ENT infections

Question 1

Sinusitis

Answer 1

No penicillin allergy
First 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.
Second line (worsening symptoms despite 2 or 3 days of antibiotic treatment):
Non-life threatening symptoms: co-amoxiclav.
Systemically very unwell, signs and symptoms of a more serious illness or at high-risk of complications: consult local microbiologist.
Penicillin allergy or intolerance
First line: doxycycline or clarithromycin (erythromycin in pregnancy).
Second line (worsening symptoms despite 2 or 3 days of antibiotic treatment): consult local microbiologist.

Question 2

Otitis Externa

Answer 2

If pseudomonas suspected
Ciprofloxacin (or an aminoglycoside).
No penicillin allergy
Flucloxacillin.
Penicillin allergy or intolerance
Clarithromycin (or azithromycin or erythromycin)

Question 3

Otitis media

Answer 3

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 (in pregnancy).
Second line (worsening symptoms despite 2 to 3 days of antibacterial treatment): consult local microbiologist.

Question 4

Conjunctivitis

Answer 4

Chloramphenicol