Chapter 5: Infection Flashcards
Name the antibiotics in the aminoglycoside class x5
Amikacin Gentamicin Neomycin Streptomycin Tobramycin
What aminoglycosides are active against Pseudomonas aeruginosa (x3) and what one is the treatment of choice?
Gentamicin - treatment of choice
Amikacin
Tobramycin - usually via inhalation in CF
What aminoglycoside is active against TB? Against what bacteria?
Streptomycin
(mainly reserved for this indication)
Mycobacterium tuberulosis
Can aminoglycosides be given orally?
No- destroyed by the gut so must be given via injection
Are not absorbed from the gut (risk of absorption in inflammatory bowel disease and liver failure) and must be given by injection for systemic infections.
Is gentamicin a broad or narrow antibiotic?
What strains does it have poor activity against?
Broad but it is inactive against anaerobes and poor activity against haemolytic streptococci and pneumococci
Very good for gram negative organisms
Which aminoglycoside is used for encocarditis?
If it is resistant to this, what is an alternative aminoglycoside?
Gentamicin plus another antibiotic
Streptomycin is an alternative if resistant to gentamicin
Are aminoglycosides more active against gram positive or gram negative?
Gram negative but are broad
Can neomycin be given IV?
No
too toxic
Can only be used for skin/mucous membrane infections… However BNF states the cream is less suitable for prescribing
(Can also be used to reduce the bacterial population of the colon prior to bowel surgery or in hepatic impairment)
What is the problem with using aminoglycosides in myasthenia gravis?
Contraindicated
May impair neuromuscular transmission
What antibiotics can be used for prophylaxis in rheumatic fever?
Pen V or sulfadiazine
phenoxymethylpenicillin
What anitbiotics can be used for prevention of secondary case of menincoccal meningitis?
Ciprofloxacin or rifampicin
Or IM ceftriaxone (unlicensed)
What antibiotic can be used for prevention of secondary infection for Group A strep?
Pen V
Phenoxymethylpenicillin
pen allergic - erythromycin or azithromycin
What antibiotic can be used for prevention of secondary infection in Influenza Type B?
Rifampicin
If rifampicin cannot be used – IM or IV ceftriaxone
What antibiotic can be used for prevention of secondary cases of diphtheria in non-immune patients?
Erythromycin (or another macrolide e.g. azithromycin or clarithromycin)
What is pertussis?
Whooping cough
What antibiotic is used for prophylaxis of pertussis (whooping cough)?
Clarithromycin
What antibiotic is used post splenectomy or in patients with sickle cell disease for prevention of pneumococcal infection?
Pen V
Erythromycin is penicillin allergic
What antibacterial prophylaxis/treatment is used in animal and human bites?
If the patient is penicillin allergic, what should be used instead?
Co-amox
If penicillin allergic: Doxycycline and metronidazole
Up to 5 days and give tetanus jab
What antibacterial prophylaxis do you use in hip and knee replacement?
Single dose IV cefuroxime
OR IV flucloxacillin + IV gent
What antibacterial prophylaxis do you use in high lower limb amputation?
Use i/v co-amoxiclav alone or i/v cefuroxime + i/v metronidazole
What antibacterial prophylaxis do you use in caesarean section?
Single dose IV cefuroxime
What is 1st line for aspergillosis?
What is 2nd line if this cannot be used?
Voriconazole
Liposomal amphotericin
If a patient with aspergillosis is intolerant/refractory to voriconazole and liposomal amphotericin, what other antifungals can be used?
Caspofungin
Itraconazole
What antifungal is used in vaginal candidiasis?
For resistant organisms, what can be used?
Locally acting antifungals or with fluconazole given by mouth.
Itraconazole PO as an alternative for resistant organisms