Gram negative

Question 1

Legionella treatment

Answer 1

Co-amoxicillin and levofloxacin

Fluoroquiniolone (better than doxy)or a newer generation macrolide

Question 2

Where is the site of infection?

Answer 2

Rubor, dolor, calor, tumor

Question 3

What do you do if you suspect endocarditis?

Answer 3

3 sets of blood culture in the 1st hour and give antibiotics after that

Question 4

Side effects and complications of fluoroquinolones

Answer 4

generalised tnedonitis
achiles tendon rupture
epilepsy
ruptures of aortic aneurysms

Question 5

Which is the common monobactam used and why is it used?

Answer 5

Aztreonam - purely active against gram negatives

Alternative to gentamicin for people whose kidneys can’t stand gentamicin

Question 6

Workforce for gram negative sepsis in tayside?

Answer 6

Gentamicin

Question 7

What is gentamicin not sensitive against?

Answer 7

gram positives or anaerobes

Question 8

Common g. negative organisms shape

Answer 8

bacilli

Question 9

When is pseudomonas seen more commonly?

Answer 9

CF and burns

Question 10

What is the drug of choice for haemophilus influenzae?

Answer 10

Amoxicillin (covers for haemophilus and pneumoniae)

Doxcycycline active as well

Question 11

What is atypical pneumonia?

Answer 11

pneumonia that is not typical of strep pneumonia

Question 12

Treatment for atypical pneumonia?

Answer 12

Doxycycline

Clarithomycin (reserved)

Fluoroquinolones (only in Legionella)

Question 13

What is the mortality rates assoctaed with legionella?

Answer 13

10% outside

25% mortality - if aquired in the hospital

Question 14

How can the diagnosis of legionella be made?

Answer 14

Urine Legionella antigen

Question 15

Important causes of gram negative sepsis - enterobacter

Answer 15

E.coli, Klebsiella, Pseudomonas, Neisseria meningitidis

Question 16

Which drug will treat pseudomoas?

Answer 16

Ciprofloxacin (ONLY)

Ceftazidime (only cephalosporin that works)

Meropenem

Question 17

Meningitis antigen importance

Answer 17

Capsule polysaccharides - to track outbreaks and make vaccines

Question 18

Ecoli 0157 H7 antigens

Answer 18

O and H

Question 19

Salmonella antigens

Answer 19

0

Question 20

Which bugs can be identified with anitgens?

Answer 20

Haemophilus influenza
Neisseria meningitis
Ecoli 0157
Salmonella
Shigella

Question 21

Geatures of coliforms

Answer 21

g. negative rods

Question 22

How does klebsiella cause resistance?

Answer 22

Due to plasmids -> colonisation with gram negative resistant bacteria

Question 23

Which bug turns McConkey agar pink?

Answer 23

Ecoli

Question 24

Perforated peritonitis treatment

Answer 24

Amoxicillin + gentamicin + metronidazole

Gentamicin (gram negative coliforms)

metronidazole - anaerobes

Question 25

Which drugs won’t work in ESBL producing organisms?

Answer 25

Penicillin, cephalosporins and aztreonam

Question 26

If it states that penicillin, cephalosporin and aztreonam works –> iwhat does it mean?

Answer 26

No ESBL production

Question 27

If you have an ESBL and we don’t recognise and we have given a wrong antibiotic in SEPSIS, what happens?

Answer 27

2x risk of mortality

Question 28

What is the major problem associated with gentamicin?

Answer 28

Nephrotoxicity

Question 29

Would you use trimethoprim in a SEPSIS scenario?

Answer 29

No, as the bacteriostatic