-Chicken pox: self-limiting in healthy children, treatment is not recommended. Ibuprofen should be avoided due to the risk of skin reaction.
-Chicken pox is more severe in adolescents and adults- start antiviral tratment within 24 hours of onset.

Shingles- caused by the same virus. Offer oral antiviral treatment to immunocompromised patients, non-truncal involvement or those in severe pain. Start within 72 hours of rash onset.
-Offer to over 50s to reduce risk of post-herpetic neuralgia (chronic pain which persists after the rash has healed).

A

.

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32
Q

What is human immunodeficiency virus (HIV)?

A

A retrovirus that causes immunodeficiency by infecting and destroying cells of the immune system, especially the CD4 cells. AIDs occurs when the number of CD4 cells falls below 200 cells/microlitre.

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33
Q

When does AIDS develop?

A

When the number of CD4 cells falls to below 200 cells/microlitre

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34
Q

What contributes to the greatest risk to mortality and morbidity due to HIV/AIDS?

A

Delayed HIV diagnosis and treatment

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35
Q

Aims of HIV Treatment

-Achieve an undetectable viral load
-Preserve immune function
-Reduce the mortality and morbidity associated with chronic HIV infection
-Reduce onward transmission of HIV

A

.

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36
Q

HIV Treatment

-Initiate with two nucleoside reverse transcriptase inhibitors (NRTIs) as a backbone regimen plus one of the following: an integrase inhibitor (INI), a non-nucleoside reverse transcriptase inhibitor (NNRTI) OR a boosted protease inhibitor (PI).

-Backbone: emetricitabine + tenofovir OR disoproxil OR tenofovir alafenamide
-Third drug: atazanavir or darunavir.

A

.

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37
Q

What is lyme disease?

A

A bacterial infection caused by Borrelia burgdorferi; transmitted to humans from the bite of an infected insect.

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38
Q

Lyme Disease

-Caused by the bite of an infected insect
-Characteristic rash- accompanied by malaise, fatigue, fever, swollen glands, neck pain, headache.

Treat with an antibacterial:
- Doxycycline is first-line
-Amoxicillin is an alternative if docycycline is unsuitable.

If there is CNS involvement, then ceftriaxone is first-line.

A
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39
Q

What are examples of macrolide antiobiotics?

A

Azithromycin
Erythromycin
Clarithromycin

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40
Q

Antibiotics and Food

-Nitrofurantoin- with or just after food
-Clarithromycin- with or just after
-Metronidazole- with or just after

-Ciprofloxacin- no milk two hours before or after
-Oxytetracycline- no milk two hours before or after
-Tetracycline- no milk two hours before or after

-Flucloxacillin- an hour before food, or two hours after
-Penicillin- an hour before food, or two hours after

A

.

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41
Q

What are some examples of cephalosporin antibioitcs?

A

Cefalexin (most commonly used)
Cefazolin

Cefuroxime
Cefaclor

Ceftriaxone
Cefixime
Cefotaxime
Ceftazidime

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42
Q

What are the sub-categories of beta-lactam antibiotics?

A

Cephalosporins
Glycopeptides
Penicillins
Carbapenems
Monobactams

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43
Q

What drugs can be used first-line to treat TB?

A

Isoniazid
Rifampicin
Pyrazinamide
Ethambutol

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44
Q

Which antibiotics should be avoided in pregnancy?

A

Trimethoprim- teratogenic
Gentamicin- teratogenic
Tetracyclines- teeth discolouration

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45
Q

What antibiotics should be used to treat endocarditis?

A

Amoxicillin + low-dose gentamicin

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46
Q

What antibiotics can be used to treat chlamydia?

A

Azithromycin OR doxycycline

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47
Q

What is the standard first-line treatment for cellulitis?

A

Flucloxacillin

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48
Q

What is the antibiotic treatment for bacterial vaginosis?

A

Metronidazole

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49
Q

What are some examples of antibiotics that may discolour your urine?

A

Nitrofurantoin- yellow/brown
Metronidazole- dark
Rifampicin- yellow/orange/red/brown

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50
Q

How should ringworm be treated OTC?

A

Topical clotrimazole or terbinafine cream

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51
Q

Shingles

Refer if:
- Visual symptoms
-Unexplained red eye
-Immunocompromised
-Pain inadequately controlled by orsal analgesia
-Delayed healing

Oral antiviral within 72 hours of rash onset if any criteria met:
-Immunocompromised
-Non-truncal involvement
-Moderate/severe rash or pain
-Potentially in all over 50s to reduce likelihood of post-herpetic neuralgia.

A
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52
Q

In what patient groups should oral antiviral treatment be considered for the management of shingles?

A

-Immunocompromised
-Non-truncal involvement
-Moderate/severe rash or pain
-Potentially in all over 50s to reduce likelihood of post-herpetic neuralgia.

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53
Q

Advice for Shingles

-Avoid contact with people who have had not had chickenpox
-Avoid sharing clothes and towels
-Wear loose fitting clothing
-Avoid topical creams and dressings- irritation
-Keep rash clean and dry

A
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54
Q

Which antibiotic is first-line for cellulitis?

A

Flucloxacillin- take an hour before food, or two hours after. 500mg-1g QDS if orally, 1-2g QDS if IV

Clarithromycin (500mg BD 5-7 days), erythromycin or doxycycline if allergic

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55
Q

Which antibiotic can make you more sensitive to sunlight?

A

Doxycycline

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56
Q

_ is an antibiotic that can cause bone marrow suppression

A

Azithromycin

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57
Q

How does trimethoprim work?

A

By inhibiting bacterial DNA synthesis

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58
Q

What is the first-line antibiotic treatment for otitis externa?

A

Flucloxacillin

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59
Q

What is commonly prescribed for children with croup?

A

Oral corticosteroids, such as dexamethasone

60
Q

Tendonitis is a potential side-effect from which group of antibioitics?

A

Fluoroquinolones (ciprofloxacin, levofloxacin etc)

61
Q

Which antibiotics are most likely to lead to a C.diff infection?

A

Clindamycin
Cephalosporins (cefalexin, cefuroxime etc)
Penicillins
Fluoroquinolones (ciprofloxacin, ofloxacin etc)

62
Q

What are some examples of fluoroquinolone antibiotics?

A

Ciprofloxacin
Ofloxacin
Moxifloxacin

63
Q

What is the main indication for metronidazole?

A

Dental anaerobic infections

64
Q

Clarithromycin is generally first-line for chest infections.

True or False?

A

True

65
Q

_ is an antibiotic that can cause cholestatic jaundice or hepatitis as a side-effect.

A

Flucloxacillin

66
Q

Penicillin-induced anaphylaxis is rare, but can be fatal. Cephalosporins are often used second-line, but there is cross-sensitivity- 7% of patients with a penicillin allergy will also be allergic to cephalosporins. ALWAYS worth a conversation with the prescriber.

A

.

67
Q

What infections is phenoxymethylpenicillin most indicated for?

A

Strep throat
Otitis media
Cellulitis

68
Q

First gen. cephalosporins: cefalexin, cefixime, cefadroxil

Second gen.: Cefaclor

Third gen.: Cetotaxime

A

.

69
Q

Food and Antibiotics:

-Cephalosporins: ideally empty stomach EXCEPT cefuroxime
-Penicillin: ON AN EMPTY STOMACH
-Tetracyclines: ON AN EMPTY STOMACH
-Macrolides (azithromycin, clarithomycin, erythromycin etc): With or after food
-Quinolones (ciprofloxacin, levofloxacin etc): Ideally on an empty stomach
-Nitrofuranton: With food to aid absorption
-Clindamycin: Doesn’t matter
-Trimethoprim: Doesn’t matter

A

.

70
Q

How should a dose of an aminoglycoside antibiotic be calculated in an obese patient?

A

Use ideal body weight

71
Q

What is clarithromycin most commonly prescribed for?

A

Stomach ulcers
Chest infections

72
Q

Clindamycin: Patient must discontinue immediately and consult doctor if _ develops.

A

Diarrhoea

73
Q

What can the use of systemic chloramphenicol cause?

A

Bone marrow suppression

74
Q

Antituberculosis Drugs

-Cycloserine: need to monitor blood conc, especially in renal impairment
-Ethambutol
-Isoniazid- patient needs to be able to recognise signs of liver disorder, discontinue.
-Pyrazinamide
-Rifabutin
-Rifampicin- recognise symptoms of liver disorder, discontinue.
-Streptomycin- teratogenic

A

.

75
Q

Quinolones

-Ciprofloxacin
-Levofloxacin
-Moxifloacin
-Ofloxacin

All may impair performance of tasked skills, e.g. driving.
Can cause TENDON damage, although rare. Can also cause convulsions in patients with or without a history of seizures, NSAID use may also induce them.

A
76
Q

Antifungals

Triazole: Fluconazole, Itraconazole, Voriconazole.
-Itraconazole: advise to recognise signs of liver disorder, discontinue

Imidazole: Ketoconazole, Miconazole

Polyene: Amphotericin, Nystatin

Echinocandin: Anidulafungin, Caspofungin, Micafungin

Other: Flucytosine, Griseofulvin, Terbinafine

A

.

77
Q

Which two groups of antibiotics are generally considered safest to use in pregnancy?

A

Penicillins
Cephalosporins

78
Q

Which antibiotic is used to treat otitis externa?

A

Flucloxacillin

79
Q

Which bacteria is a common cause of UTIs?

A

E.coli

80
Q

Which antibiotic is injected in cases of suspected meningitis?

A

Benzylpenicillin IM

81
Q

What are the main side-effects of tetracyclines?

A

Rash
Photosensitivity
Diarrhoea

82
Q

In which situation may co-amoxiclav be used rather than amoxicillin?

A

If the infection is caused by resistant beta-lactamase bacteria

83
Q

Which bacteria is the most common cause of a lower respiratory tract infection?

A

Streptococcus Pneumoniae

84
Q

What is the first-line antibiotic for a C.difficile infection?

A

Vancomycin 125mg QDS for 10 days

85
Q

Antibiotic Side-Effeccts

Tetracyclines:
-Photosensitivity
-_ hypertension
-_ discolouration
-Oesophageal irritation
-Visual disturbance

Quinolones:
-_ damage
-Seizures
-Psychiatric reactions
-_ prolongation
-Hypersensitivity/severe rash

Penicillin:
-Skin rash
Antibiotic-associated colitis
-Anaphylaxis
-Thrombocytopenia
-Vomiting

Macrolides:
-_ prolongation
-Antibiotic associated colitis
-Seizures
-Myasthenia gravis
-Pancreatitis

Cephalosporins:
-Hypersensitivity
-Diarrhoea
-Vulvovaginal candidiasis
-Vomiting
-Thrombocytopenia

Glycopeptides:
-Infusion reaction
-Red-man syndrome
-Nephrotoxicity
-Tinnitus
-Drug fever

A

Intracranial
Tooth

Tendon
QT

86
Q

Which antibiotic is first-line for managing mastitis in breastfeeding?

A

Flucloxacillin

87
Q

What are the three main symptoms of measles?

A

3C’s:
Cough, Conjunctivitis and cold symptoms

88
Q

When would quinolones (ciprofloxacin, ofloxacin etc) be contraindicated?

A

In patients at risk of QT interval prolongation

89
Q

Which antibiotics are most likely to cause C. difficile infections? What other drug too?

A

Second and third-generation cephalosporins, also clindamycin

PPIs

90
Q

C.Difficile Infection Summary

-Symptoms include diarrhoea, abdominal pain, raised WBC count and a toxic megacolon if severe.

-Diagnosed by detecting C.Difficile in the stool.

Treatment of first-episode of infection:
-Vancomycin 125mg QDS for 10 days orally.
-Second line: Oral fidaxomicin
Third line: oral vancomycin +/- IV metronidazole

Recurrent Infection:
-Occurs in about 20% of patients, increases to 50% after second episode. If recurrent infection is within 12 weeks of symptom resolution, treat with oral fidaxomicin. If after 12 weeks, oral _ or fidaxomicin.

A

Vancomycin

91
Q

How would recurrent C.difficile infections be managed?

A

If symptoms recur within 12 weeks of initial symptom resolution: oral fidaxomicin

If after 12 weeks: oral vancomycin or oral fidaxomicin

92
Q

Which antibiotics can be used to treat an acute COPD exacerbation?

A

Amoxicillin OR
Tetracycline (doxycycline) OR
Clarithromycin

93
Q

How would uncomplicated community-acquired pneumonia be treated?

A

Amoxicillin first-line

Doxycycline or clarithromycin in penicillin allergy

94
Q

Which antibiotics would be used to treat hospital-acquired pneumonia?

A

Within 5 days of admission: co-amoxiclav or cefuroxime

More than 5 days: Piperacillin with taxobactam OR a broad-spectrum cephalosporin (ceftazidime) OR a quinolone (ciprofloxacin)

95
Q

Which two antibiotics are options for treating acute pyelonephritis (upper UTI)?

A

Broad-spectrum cephalosporin OR quinolone

96
Q

How would local impetigo be treated? What about if it is widespread?

A

Local: topical hydrogen peroxide
Widespread: oral flucloxacillin or erythromycin

97
Q

Flucloxacillin is first-line for treating cellulitis. Which antibiotic is first-line if the cellulitis is near the eyes or nose?

A

Co-amoxiclav

98
Q

Which antibiotic is first-line for managing animal or human bites?

A

Co-amoxiclav

99
Q

Antibiotics for Ear/Nose/Throat

-Throat infections- phenoxymethylpenicillin
-Sinusitis- phenoxymethylpenicillin
-Otitis media- _ (erythromycin is allergic)
-Otitis externa- _ (erythromycin if allergic)
-Periodontal abscess- amoxicillin
Gingivitis- _

A

Amoxicillin
Flucloxacillin
Metronidazole

100
Q

Which antibiotic is used to treat gingivitis?

A

Metronidazole

101
Q

Which antibioitc is used to treat throat infections?

A

Phenoxymethylpenicillin

102
Q

Which antibiotic is first-line for treating uncomplicated chlamydia? What about in allergies/pregnancy/breastfeeding?

A

Doxycycline 100mg BD for 7 days
Azithromycin second-line

103
Q

How is gonorrhoea treated?

A

Intramuscular ceftriaxone

104
Q

How is pelvic inflammatory disease treated?

A

Oral ofloxacin + oral metronidazole OR
IM ceftriaxone +oral doxycycline + oreal metronidazole

105
Q

How is bacterial vaginosis treated?

A

Oral or topical metronidazole OR topical clindamycin

106
Q

Which antibiotic is used to treat salmonella, shigellosis and campylobacter enteritis?

A

Ciprofloxacin

107
Q

Gentamicin

Side-effects include:
-Ototoxicity, due to auditory or vestibular nerve damage (irreversible)
-Nephrotoxicity (risk increased by use alongside _)

CI in myasthenia gravis.

Monitoring of both peak (1 hour after administration) and trough (just before next dose) should be done. If trough level high= increase dosing interval.
If the peak is high then the dose should be decreased.

A

Furosemide

108
Q

Management of Community-Acquired Pneumonia

Uncomplicated:
-_ is first-line for 5 days
-Doxycycline or clarithromycin in penicillin allergy

Moderate and high severity:
-Dual antibiotic therapy; amoxicllin + macrolide for 7-10 days

A
109
Q

What is the maximum recommended treatment duration for gentamicin?

A

7 days

110
Q

Why is chloramphenicol contraindicated for use in pregnancy?

A

Can cause ‘grey baby’ syndrome

111
Q

Scabies Treatment

-Permethrin is first-line. Whole family should be treated, applied to the whole body, leave for 8-12 hours before washing and repeating _ week later.

A

One

112
Q

What is the incubation period for chicken pox?

A

11-20 days

113
Q

What is the incubation period for slapped cheek?

A

13-18 days

114
Q

What is the incubation period for whooping cough?

A

7-10 days

115
Q

What is the incubation period for mumps?

A

15-24 days

116
Q

When would co-amoxiclav be used?

A

To treat infections that are resistant to amoxicllin by itself

117
Q

How is Kawasaki disease treated?

A

Aspirin and IV immunoglobulin

118
Q

HPV can cause warts.
True or False?

A

True

119
Q

German measles can be very serious if caught by a pregnant lady in the first 20 weeks. Why is that?

A

Can disrupt the development of the baby and cause health issues

120
Q

What is a key differentce between german measles and regular measles?

A

Regular measles manifests itself by producing white spots in the mouth as a symptom

121
Q

Antimalarial prophylaxis should be continued for 4 weeks after leaving the endemic area, with the exception of which antimalarial?

A

Malarone

122
Q

Which group of antibiotics can lower the seizure threshold?

A

Quinolones (risk is further increased by use alongside NSAIDs)

123
Q

Which antibioitic is first-line for treating lyme disease?

A

Doxycycline 100mg BD for 21 days
Amoxicillin 2nd line: 1000mg TDS for 21 days

Azithromycin third line

124
Q

Which parasite is the most common cause of infectious gastroenteritisis in the world?

A

Gardia Lamblia

125
Q

What is the parasitic name for scabies?

A

Sarcoptes scabiei

125
Q

What is the parasitic name for head lice?

A

Pediculus humanus capitis

126
Q

What is the parasitic name for threadworm?

A

Enterobius vermicularis

127
Q

Which three antibiotics should be taken with a full glass of water?

A

Clindamycin
Doxycycline
Metronidazole

128
Q

With which three antibiotics should indigestion remedies be avoided two hours before and after?

A

Azithromycin
Minocycline
Doxycycline

129
Q

With which three antibioitcs should milk, indigestion remedies, zinc and iron be avoided?

A

Oxytetracycline
Ciprofloxacin
Tetracycline

130
Q

What is the mechanism of action for tetracyclines?

A

Inhibit the 30S ribosomal subunit, hindering the binding of the aminoacyl-tRNA to the acceptor site on the mRNA-ribosome complex

131
Q

What is the mechanism of action of pencillins?

A

Kill bacteria through the binding of the beta-lactam ring to DD-transpeptidase, inhibiting its ross-linking activity and preventing new cell wall formation.

132
Q

What is the mechanism of action of cephalosporins?

A

Similar to penicillins: bind to penicillin-binding proteins and interfere with cell wall enzymes.

133
Q

What is the mechanism of action of macrolides?

A

Bind to bacterial 50S ribosomal subunits and cause the cessation of bacterial protein synthesis.

134
Q

What is the mechanism of action of aminoglycosides?

A

Bind to the aminoacyl site of 16S ribosomal RNA within the 30S ribosomal subunit, leading to misreading of the genetic code.

135
Q

What should be monitored if clindamycin treatment exceeds 10 days?

A

Liver and renal function

136
Q

What should be monitored during vancomycin treatment?

A

Renal function
Urinalysis
FBC

137
Q

Which antimalarial is contraindicated in patients with a history of psychiatric disease?

A

Mefloquine

138
Q

What is the maximum recommended treatment length with gentamicin?

A

7 days

139
Q

What is polyuria?

A

Excessive urinating

140
Q

What is polydipsia?

A

Excessive thirst

141
Q

What is the mechanism of action of rifampicin?

A

Inhibits RNA synthesis

142
Q

What is the mechanism of action of sulphonamides?

A

Inhibits folic acid formation

143
Q

What is the first-line antibiotic choice for pyelonephritis?

A

Cefalexin: 500 mg twice or three times a day (up to 1 to 1.5 g three or four times a day for severe infections) for 7 to 10 days

Can also use co-amoxiclav or trimethoprim if susceptible, and also ciprofloxacin (consider safety issues)

144
Q

How often should gentamicin levels be measured in an elderly patient?

A

Every 3 or 4 doses, and after every dose change

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