Hospital Flashcards
What is the first-line treatment for someone with Community Acquired Pneumonia and a CURB65 score of 0-2? For how long?
IV/PO Amoxicillin 1g tds
For 5 days
What is the treatment for a Community Acquired Pneumonia with a CURB 65 score of 0-2 in someone who is penicillin allergic?
PO Doxycycline 200mg on day 1 and then 100mg for the following 6 days.
What is the treatment for a Community Acquired Pneumonia with a CURB 65 score of 0-2 in someone who is penicillin allergic AND nil-by-mouth?
IV Clarithomycin 500mg bd for 7 days
What is the first-line treatment for someone with Community Acquired Pneumonia and a CURB65 score of 3-5? For how long?
IV Co-amoxiclav 1.2g tds AND PO Doxyclycline 100mg bd
For 7 days
What is the treatment for someone with Community Acquired Pneumonia and a CURB65 score of 3-5 but is penicillin allergic?
IV Levothyroxin 500mg bd for 7 days
What is the first line treatment for Hospital Acquired Pneumonia when it is non-severe? And for how long?
PO Amoxicillin 1g tds
for 5 days
What is the treatment for Hospital Acquired Pneumonia when it is non-severe but the patient is penicillin allergic? And for how long?
PO Doxycycline 100mg bd
for 5 days
What is the first line treatment for Hospital Acquired Pneumonia when it is severe?
IV Amoxicillin 1g tds AND calculated gentamicin dose
for 7 days
What is the first line treatment for Hospital Acquired Pneumonia when it is severe and the patient is penicillin allergic?
IV Co-trimoxazole AND calculated genatmicin dose
for 7 days
What is the treatment for non-severe aspiration pneumonia?
PO amoxicillin 1g tds and metronidazole 400mg tds
(or doxycycline 100mg bd and metronidazole 400mg tds)
for 7 days
What is the treatment for severe aspiration pneumonia?
TRIPLE THERAPY
IV Amoxicillin 1g tds, IV metronidazole 500mg tds and calculated gentamicin dose
(If penicillin allergic, use PO doxycyline 100mg bd or IV clarithromycin 500mg bd)
cut out gentamicin for step-down treatment as patient improves
for 7 days
What is the antibiotic first-line management of an acute exacerbation of COPD?
PO Amoxicillin 1g tds for 5 days
doxycycline 200mg bd on day one and then 100mg bd if penicillin allergic
What is the empirical treatment for meningitis?
IV Ceftriaxone 2g bd + IV Dexamethasone 10mg qds
What can use use for suspected encephalitis?
IV Aciclovir 10mg/kg tds
In patients with meningitis/encephalitis who are over 60 or immunocompromised, what should be added?
IV Amoxicillin 2g 4hrly
What is the treatment for epiglottitis/supraglottitis?
IV Ceftriaxone 2g od
What action should you take for most ENT infections?
refer to ENT guidance
How should you proceed in suspected endocarditis?
- take blood cultures
- star empirical therapy and refer to ID/microbiology
- check endocarditis guidance for gentamicin/vancomycin
In subacute (indolent native valve) endocarditis, what treatment would you prescribe?
IV Amoxicillin 2g 4 hourly + 1mg/kg gentamycin bd
How would you treat acute (native valve severe sepsis) endocarditis?
IV Flucloxacillin 2g 6hrly (or 4hrlt if >85kg)
How would you treat endocarditis in a patient with a prosthetic valve or suspected MRSA?
IV Vancomycin + IV gentamycin 1mg/kg bd
once theraputic vancomycin levels reached, add rifampicin PO 600mg bd
What inflammatory GI conditions do not require antibiotics?
acute gastritis and acute pancreatitis
What antibiotic would you use for non-severe C Diff infection?
PO metronidazole 400mg tds for 10 days
What antibiotic would you use for severe C Diff infection?
PO/NG Vancomycin 125mg qds +/- IV metronidazole for 10 days
for recurrent C Diff?
see local guidelines
How would you treat any of peritonitis / biliary tract infection or intra-adominal infection?
IV Triple therapy
step down to PO co-trimoxazole +metronidazole
if penicillin allergic, replace amox with vancomcin
Proven spontaneous Bacterial Peritonitis. treatment for mild disease?
PO Co-trimoxazole
Proven spontaneous Bacterial Peritonitis. treatment for severe disease?
IV Piperacillin/Tazobactam 4.5g tds
then step down to mild treatment
Complicated UTI/pyloneohritis/ urosepsis treatment?
IV amoxicillin + gentamicin (or co-trim if allergic)
step down to PO co-trimaxazole for 7 days
What are the male and female treatments for uncomplicated UTIs?
nitrofuratoin 50mg qds or Trimethoprim 200mg bd
3 or 7 days
How would you treat cellulitis?
IV/PO flucloxacillin 1g qds for 7 days
or doxy 100mg if allergic
What would you use for an open fracture prophlaxis?
IV co-amoxiclav 1.2g tds (started within 3hrs)
or IV Co-trim 960mg bd and metronidazole 500mg tds
How would you treat mild diabetic foot infections?
Flucloxacillin 1g qds
or 100mg doxy bd
How would you treat moderate diabetic foot infections?
FLucloxacillin 1g qds + metronidazoe 400mg tds
or doxy 100mg bd and met
What is the treatment for acute spetic arthritis/osteomylitis?
- seek ID Advice
2. IV flucloxacillin 2g qds
