Gastrointestinal

Question 1

C. diff?

Answer 1

Non-severe = metronidazole PO

Severe = vancomycin +/- metronidazole

Question 2

Gastroenteritis

a) E. coli?
b) Campylobacter?
c) Salmonella?

Answer 2

a) E.coli = none
b) Campylobacter = clarithromycin (only if immunosuppressed and very sick)
c) Salmonella = ciprofloxacin or ceftotaime (only if co-morbidities)

Question 3

Diverticulitis?

Remember uncomplicated acute diverticulitis may respond to analgesia and dietary modification so only if indicated

Answer 3

Metronidazole + co-trimoxazole

Question 4

Acute pancreatitis?

Answer 4

Unlikely to affect outcome so not really given

Question 5

Peritonitis / biliary tract / intra-abdominal infections?

Answer 5

IV amoxicillin + metronidazole + gentamicin

Allergic: IV vancomycin + met + gent

Question 6

Spontaneous bacterial peritonitis?

Answer 6

Mild = co-trimoxazole PO

Severe = piperacillin / tazobactam IV

Question 7

Liver Abscess?

Answer 7

IV gentamicin + IV amoxicillin + IV metronidazole

Question 8

H. pylori?

Answer 8

Omeprazole + amoxicillin + clarithromycin

Allergic: omeprazole + metronidazole + clarithromycin

Question 9

Sepsis

a) sepsis and enterococci?
b) sepsis and coliforms?
c) sepsis and anaerobes?

Answer 9

a) amoxicillin (co-trimoxazole if allergic)
b) gentamicin (azetreonam if allergic)
c) metronidazole IV then oral