Common Infections (UTI, Pneumonia, Skin/Soft Tissue) Flashcards
What are the symptoms of a urinary tract infection?
Bloody/cloudy urine
Pelvic pain
Insufficient bowel emptying
When do you refer if a patient presents UTI symptoms to you in a community pharmacy?
Pregnant
Child
Male
>65 years old
Which people do you not treat for a UTI infection?
Asymptomatic non-pregnant women
What are the 1st line treatment options for an uncomplicated UTI?
- Nitrofurantoin 100mg M/R BD 3/7
- Trimethoprim 200mg BD 3/7
What should the patients eGFR be in order to give nitrofurantoin?
> 45ml/min
What are the 2nd line treatment options for an uncomplicated UTI?
- Pivmecillinam 400mg, then 200mg TDS 3/7
- Fosfomycin 3mg single dose
What is the 1st line treatment option for a pregnant woman with a UTI?
Nitrofurantoin 100mg M/R BD 7/7
What are the 2nd line treatment options for a pregnant woman with a UTI?
- Amoxicillin 500mg TDS 7/7
- Cefalexin 500mg BD 7/7
What is the 1st line treatment option for a man with a UTI?
- Trimethoprim 200mg BD 7/7
- Nitrofurantoin 100mg M/R BD 7/7
When should you never give trimethoprim to a woman, and why?
During her 1st trimester of pregnancy as there is risk of teratogenicity
What is the 1st line treatment option for a child (<16 yrs) with a UTI?
Trimethoprim 200mg BD 3/7
Nitrofurantoin 100mg M/R BD 3/7
What age do you refer a patient with a suspected UTI in a community pharmacy setting?
<16 years old
What are some non-pharmacological treatment options for a UTI?
Increase fluid intake
Manage any constipation symptoms
Urinate after sex
What is pyelonephritis?
A type of UTI that travels to the kidneys
What are the symptoms of pyelonephritis?
Fever
Middle-back pain (where kidneys are)
N+V
What is the 1st line treatment option for pyelonephritis (men + women)?
Cefalexin 500mg BD 7-10 days
What are some 2nd line treatment options for pyelonephritis?
- Co-amoxiclav 500/125mg TDS 7-10 days
- Trimethoprim 200mg BD 14 days
What is cellulitis/erysipelas?
Cellulitis: infection of the deeper layers of the skin
Erysipelas: infection of the uppermost layers of the skin
What are the symptoms of cellulitis/erysipelas?
Red, swollen skin
Oedema
Warmth
Skin appearing shiny
Systemic symptoms if severe
What areas of the body can cellulitis/erysipelas occur?
Hands
Feet
Upper legs
When do you refer a patient if you suspect cellulitis/erysipelas?
Diabetic
Immunocompromised
Appearing on the face
<1 yrs old
If infection appears severe
What are some non-pharmacological interventions for cellulitis/erysipelas?
Painkillers for pain
Increase fluid intake
Avoid compression garments
Manage any skin breaks
What is the 1st line treatment option for cellulitis/erysipelas?
Flucloxacillin 500mg QDS 5-7 days
What are the 2nd line treatment options for cellulitis/erysipelas, or if the patient has a penicillin allergy?
- Clarithromycin 500mg BD 5-7 days
- Doxycyline 200mg STAT, then 100mg OD 5-7 days
Which antibiotic do you give to a pregnant woman with cellulitis/erysipelas?
Erythromycin 500mg QDS 5-7 days
What are the symptoms of a respiratory tract infection?
Cough
SOB
Systemic symptoms - fever/sweats/chills/aches
What does CURB65 stand for?
Confusion
Urea
Respiratory rate
Blood pressure
Age >65 years old
What is community acquired pneumonia?
Pneumonia acquired outside of a hospital setting
When do you refer a patient who presents CAP?
If they have a CURB65 score of >1
What is the 1st line treatment option if the CURB65 score of a CAP patient is <2?
Amoxicillin 500mg TDS 5/7
What are the 2nd line treatment options if the CURB65 score of a CAP patient is <2?
- Doxycyline 200mg STAT, then 100mg OD 5/7
- Clarithromycin 500mg BD 5/7
What is the 1st line treatment option if the CURB65 score of a CAP patient is >3
- Co-amoxiclav 500/125mg TDS 5/7
- Benzylpenicillin 1.2g IV 4 hourly + dox.
- Clarithromycin 500mg BD 5/7
What is the 2nd line treatment option if the CURB65 score of a CAP patient is >3?
Levofloxacin 500mg BD 5/7 IV/PO
Can also use if penicillin allergy present
What is hospital acquired pneumonia (HAP)?
A patient acquiring pneumonia >48h during a hospital setting
What is the 1st line treatment option for HAP?
Co-amoxiclav 500/125mg TDS 5/7
What are the 2nd line treatment options for HAP?
- Doxycyline 200mg STAT then 100mg OD 5/7
- Cefalexin 500mg BD 5/7
- Co-trimoxazole 960mg BD 5/7
- Levofloxacin 500mg OD/BD 5/7