Infection: Blood infections, antibacterial therapy

Question 1

For community acquired septicaemia, a broad-spectrum antipseudomonal penicillin or a broad-spectrum cephalosporin should be used. What are examples of these?

Answer 1

Broad-spectrum antispeudomonal penicillin: piperacillin with tazobactam, ticarcillin with clavulanic acid.

Broad-spectrum cephalosporin: Cefuroxime

Question 2

If meticillin-resistant s.aureus is suspected as causing septicaemia, what should be added to treatment with either a broad-spectrum antipseudomonal penicillin (e.g. piperacillin with tazobactam, ticarcillin with clavulanic acid) or a broad-spectrum cephalosporin (e.g. cefuroxime)?

Answer 2

Vancomycin or teicoplanin

Question 3

If anaerobic infection is suspected with community-acquired septicaemia, what should the treatment be?

Answer 3

A broad spectrum cephalosporin and metronidazole

Question 4

How is septicaemia (hospital-acquired) managed?

Answer 4

With a broad-spectrum antipseudomonal beta-lactam antibacterial:

Piperacillin with tazobactam, 
Ticarcillin with clavulanic acid, 
Ceftazidime, 
Imipenem with cilastatin,
Meropenem.

Question 5

What are the broad-spectrum antipseudomonal beta-lactam antibacterials? (5)

Answer 5

1. Piperacillin with tazobactam.
2. Ticarcillin with clavulanic acid.
3. Ceftazidime
4. Imipenem with cilastatin
5. Meropenem.

Question 6

If meningococcal disease is suspected, a single dose of what should be given before urgent transfer to hospital?

Answer 6

Benzylpenicillin

Question 7

If meningococcal disease is suspected and the patient is penicllin allergic, a single dose of what should be given before urgent transfer to hospital?

Answer 7

Cefotaxime.

Question 8

What can be used for meningococcal disease if there is a history of immediate hypersensitivity reaction to penicillin or to cephalosporins?

Answer 8

Chloramphenicol.

Question 9

In meningococcal septicaemia, what can be used to eliminate nasopharyngeal carriage?

Answer 9

Ciprofloxacin
Rifampicin
Ceftriaxone