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Common infections Flashcards

1
Q

How should mild-to-moderate C. difficile infection be treated ?

A

oral metronidazole 400 mg three times a day for 10–14 days.

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2
Q

How should severe C.difficile be treated ?

A

Vancomycin oral 125 mg QDS 10-14 days

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3
Q

What is the treatment for recurrent or second line antibiotic for C.difficile ?

A

Fidaxomicin 200mg BD

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4
Q

What is initial blind therapy for endocarditis ?( Native valve endocarditis)

A

Amoxicillin (or amipicilin) + low dose gentamicin

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5
Q

If patient is penicillin allergic, what antibiotics can be offered for initial blind therapy of endocarditis ?

A

penicillin-allergic, or if meticillin-resistant Staphylococcus aureus suspected, or if severe sepsis, use vancomycin + low-dose gentamicin

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6
Q

If prosthetic valve endocarditis, how should patients be treated ?

A

, vancomycin + rifampicin + low-dose gentamicin

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7
Q

Which antibiotics should be given for endocardatitis caused by staphylococci or streptococci?

A

Flucloxacillin: staphylococci
Benzylpenicillin: streptococci

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8
Q

What is first line treatment for mild severity CAP ? 5 days treatment

A

Amoxicillin 1st line

Alternative: doxycycline, clarithromycin, erythromycin ( pregnancy)

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9
Q

What is first line treatment for moderate severity CAP ?

A

Amoxicillin + clarithromycin or erythromycin or if penicillin allergic doxycycline alone or calrithormycin

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10
Q

What is first line treatment for severe CAP ?

A

Co-amoxiclav and clarithromycin or erythromycin. Alternative: levofloxacin

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11
Q

What is first choice antibiotic in non-severe HAP?

A

co-amoxiclav
Alternatives: doxycycline, cefalexin, co-trimoxazole, levofloxacin
children alternative 1st choice: clarithormycin
5 days then review

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12
Q

What is first line treatment in severe or at higher risk of resistance HAP ?

A

Intravenous first line:
Piperacillin with tazobactam, ceftazidime, ceftazidime with avibactam, ceftriaxone, cefuroxime, levofloxacin [unlicensed], or meropenem.
If meticillin-resistant Staphylococcus aureus confirmed or suspected add vancomycin, or teicoplanin, or linezolid (under specialist advice only if vancomycin cannot be used).

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13
Q

If meningococcal disease (meningitis with non-blanching rash or meningococcal septicaemia) suspected, which antibiotic should be given before transfer to hospital ?

A

benzylpenicillin sodium
cefotaxime alternative
chloramphenicol if penicillin allergy

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14
Q

In hospital which drug should be considered as adjuvant to antibiotic, but should be given no longer than 12 hours after starting antibiotic in meningitis ?

A

dexamethasone
avoid dexamethasone in septic shock, meningococcal septicaemia, or if immunocompromised, or in meningitis following surgery.

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15
Q

What is empirical treatment of meningitis in hospital if aetiology not known for Adult and child 3 months–50 years and Adult over 50 years ?

A

Adult and child 3 months–50 years,cefotaxime (or ceftriaxone)
Adult over 50 yearscefotaxime (or ceftriaxone) + amoxicillin (or ampicillin)
Suggested duration of treatment at least 10 days

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16
Q

How should osteomyelitis be treated ?

A

Flucloxacillin
Consider adding fusidic acid or rifampicin for initial 2 weeks.
Suggested duration of treatment 6 weeks for acute infection
If penicillin-allergic, clindamycin
Consider adding fusidic acid or rifampicin for initial 2 weeks.
Suggested duration of treatment 6 weeks for acute infection
If meticillin-resistantStaphylococcus aureussuspected, vancomycin (or teicoplanin)
Consider adding fusidic acid or rifampicin for initial 2 weeks.
Suggested duration of treatment 6 weeks for acute infection

17
Q

Outline antibiotic treatment for impetigo ?

A

Topical first line if hydrogen peroxide unsuitable or ineffective: fusidic acid.
Alternative if fusidic acid resistance suspected or confirmed: mupirocin.
Oral first line:Flucloxacillin.
Alternative if penicillin allergy or flucloxacillin unsuitable: clarithromycin or erythromycin (in pregnancy).

18
Q

What are the first choice antibacterials for cellulitis ?

A

Oral or Intravenous first line: Flucloxacillin.
Alternative in penicillin allergy or flucloxacillin unsuitable: clarithromycin, oral erythromycin (in pregnancy), or oral doxycycline.
Oral or Intravenous first line if infection near the eyes or nose: Co-amoxiclav.
Alternative in penicillin allergy or co-amoxiclav unsuitable: clarithromycin with metronidazole.

19
Q

Which antibiotics are used in animal and human bites ?

A

Co-amoxiclav

If penicillin-allergic, doxycycline + metronidazole

20
Q

Which antibiotics can be used for skin and soft-tissue infections caused by MRSA?

A
  • A tetracycline alone or a combination of rifampicin and fusidic acid can be used
  • Clindamycin alone is alternative
  • vancomycin can be used for severe skin and soft-tissue infections associated with MRSA; if a glycopeptide is unsuitable, linezolid
21
Q

What is the treatment for pericoronitis, gingivitis ?

A

metronidazole or amoxicillin alternative

3 day treatment

22
Q

What is the treatment for periodontitis ?

A

Metronidazole or alternative if over 12 doxycycline

23
Q

What is the treatment for sore throat ( acute ) ?

A

Phenoxymethylpenicillin
Suggested duration of treatment 5 to 10 days.
If penicillin-allergic, clarithromycin (or erythromycin)
Suggested duration of treatment 5 days.

24
Q

What is the treatment for sinusitis ?

A

1st line:Non-life threatening symptoms:phenoxymethylpenicillin.
Systemically very unwell, signs and symptoms of a more serious illness, or at high-risk of complications: co-amoxiclav.
2nd line: co-amoxiclav
Penicillin allergy or intolerance: First line: doxycycline or clarithromycin (erythromycin in pregnancy).

25
Q

How should otitis externa be treated ?

A 
No penicillin allergy:
Flucloxacillin
Penicillin allergy or intolerance:
Clarithromycin (or azithromycin or erythromycin)
If pseudomonas suspected:
Ciprofloxacin (or an aminoglycoside)
26
Q

What are the antibiotics of choice in otitis media ?

A

No penicillin allergy
First line: amoxicillin.
Second line (worsening symptoms despite 2 to 3 days of antibacterial treatment): co-amoxiclav.
Penicillin allergy or intolerance
First line: clarithromycin or erythromycin (preferred in pregnancy).

27
Q

What is the first line treatment for h.pylori ?

A

Oral first line for 7 days:

A proton pump inhibitor, plus amoxicillin, and either clarithromycin or metronidazole

28
Q

What is the first line treatment for h.pylori in patients allergic to penicillins ?

A

Oral first line for 7 days:

A proton pump inhibitor, plus clarithromycin, and metronidazole.

29
Q

What are the first line treatment for leprosy ?

A

Drugs recommended are dapsone, rifampicin, and clofazimine.

30
Q

CRB-65 score of 0 indicates what type of CAP severity ?

A

LOW

31
Q

CRB-65 score of 1 or 2 indicates what type of CAP severity ?

A

Moderate

infections (17 decks)

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