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Roomies Collab Deck 1: Infectious Disease and CV > GI infections: antibacterial therapy > Flashcards

GI infections: antibacterial therapy Flashcards

1
Q

Would you routinely prescribe antibiotics in an immunocompetent patient with Campylobacter enteritis?

A

NO
- frequently self-limiting

Treat if immunocompromised or if severe infection

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2
Q

What is the first-line antibiotic for Campylobacter enteritis (if patient is immunocompromised or if severe infection)?

A

Clarithromycin
(or azithromycin or erythromycin)

Alternative: ciprofloxacin

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3
Q

What complications are associated with complicated acute diverticulitis? (6)

A
  • Abscess
  • Bowel perforation and peritonitis
  • Fistula
  • Intestinal obstruction
  • Haemorrhage
  • Sepsis
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4
Q

Which patients with acute diverticulitis should be offered oral antibacterials? (3)

A
  • Systemically unwell
  • Immunosuppressed
  • Significant comorbidities

For patients with acute diverticulitis who are systemically well, consider a watchful waiting and no antibacterial prescribing strategy

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5
Q

How soon should patients with suspected complicated acute diverticulitis and uncontrolled abdominal pain be referred to the hospital for assessment?

A

Same-day

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6
Q

If patients are admitted to hospital with suspected or confirmed complicated acute diverticulitis, what is the route of administration for antibacterials?

A

IV

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7
Q

Should antibacterial prophylaxis be given to prevent recurrent acute diverticulitis?

A

NO

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8
Q

What is the route of administration of antibiotics in suspected or confirmed uncomplicated acute diverticulitis?

A

Oral

First line: co-amoxiclav
- 500/125 mg 3 times a day for 5 days then review

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9
Q

What is the first-line antibiotic in suspected or confirmed uncomplicated acute diverticulitis?

A

Co-amoxiclav (oral)
- 500/125 mg 3 times a day for 5 days then review

Alternative in penicillin allergy or co-amoxiclav unsuitable:

  • cefalexin (caution in penicillin allergy) + metronidazole, OR
  • Trimethoprim + metronidazole, OR
  • Ciprofloxacin (only if switching from IV route with specialist advice) + metronidazole
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10
Q

What are the two options for antibiotic regimes in suspected or confirmed complicated acute diverticulitis?

A
  1. Co-amoxiclav, or cefuroxime, + metronidazole

OR

  1. Amoxicillin + gentamicin + metronidazole

Alternative in penicillin and cephalosporin allergy:
- ciprofloxacin + metronidazole

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11
Q

When do we treat salmonella (non-typhoid) with antibiotics? (2)

A
  1. Invasive or severe infection
  2. Risk of developing invasive infection (e.g. immunocompromised patients, those with haemoglobin, or children under 6 months of age)

Antibiotics: ciprofloxacin or cefotaxime

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12
Q

Which patients are at increased risk of an invasive salmonella (non-typhoid) infection and should be treated with antibiotics?

A
  1. Immunocompromised patients
  2. Patients with haemoglobinopathy
  3. Children under 6 months of age

Antibiotics: ciprofloxacin or cefotaxime

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13
Q

Which two antibiotics are used to treat invasive or severe salmonella (non-typhoid) infections?

A

Ciprofloxacin
OR
Cefotaxime

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14
Q

Name 6 antibiotic classes/drugs that have increased risk of the patient developing a C. difficile infection?

A
  1. Ampicillin
  2. Amoxicillin
  3. Co-amoxiclav
  4. 2nd and 3rd generation cephalosporins
  5. Clindamycin
  6. Quinolones

May be a side effect of all antibiotics

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15
Q

What are the three antibiotic drugs used in the treatment of C- difficile infection?

A

Metronidazole (oral)
- 400 mg every 8 hours for 10-14 days

Vancomycin (oral)
- 125 mg every 6 hours for 10-14 days

Fidaxomicin (oral)
- 200 mg every 12 hours for 10-14 days

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16
Q

What is the first-line treatment for the first episode of mild to moderate C. difficile infection?

A

Metronidazole (oral)

- 400 mg every 8 hours for 10-14 days

17
Q

What is the first-line treatment for the second or subsequent episode of C. difficile infection?

A

Vancomycin (oral)
- 125 mg every 6 hours for 10-14 days

Alternative: fidaxomicin (oral)
- 200 mg every 12 hours for 10-14 days

18
Q

What is the first-line treatment for a severe infection of C. difficile?

A

Vancomycin (oral)
- 125 mg every 6 hours for 10-14 days

Alternative: fidaxomicin (oral)
- 200 mg every 12 hours for 10-14 days

19
Q

What antibiotic would you consider for a C. difficile infection that is not responding to metronidazole or if the patient is intolerant of metronidazole?

A

Vancomycin (oral)

- 125 mg every 6 hours for 10-14 days

20
Q

What antibiotic would you consider for a C. difficile infection that is not responding to vancomycin (it is NOT a life-threatening infection and there is NO ileus)?

A

Fidaxomicin (oral)

- 200 mg every 12 hours for 10-14 days

21
Q

What is the first-line treatment for life-threatening C. difficile infection?

A

Oral vancomycin + IV metronidazole

- 10-14 days

22
Q

What is the first-line treatment for C. difficile in a patient with ileus?

A

Oral vancomycin + IV metronidazole

- 10-14 days

23
Q

What antibiotic treatment would you consider for a C. difficile infection that is NOT responding to vancomycin or fidaxomicin?

A

Oral vancomycin + IV metronidazole

- 10-14 days

24
Q

What are two antibacterial options for a severe C. difficile infection in patients with multiple co-morbidities who are receiving treatment with other antibacterials?

A

Fidaxomicin (oral)
- 200 mg every 12 hours for 10-14 days

OR

Vancomycin (oral)
- 125 mg every 6 hours for 10-14 days

25
Q

Can fidaxomicin be used to treat systemic infections?

A

NO
It is poorly absorbed from the GI tract

Fidaxomicin is a macrocyclic antibacterial

26
Q

What three antibiotics would you consider in the treatment of a biliary-tract infection?

A 
Ciprofloxacin
OR
Gentamicin
OR
A cephalosporin
27
Q

What are 4 options for antibiotic regimes for the treatment of peritonitis?

A 
A cephalosporin + metronidazole
OR
Gentimacin + metronidazole
OR
Gentamicin + clindamycin 
OR
Peperacillin with tazobactam alone
28
Q

What are the two options for antibiotic regimes for peritonitis associated with peritoneal dialysis?

A

Vancomycin (or teicoplanin) + ceftazidime added to dialysis fluid

OR

Vancomycin added to dialysis fluid + ciprofloxacin by mouth

Duration of treatment 14 days or longer

29
Q

What organisms are commonly involved in cholangitis in the UK?

A 
Klebsiella spp.
Escherichia coli
Enterobacter spp.
Enterococci
Streptococci

https://patient.info/doctor/cholangitis

Roomies Collab Deck 1: Infectious Disease and CV (84 decks)

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