General ID Knowledge Flashcards
Is ceftriaxone a 4C antibiotic?
Yes
Is co-amoxiclav a 4C antibiotic?
Yes
Is clarithromycin a 4C antibiotic?
No
Is co-trimoxazole a 4C antibiotic?
No
Is ciprofloxacin a 4C antibiotic?
Yes
Is clindamycin a 4C antibiotic?
Yes
Gram negative ‘coliforms’ and pseudomonas aeruginosa and sensitive to which commonly used antibiotic?
Gentamicin
Anaerobes are sensitive to which commonly used antibiotic?
Metronidazole
MRSA is sensitive to which commonly used antibiotic?
Vancomycin
Beta-haemolytic streps (groups A C G) are sensitive to which 2 common antibiotics that are both in the same family?
Penicillin and flucloxacillin
Is chloramphenicol a 4C antibiotic?
No
Which antibiotic is used against coliforms if gentamicin has already been used for 3 days?
Aztreonam
When should you notify public health about a notifiable disease?
As soon as you have a reasonable clinical suspicion - DO NOT wait for lab confirmation
Name some of the most common notifiable diseases you may encounter
- E.coli O157
- Haemolytic Uraemic Syndrome (HUS)
- Meningococcal disease
- Necrotizing fasciitis
- TB
- Tetanus / diptheria / polio
- Measles / Mumps / Rubella
- Pertussis
- Haemophilus influenzae type b (Hib)
- etc
What are the exclusion criteria that determine a patient needs to wait for confirmation of stool clear or E.coli rather than just wait 48hrs like everyone else?
- Doubtful personal hygiene or unsatisfactory access to sanitary facilities
- Pre-school attending child
- Food worker
- Clinical/social care staff of vulnerable people
Does Legionnaire’s disease need contact tracing?
No - there is no human to human transmission but you do need to do case finding and try to discover the source
What are the exclusion criteria for gentamicin treatment?
- < 16 years old
- Ascites > 20% body weight
- Major burns > 20% body surface
- Decompensated Liver Disease
- Myasthenia Gravis
- Renal Transplant
- Acute Kidney Injury (AKI 3) on dialysis or eGFR <20ml/min
- End stage renal failure on dialysis with residual kidney function
What is the maximum course length of gentamicin?
72hrs (3 days)
What are the indications for vancomycin use?
- Serious proven or suspected MRSA or coagulase negative staphylococcal infections
- Infections due to other resistant gram positive organisms
- Native (with severe sepsis or where MRSA suspected) or prosthetic valve endocarditis
- Other infections – after consultation with ID Physician or Microbiologist
How long can a PVC be left in before you have to consider taking it out?
72 hrs (3 days)
The bottom of a blood culture bottle should be greenish in colour. An orange/red colour indicates what?
Contamination
What is the optimum volume of blood to draw for a blood culture?
8-10ml - overfilling can lead to false positives
If the patient has an arteriovenous fistula/graft in place in their arm can you cannulate them?
You must use the other arm
Can you take blood cultures from a PVC?
No
If a patient has an existing PVC, where should you not draw blood cultures from?
Sites on the arm above the PVC
A patient has been started on intravenous antibiotics due to severe sepsis. There was not the opportunity to take a blood culture sample prior to commencement of antibiotics.
When should a blood culture be taken or is it even necessary now?
Yes. It is necessary and a blood culture sample should be taken immediately before the next dose of antibiotics
What are the components of SIRS
≥2 of the following:
- Temp >38 or <36
- HR >90
- RR >20
- WBC count >12,000/mm3 or <4,000/mm3 or >10% immature neutrophils
What are the side effects of gentamicin?
Kidney damage and deafness/dizziness
What organs can vancomycin damage?
Kidneys
What side effect can tetracyclines (eg doxycyline) have in children <12?
Permanent staining of teeth and bones
What can you not do while taking metronidazole?
Drink alcohol
What classes of antibiotics are all generally safe in pregnancy?
Penicillins and cephalosporins
What antibiotics should be avoided in the first 3 months of pregnancy?
Trimethoprim and metronidazole
What antibiotics shouldn’t be given to pregnant women?
Gentamicin, tetracyclines (eg doxycycline) and fluoroquinolones (eg ciprofloxacin)
What is co-amoxiclav made up of?
Amoxicillin + clavulanic acid
What is the treatment of TB?
Rifampicin, Isoniazid, Pyrazinamide, Ethambutol orally
