Choice of antibiotic: patient factors

Question 1

Which antibiotic class is contraindicated in children under 12 years of age ?

Answer 1

TETRACYCLCINES

Question 2

Why should quinolones be avoided in children and adolescents under 18 years of age ?

Answer 2

cause arthropathy: damage weight-bearing joints in juvenile animals according to research.

Question 3

Which antibiotic has the highest risk of C.Difficile in the elderly ?

Answer 3

Clindamycin

Question 4

If a patient has penicillin allergy which class of antibiotics should also be avoided due to cross-sensitivity ?

Answer 4

cephalosporins and b-lactam antibiotics

Question 5

What are the alternatives in penicillin allergy ?

Answer 5

macrolides

metronidazole in dental infections

Question 6

Which antibiotic classes should be avoided in renal impairment ?

Answer 6

• aminoglycoside, glycopeptide ( vancomycin )
• tetracyclines ( except minocycline/doxycycline)
• nitrofurantoin ( eGFR <45)

Question 7

Which tetracycline antibiotics are OK to give in renal impairment ?

Answer 7

minocycline

doxycycline

Question 8

Which antibiotics should be used with caution in hepatic impairment and why ?

Answer 8

co-amoxiclav, flucloxacillin: s/e cholestatic jaundice

Question 9

Which antibiotic classes are best avoided in hepatic impairment and why ?

Answer 9

rifampicin, tetracyclines: s/e hepatotoxicity

Question 10

If patient has severe hepatic impairment and take metronidazole what changes would you recommend to the dose?

Answer 10

reduce dose in hepatic encephalopathy (dose may be given once daily).

Question 11

Which antibiotics are contraindicated in pregnancy ?

Answer 11

tetracyclines

trimethoprim

Question 12

Why should nitrofurantoin be avoided at term? ( anytime between 37 weeks and 42 weeks )

Answer 12

causes nausea

Question 13

Which antibiotics should be avoided in pregnancy ?

Answer 13

metronidazole, chloramphenicol, aminoglycosides, quinolones, sulphonamides

Question 14

Which antibiotics are safest in pregnancy ?

Answer 14

penicillins/cephalasporins

Question 15

which antibiotics are associated with superinfections ?

Answer 15

clindamycin ( antibiotic associated colitis-c.difficile), cephalasporins ( fungal infections and colitis)

Question 16

For the following causative organisms name suitable antibiotic:

• staph
• MRSA
• Streptococci
• Anaerobic bacteria
• P. aeruginosa

Answer 16

staph: fluclo
MRSA: vanco
Streptococci:benzylpeniccilin or phenoxymythpenicillin
Anaerobic: metronidazole
P.Aeruginosa: gentamicin