Hospital

Question 1

What is the first-line treatment for someone with Community Acquired Pneumonia and a CURB65 score of 0-2? For how long?

Answer 1

IV/PO Amoxicillin 1g tds

For 5 days

Question 2

What is the treatment for a Community Acquired Pneumonia with a CURB 65 score of 0-2 in someone who is penicillin allergic?

Answer 2

PO Doxycycline 200mg on day 1 and then 100mg for the following 6 days.

Question 3

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?

Answer 3

IV Clarithomycin 500mg bd for 7 days

Question 4

What is the first-line treatment for someone with Community Acquired Pneumonia and a CURB65 score of 3-5? For how long?

Answer 4

IV Co-amoxiclav 1.2g tds AND PO Doxyclycline 100mg bd

For 7 days

Question 5

What is the treatment for someone with Community Acquired Pneumonia and a CURB65 score of 3-5 but is penicillin allergic?

Answer 5

IV Levothyroxin 500mg bd for 7 days

Question 6

What is the first line treatment for Hospital Acquired Pneumonia when it is non-severe? And for how long?

Answer 6

PO Amoxicillin 1g tds

for 5 days

Question 7

What is the treatment for Hospital Acquired Pneumonia when it is non-severe but the patient is penicillin allergic? And for how long?

Answer 7

PO Doxycycline 100mg bd

for 5 days

Question 8

What is the first line treatment for Hospital Acquired Pneumonia when it is severe?

Answer 8

IV Amoxicillin 1g tds AND calculated gentamicin dose

for 7 days

Question 9

What is the first line treatment for Hospital Acquired Pneumonia when it is severe and the patient is penicillin allergic?

Answer 9

IV Co-trimoxazole AND calculated genatmicin dose

for 7 days

Question 10

What is the treatment for non-severe aspiration pneumonia?

Answer 10

PO amoxicillin 1g tds and metronidazole 400mg tds
(or doxycycline 100mg bd and metronidazole 400mg tds)

for 7 days

Question 11

What is the treatment for severe aspiration pneumonia?

Answer 11

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

Question 12

What is the antibiotic first-line management of an acute exacerbation of COPD?

Answer 12

PO Amoxicillin 1g tds for 5 days

doxycycline 200mg bd on day one and then 100mg bd if penicillin allergic

Question 13

What is the empirical treatment for meningitis?

Answer 13

IV Ceftriaxone 2g bd + IV Dexamethasone 10mg qds

Question 14

What can use use for suspected encephalitis?

Answer 14

IV Aciclovir 10mg/kg tds

Question 15

In patients with meningitis/encephalitis who are over 60 or immunocompromised, what should be added?

Answer 15

IV Amoxicillin 2g 4hrly

Question 16

What is the treatment for epiglottitis/supraglottitis?

Answer 16

IV Ceftriaxone 2g od

Question 17

What action should you take for most ENT infections?

Answer 17

refer to ENT guidance

Question 18

How should you proceed in suspected endocarditis?

Answer 18

1. take blood cultures
2. star empirical therapy and refer to ID/microbiology
3. check endocarditis guidance for gentamicin/vancomycin

Question 19

In subacute (indolent native valve) endocarditis, what treatment would you prescribe?

Answer 19

IV Amoxicillin 2g 4 hourly + 1mg/kg gentamycin bd

Question 20

How would you treat acute (native valve severe sepsis) endocarditis?

Answer 20

IV Flucloxacillin 2g 6hrly (or 4hrlt if >85kg)

Question 21

How would you treat endocarditis in a patient with a prosthetic valve or suspected MRSA?

Answer 21

IV Vancomycin + IV gentamycin 1mg/kg bd

once theraputic vancomycin levels reached, add rifampicin PO 600mg bd

Question 22

What inflammatory GI conditions do not require antibiotics?

Answer 22

acute gastritis and acute pancreatitis

Question 23

What antibiotic would you use for non-severe C Diff infection?

Answer 23

PO metronidazole 400mg tds for 10 days

Question 24

What antibiotic would you use for severe C Diff infection?

Answer 24

PO/NG Vancomycin 125mg qds +/- IV metronidazole for 10 days

Question 25

for recurrent C Diff?

Answer 25

see local guidelines

Question 26

How would you treat any of peritonitis / biliary tract infection or intra-adominal infection?

Answer 26

IV Triple therapy
step down to PO co-trimoxazole +metronidazole

if penicillin allergic, replace amox with vancomcin

Question 27

Proven spontaneous Bacterial Peritonitis. treatment for mild disease?

Answer 27

PO Co-trimoxazole

Question 28

Proven spontaneous Bacterial Peritonitis. treatment for severe disease?

Answer 28

IV Piperacillin/Tazobactam 4.5g tds

then step down to mild treatment

Question 29

Complicated UTI/pyloneohritis/ urosepsis treatment?

Answer 29

IV amoxicillin + gentamicin (or co-trim if allergic)

step down to PO co-trimaxazole for 7 days

Question 30

What are the male and female treatments for uncomplicated UTIs?

Answer 30

nitrofuratoin 50mg qds or Trimethoprim 200mg bd

3 or 7 days

Question 31

How would you treat cellulitis?

Answer 31

IV/PO flucloxacillin 1g qds for 7 days

or doxy 100mg if allergic

Question 32

What would you use for an open fracture prophlaxis?

Answer 32

IV co-amoxiclav 1.2g tds (started within 3hrs)

or IV Co-trim 960mg bd and metronidazole 500mg tds

Question 33

How would you treat mild diabetic foot infections?

Answer 33

Flucloxacillin 1g qds

or 100mg doxy bd

Question 34

How would you treat moderate diabetic foot infections?

Answer 34

FLucloxacillin 1g qds + metronidazoe 400mg tds

or doxy 100mg bd and met

Question 35

What is the treatment for acute spetic arthritis/osteomylitis?

Answer 35

1. seek ID Advice

2. IV flucloxacillin 2g qds