CMN 568 - Unit 1 Antibiotics

Question 1

First line treatment for AOM

Answer 1

Amoxicillin 80-90mg / kg / day BID for:
< 2 years with severe symptoms - 10 days
2-6 years mild-mod symptoms - 7 days
> 6 years with mild-mod symptoms - 5 days

NTE 4 g / day

Question 2

If unable to take oral Antibiotics for AOM

Answer 2

Ceftriaxone (Rocephin) 50 mg / kg IM for 1 to 3 days

Question 3

If patient develops papular rashes / hives from Amoxicillin (PCNs)

Answer 3

1. Cefuroxime (Ceftin)
2. Cefpodoxime (Vantin)
3. Cefdinir (Omnicef)
4. Rocephin (Ceftrioxine) IM 50mg / kg / day for 1 to 3 days

Question 4

If patient develops severe allergic reaction from Amoxicillin (PCNs)

Answer 4

1. Triamthoprin-Sulfamethoxazole (Bactrim)
2. Azithromycin
3. Erythromycin
4. Clarithromycin
5. Clindamycin with or without ceftriaxone

Question 5

What to consider with using Macrolides for prescribing

Answer 5

Consider that Macrolides are usually ineffective in Drug-resistant Strep Pneumoniae and H. Flu, especially as winter progresses

Question 6

Second line treatment for AOM or If patient has had antibiotic in the last month, or does not improve in 48-72 hours on Amoxicillin, or has otitis-conjunctivitis syndrome

Answer 6

1. Amoxicillin-Clavulonate ES (Augmentin) 90 mg / kg / day BID
2. Rocephin (Ceftrioxine) IM 50mg / kg / day for 1 to 3 days
3. Cefuroxime (Ceftin)

Question 7

Antibiotic treatment for OME

Answer 7

No antibiotic necessary

Question 8

First line treatment for Otitis Externa

Answer 8

1. Fluoroquinilones with steroid (Ciprodex) ottic drops 3-4 gtts BID for 7 days

Question 9

Second line treatment for Otitis Externa

Answer 9

1. Neomycin / Polymxin B / Hydrocortisone 3-4 gtts TID-QID for 7 to 10 days

CAUTION: Not to be used if TM is perforated

Question 10

Penicillin V and Benzathine (Bicillin) dosage for GABHS Pharyngitis if LESS than 27 kg

Answer 10

1. Penicillin V 250 mg BID to TID for 10 days

2. Benzathine IM 600,000 units

Question 11

Penicillin V and and Benzathine (Bicillin) dosage for GABHS Pharyngitis if MORE than 27 kg

Answer 11

1. Penicillin V 500 mg BID to TID for 10 days

2. Benzathine IM 1.2 Million units

Question 12

Antibiotic considerations for GABHS Pharyngitis

Answer 12

1. Amoxicillin 50 mg / kg / day BID for 10 days NTE 1200 mg total dose
2. Cephalexin 25-50mg / kg / day BID for 10 days
3. Clindamycin 20 mg / kg / day TID for 10 days (Allergies to PCN)
4. Azithromycin 12 mg / kg OD for 5 days NTE 500 mg / day

Question 13

First line treatment for Acute Bacterial Rhinosinusitis (ABRS)

Answer 13

1. Amoxicillin

2. Amoxicillin-Clavulonate (Augmentin)

Question 14

Treatment for ABRS if with mild and severe allergic reaction to penicillin

Answer 14

1. Mild - Cefuroxime or Cefpadoxime

2. Severe - Clindamycin or Linezolid

Question 15

Second line treatment for ABRS or if no improvements for 48-72 hours

Answer 15

1. Augmentin

2. Cehpalosphorin

Question 16

Treatment for Chlamydia and N. Gonorrhea conjunctivitis

Answer 16

Will need systemic antibiotic

Question 17

Treatment of Bacterial Conjunctivitis

Answer 17

1. Erythromycin ophthalmic ointment: Apply 0.5-in ribbon QID for 5-7d
2. Polymyxin-trimethoprim ophthalmic solution: Instill 1-2 drops QID for 5-7d
3. Sulfacetamide ophthalmic solution: Instill 1-2 drops QID for 5-7d
4. Azithromycin ophthalmic solution: Instill 1-2 drops BID for 2d, then 1 drop for 5d
5. Ciprofloxacin ophthalmic solution: Instill 1-2 drops every 2h while awake for 2d, then 1 or 2 drops every 4h while awake for the next 5d
6. Levofloxacin ophthalmic solution: Instill 1-2 drops in affected eye(s) every 2h while awake (up to 8 times daily) on days 1-2; instill 1-2 drops in affected eye(s) every 4h while awake (up to 4 times daily) on days 3-7
7. Ofloxacin ophthalmic solution: Instill 1-2 drops in affected eye(s) every 2-4h on days 1-2; instill 1-2 drops QID on days 3-7