GI infections

Question 1

GI system:

What is a common associated infection?

Answer 1

C.difficile
diarrhoea

H.pylori

Question 2

GI system:

What antibiotics are associated with colitis?

Answer 2

Clindamycin
ampicillin/ amoxicillin
2/3rd gen cephalosporins
quinoline

Question 3

GI system:

Who are at risk of c.diff?

Answer 3

-over 65 years
-antibiotics
-hospital or a care home for a long time
-weakened immune system
-proton pump inhibitor (PPI) or other medicines that reduce stomach acid
-you’ve had a C. diff infection in the past

Question 4

GI System:

How long will C.diff infection last for and how long will patient remain infections for?

Answer 4

resolve in 1–2 weeks. The person will remain infectious whilst they still have symptoms, and they should stay away from work or school until they have been free from diarrhoea for 48 hours.

Question 5

What should be avoided in C.difficile?

Answer 5

Loperamide
alcohol hand rubs are ineffective against c.diff spores.

Question 6

GI System:

What is gastroenteritis?

Answer 6

Gastroenteritis is an infection of the gut with microbes, which usually causes a mild tummy upset for a day or two. It can also be called ‘stomach flu’.

Question 7

GI System:

How is gastroenteritis managed?

Answer 7

hydration

metronidazole

clindamycin

Question 8

GI system:
What are common causes?

Answer 8

-Infection with noroviruses and adenoviruses are common causes

-Food poisoning from eating contaminated; Common bacterial causes campylobacter, salmonella and Escherichia coli (E. coli).

-Poisons (toxins) produced by bacteria can also cause food poisoning.

-parasites

-Food and Water contaminated particularly in countries with poor sanitation.

Question 9

When is antibiotics given in gastroenteritis infection?

Answer 9

If microbiological cause is found:

Giardiasis
Prescribe metronidazole 2000 mg once daily for 3 days, or 400 mg three times daily for 5 days.

Campylobacteriosis
Antibiotic treatment is not usually needed for people with mild symptoms, as infection is usually self-limiting.
If symptoms are severe (high fever, bloody and/or high-output diarrhoea) or the person is immunocompromised, consider early prescribing with clarithromycin 250–500 mg twice daily for 5–7 days, within 3 days of onset of illness.

Amoebiasis or amoebic dysentery
Drug treatment is usually recommended for all confirmed cases after specialist advice, such as metronidazole followed by the anti-protozoal drug diloxanide.

Question 10

H.Pylori
What is first line treatment if patient is NOT penicillin allergic ?

Answer 10

7 days
PPI BD
+
Amoxicillin 1g BD
+
and either
clarithromycin BD ot metronidazole 400mg BD

Question 11

H.Pylori
What is first line treatment if patient is penicillin allergic ?

Answer 11

7days
PPI BD
+
Clarithromycin 500mg BD
+
Metronidazole 400mg BD

Question 12

H.PYLORI:
What PPI can be given as part of treatment regimes?

Answer 12

Lansoprazole 30 mg,
omeprazole 20–40 mg,
esomeprazole 20 mg,
pantoprazole 40 mg,
rabeprazole 20 mg.

Question 13

H.PYLORI:
What is treatment If the person is allergic to pencillin and has had previous exposure to clarithromycin?

Answer 13

A PPI BD
+
metronidazole 400 mg BD
+
tetracycline hydrochloride 500 mg QDS
+
bismuth subsalicylate 525 mg QDS

Question 14

What is treatment if the person has had previous exposure to clarithromycin and metronidazole in second line treatment?

Answer 14

offer a 7-day triple therapy regimen of
A PPI BD and amoxicillin 1 g BD
and
Either levofloxacin 250 mg BD
or
tetracycline hydrochloride 500 mg QDS

Question 15

H.pylori:
What is second line treatment?

Answer 15

eradication regimens consist of (PPI) together with a combination of antibiotics (taking into account previous exposure to clarithromycin, metronidazole, or levofloxacin), and in some cases bismuth (a chelate).