GI Infections Flashcards
Treatment for acute pancreatitis?
Antibiotics unlikely to affect outcome
Treatment for gastroenteritis?
Supportive
Non severe C Difficile infection?
Metronidazole PO 400mg tds (10 days)
Severe C Difficile infection?
Vancomycin PO/NG (10 days)
+/- IV Metronidazole
Treatment for infection of the biliary tract (acute cholecystitis/cholangitis)?
IV Amoxicillin + Metronidazole + Gentamicin
Treatment for severe spontaneous bacterial peritonitis?
Piperacillin/Tazobactam then step down to Co-trimoxazole
Treatment for mild spontaneous bacterial peritonitis?
Co-trimoxazole
Treatment for peritonitis of an uknown cause (i.e. possible biliary tract perforation)
IV Amoxicillin + Metronidazole + Gentamicin
Treatment for intraabdominal infection if penicillin allergic?
Swap amoxicillin for Vancomycin -
Vancomycin + Metronidazole + Gentamicin
All anaerobes are sensitive to which antibiotic?
Metronidazole
All coliforms are sensitive to which antibiotic?
Gentamicin
What are the common causative organisms of intraabdominal infections?
Coliforms, anaerobes and enterococci
What are the common causative organisms of spontaneous bacterial peritonitis?
coliforms +/- anaerobes
What are the features of coliforms?
- Gram negative (stain pink)
- bacilli
- able to ferment lactose
- found in faeces
- unable to form spores
What are enterococci?
- Gram positive (stain purple)
- facultative anaerobic
- usually found as diplococci
- Part of normal COLON flora
- unable to form spores
What are the features of C difficile?
- spore forming
- gram positive
- bacilli
- anaerobic
- produce toxins
Which pathogens are resistant to all penicillins and why?
Extended-spectrum beta-lactamase producing bacteria
This enzyme breaks down the beta lactam ring that some antibiotics (such as penicillins and cephalosporins) use to inhibit bacterial cell wall synthesis.
What steps should you take if an infection of the E Coli strain 0157 is SUSPECTED?
- Notify Health Protection & Infection Control
- Faeces for culture
- film for fragmented blood cells for suspected Heamolytic-Uraemic Syndrome
- Biochemistry: U&E, LDH, CRP for baseline assessment
Which parts of the GI system are usually sterile?
The peritoneum, the duodenum, the stomach and the biliary tract
Which group of organisms are in the normal flora of the mouth?
Streptococcus viridans
Neisseria species
Anaerobic organims
Which organisms are found in the colon or faecal flora?
Coliforms, anaerobes, enterococci
Organisms such as C dif are strict anaerobes, what does this mean?
The organism will NOT grow in the presence of oxygen
What is the drug of choice for enterococci?
Amoxicillin (co -trimoxazole if allergic)
