Infection Flashcards
What does CRB-65 Score stand for?
C= New onset confusion R= Respiratory rate greater than 30/min B = Systolic blood pressure less than 90 or diastolic BP below or equal to 60mmHg
Age 65 years or above.
Whats the threshold for CRB-65?
CRB-65 Score of:
2 = Consider short stay in hospital or monitor as an outpatient
3 = Requires hospitalisation. Consider ICU
If your CRB-65 score is equal or below 2, what is this classed as?
Non-Severe CAP
First line Treatment in CAP?
First line = Amoxicillin 500 mg TDS + Doxycyline 200mg od
If Amoxicillin is contraindicated in non severe CAP what do you give
Doxycyline 200mg od PO 5-7/7
treatment of severe CAP?
Co-amoxiclav 1.2g TDS IV + Doxyxycline 200mg OD PO 5-7 days
If your CRB-65 score is equal or below 3, what is this classed as?
Severe CAP
In case of penicillin allergy for severe CAP, what do you give?
Vancomycin IV + Ciprofloxacin IV or PO for 5 - 7 days
If i have infection exacerbation of COPD what would you give me?
Doxycycline 200mg STAT
Then 100mg PO for 6 days.
Treat me for bacterial tonsillitis what if i got allergies?
Penicillin V 500mg QDS if unable to swallow give Benzylpenicillin IV
in case of allergy give Clarithromycin
Treatment for Otitis media Sinusitis
Amoxicillin 250mg TDS PO for 7 days Or Clarithromycin
Early onset HAP. How to treat? What about allergies?
Co-Amoxiclav PO 5/7
Or in case of allergy
Doxycycline 5/7 days
UTI first line Treatment if patient has a penicillin allergy?
Trimethoprim 200mg bd PO for 5/7 days
Clostridium Difficile - How to treat? What about severe C Diff?
Metronidazole 400mg PO for 10-14 days
Vancomycin PO for 14 days
First line for cellulitis or in case of allergy?
Flucloxicillin oral QDS
in case of allergy give Clarithromycin
Human and Animal Bites?
Co-Amoxiclav Oral.
how do you treat Diabetic foot infection and how to treat in case of allergy?
Flucloxacillin + Amoxicillin PO for 14 days.
Clarithromycin 500 for 14 days in case of penicillin allergy.
SBP Treatment?
Co-Amoxicillin for SBP Treatment.
Helicobacter Pylori First line Tx?
H Pylori First line.
Amoxicillin / Clarithromycin / Omeprazole.
Metronidazole can be given as part of the triple therapy if you have allergy to Amoxicillin
Important adverse effects of Penicillin?
Skin rash - Anaphylaxis - CNS toxicity
Quinolones such as Ciprofloxacin and Levofloxacin are indicated for what?
UTI - Gastrointestinal infections (Shigella) - LRTI - Pseudmonas aerugenosa.
What is a major side effect of Quinolones?
QT prolongation
What class is Doxycyline in and what SPECIFIC side effects are associated with it?
Doxycycline is a Tetracycline and it has adverse effects of oesophageal irritation, discolouration of teeth, photosensitivity and inter-cranial hypertension
State how Macrolides cause interactions and what do they inhibit
Inhibits CYP450 and this increases [drugs] made by this path e.g Statins/ Warfarin/ Amiodarone/ Antipsychotics/ Quinine/ Quinolones/ SSRIs
what Gram is vancomycin effective against? and where does it get used generally?
Vancomycin is effective against Gram Positives and ineffective against Gram negatives. It is generally prescribed in severe cases where penicillin is not appropriate.
State indication, MOA and ADR and Interactions of Metronidazole
Metronidazole
Indication: Oral Infections
MOA: Only active against Anaerobic Gram Positives. Generates Free radicals that bind to and causes DNA generation.
ADRs: Optic neuropathy, Seizures, GI upset
Interactions: Inhibits CYP450 enzymes and reduces metabolism of warfarin.
