General principles Flashcards
What are the general symptoms of infections?
- Inflammation, swelling + pus
- Confusion in elderly
- Worsening renal function
- Bio markers: INC CRP, ESR, temp, resp, glucose, DEC bp
What are the side effects of antibiotics?
Gastrointestinal: N, V + D (Taken after food (erythromycin))
Superinfection:
- Candidiasis
- Colitis: Most seen in clindamycin + broad spec (amoxicillin, 3rd + 4th generation cephalosporins and quinolones)
Give examples of narrow spectrum abx
selected: less resistance
- Clindamycin
- Metronidazole
- Trimethoprim
- Phenoxymethylpenicillin
- Linezolid
Give examples of broad spec abx
variety: serious infections
- Aminoglycosides
- Amoxicillin
- Quinolones
- Tetracyclines
- Cephalosporins
- Carbapenems
- Chloramphenicol
Penicillin allergy
- Cross sensitive: cephalosporins + beta lactams
- Alt: Macrolides + Metronidazole (dental infection)
Tetracyclines and children
- Avoid tetracyclines under 12 years old
- Discolours teeth + deposit in growing bones
- Except: doxycycline + lymecycline
Quinolones in children/pregnancy
Causes joint diseases (arthritis in weight bearing joints)
What are elderly at higher risk of when using abx?
- Abx associated colitis
- Renal + liver impairment
- Drug interactions
Which abx are nephrotoxic?
- Aminoglycoside + glycopeptide
- Avoid tetracyclines in RI as they accumulate (except minocycline + doxycycline)
- Caution: nitrofurantoin (relies on renal clearance -need certain GFR, also risk of peripheral neuropathy in RI
Which abx are hepatotoxic?
tetracyclines + rifampicin
Which abx causes cholestatic jaundice?
co-amoxiclav + flucoxacillin
Pregnancy and abx
- Can give: penicillins + cephalosporins
- Avoid: tetracyclines (discolour teeth + deposit in growing bones), trimethoprim (teratogenic) + nitrofurantoin (at term)
- Avoid Q-CAM: quinolones (arthropathy), chloramphenicol (grey baby), aminoglycosides (injection) + metronidazole
Bacteria: Staphylococci
- Impetigo + cellulitis
- Abx: Flucoxacillin
Bacteria: MRSA
- Abx: Vancomycin (OR teicoplanin) (OR linezolid - certain infections)
Bacteria: Streptococci
- Sore throat
- Abx: Benzylpenicillin (for serious infections, phenoxymethylpenicillin)