Empirical Antibiotics Flashcards
Describe the CURB65 score for pneumonia.
C - confusion U - urea: 7+ R - respiratory rate: 30+ B - BP: <90/60 65 - over 65+ yo
Which antibiotics would you give for non-severe community acquired pneumonia (CAP), with a CURB65 score of 0-1?
For how long?
Amoxicillin, OR
Doxycycline, OR
Clarithromycin
Duration: 7 days
Which antibiotics would you give for non-severe community acquired pneumonia (CAP), which a CURB65 score of 2?
What would you give in the case of true penicillin allergy?
For how long?
Amoxicillin, PLUS
Doxycycline OR clarithromycin
In penicillin allergy: ONLY clarithromycin
Duration: 7 days
Which antibiotics would you give for severe community acquired pneumonia (CAP)?
What would you give in the case of true penicillin allergy?
For how long?
IV/oral clarithromycin, PLUS
IV amoxillin OR IV co-amoxiclav
In penicillin allergy: IV/oral levofloxacin
Duration: 7-10 days (up to 14 days if atypical organisms suspected)
How would you define severe CAP?
CURB65 score: 3+
OR
CAP with sepsis
Which antibiotics would you give for hospital acquired pneumonia? What if:
a) It occurs within 4 days of admission
b) It occurs 5+ days after admission and is i) non-severe or ii) severe
For each, state how long to continue treatment, and by which route to administer it.
WITHIN 4 DAYS ADMISSION:
Treat as CAP
Duration: 7 days
5+ DAYS AFTER ADMISSION: Non-severe: -Oral co-amoxiclav, OR -Oral doxycycline -Duration: 7 days
Severe:
- IV amoxicillin, PLUS
- IV aztreonam
- Duration: 7-10 days (up to 14 if atypical bacteria suspected)
Which antibiotics would you give for infectious exacerbations of COPD, or LRTIs?
For how long?
What is the only indication for antibiotic therapy in this case?
Oral amoxicillin, OR
Oral doxycycline, OR
Oral clarithromycin
Duration: 5 days
Indication: purulent sputum
Which antibiotics would you give for uncertain diagnosis of LRTI/UTI?
For how long?
Oral doxycycline, OR
Oral amoxicillin
Duration: 5 days
PLUS oral trimethoprim
Duration: 3 days in females, 7 days in males
Which antibiotics would you give for severe/complicated infectious exacerbations of COPD?
For how long?
IV amoxicillin, OR
IV clarithromycin
Duration: 7 days
Which antibiotics would you give for aspiration pneumonia?
For how long?
IV metronidazole, PLUS
IV amoxicillin OR IV clarithromycin
Duration: 7 days
Which antibiotics would you give for mild soft tissue infection?
What if the patient had a true penicillin allergy?
For how long?
Oral flucloxacillin
In penicillin allergy: oral doxycycline OR oral clarithromycin
Duration: 7 days
Which antibiotics would you give for mild human/animal bite, OR peri-anal soft tissue infection?
What if the patient had a true penicillin allergy?
For how long?
Oral co-amoxiclav
In penicillin allergy: oral doxycycline PLUS oral metronidazole
Duration: 7 days
Which antibiotics would you give for moderate cellulitis?
What if the patient had a true penicillin allergy?
For how long?
IV flucloxacillin
In penicillin allergy: IV vancomycin
Duration: 10 days
Which antibiotics would you give for severe or rapidly progressing cellulitis?
What if the patient had a true penicillin allergy?
For how long?
IV flucloxacillin, PLUS
IV gentamicin, PLUS
IV clindamycin
In penicillin allergy: replace flucloxacillin with IV vancomycin
Duration: 10 days
Which antibiotics would you give for severe human/animal bites, or severe peri-anal infection?
What if the patient had a true penicillin allergy?
For how long?
IV co-amoxiclav
In penicillin allergy: IV metronidazole PLUS IV clarithromycin PLUS IV gentamicin
Duration: 10 days
