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Infections November 23 > Infection part 2 Q 50 - 100 > Flashcards

Infection part 2 Q 50 - 100 Flashcards

1
Q

Q51: What is used for diabetic foot infections?

A

Memory tricks:

Mild is always oral only and monotherapy (Flu DEC).

Severe is always more intensive and requires more than 1 drug. IV Gentamicin metronidazole in moderate to severe.

Mild diabetic foot Moderate to severe

No penicillin allergy:
● Flucloxacillin Penicillin allergic:
● DEC (Doxy, Erythro, Clarithro)

No penicillin Allergy:

● Flucloxacillin ± IV gentamicin + Metronidazole. (upto 3 antibiotics)
● Co-amoxiclav ± IV gentamicin + Metronidazole.
● IV ceftriaxone + metronidazole
Penicillin Allergy:

● Cotrimoxazole ± IV gentamicin + Metronidazole. (upto 3 antibiotics)

MRSA Suspected

● Add glycopeptide antibiotics (TV) or linezolid

Pseudomonas suspected:

● IV piperacillin with tazobactam
● Clindamycin + Ciprofloxacin or IV gentamicin (upto 3 antibiotics)&raquo_space;

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2
Q

Q52: What is used for osteomyelitis?

A

1st line: ———————————–Flucloxacillin

Clindamycin—————————–Penicillin allergic:

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3
Q

Q53: What is used for meningitis caused by meningococci?

A

Benzylpenicillin sodium

or cefotaxime (or ceftriaxone) ———-for 7 days

Chloramphenicol ——————————– 7 days

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4
Q

Q54: What is used for meningitis caused by pneumococci?

A

Cefotaxime (+ dexamethasone)

Benzylpenicillin

(cephalosporin + vancomycin if penicillin allergic)

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5
Q

Q55: What is used for meningitis caused by listeria?

A

Amoxicillin or ampicillin + gentamicin ——- 21 days

(consider stopping gentamicin after 7 days)<br></br>- Allergic to penicillin:

Co-trimoxazole ————————————- 21 days

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6
Q

Q56: What is used for meningitis caused by haemophilus influenza?

A

No allergies to penicillins or cephalosporins:

Ceftriaxone or cefotaxime ————–10 days with Rifampicin for haemophilus type b infections

Allergies to Penicillins or cephalosporins or resistance to cefotaxime:

Chloramphenicol ———————-10 days with Rifampicin for haemophilus type b infections

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7
Q

Q57: What is used for epiglottitis?

A

1st line: Cefotaximie OR ceftriaxone

2nd line/penicillin allergic: Chloramphenicol

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8
Q

Q58: What is used for infective COPD exacerbations?

A
  • ## Oral 1st line: Amoxicillin, clarithromycin, or doxycycline
  • High risk of treatment failure: Co-amoxiclav, or levofloxacin
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9
Q

Q59: What is used for acute cough?

A

1st line:——————————- Doxycycline

-Alternatives: Amoxicillin, clarithromycin, or erythromycin

Pregnancy:
Amoxicillin or erythromycin

Recommended duration of oral treatment: 5 days

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10
Q

Q60: What is used for community acquired pneumonia (CAP) based on severity?

A
  • Low severity:——————————-Amoxicillin
  • (penicillin allergic: clarithromycin, doxycycline, or erythromycin in pregnancy)

Moderate severity: —-

Amoxicillin or amoxicillin + clarithromycin

or erythromycin (pregnancy)

High severity:

Co-amoxiclav + clarithromycin or oral erythromycin (pregnancy)
or Levofloxacin (penicillin allergic)

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11
Q

Q61: What are the topical and oral treatments for impetigo?

A
  • Topical 1st line: Fusidic acid<br></br>- Topical 2nd line: Mupirocin<br></br>- Oral 1st line: Flucloxacillin<br></br>- Oral 2nd line: Macrolides (if penicillin allergic or resistance to flucloxacillin)
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12
Q

Q62: What is used to treat cellulitis?

A
  • 1st line: Flucloxacillin<br></br>- Penicillin allergy/unsuitable: Clarithromycin or erythromycin (pregnant), doxycycline, co-amoxiclav
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13
Q

Q64: What is used for animal and human bites?

A

Oral First line: ————————–Co-amoxiclav

(penicillin allergy or Co-Amoxiclav contraindicated: Doxycycline or metronidazole)

IV First line: —————————–Co-amoxiclav

(penicillin allergy or Co-Amoxiclav contraindicated: cefuroxime or ceftriaxone with metronidazole)

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14
Q

Q65: What is used for mastitis during breastfeeding?

A

Flucloxacillin

Penicillin allergy: Erythromycin

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15
Q

Q66: What is used to treat acute pyelonephritis?

A

Non-pregnant women and men:

Oral 1st line:———————— Ceftriaxone, ————————————————————ciprofloxacin,
——————————————–trimethoprim, or
———————————————co-amoxiclave

IV 1st line: Gentamicin, amikacin, ceftriaxone, cefuroxime, ciprofloxacin, co-amoxiclav (any combination of these meds)<br></br>- 2nd line: Refer to microbiology

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16
Q

Q67: What are the causative organisms responsible for food poisoning?

A
  • Bacterial Gastroenteritis:
  • Campylobacter jejuni,
  • E.coli,
  • Salmonella,
  • Shigella, Listeria
  • Viral Gastroenteritis: Rotavirus, Norovirus
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17
Q

Q68: What is the causative organism for TB?

A
  • Mycobacterium tuberculosis complex:
  • M. tuberculosis,
  • M. africanum,
  • M. bovis,
  • M. microti
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18
Q

Q69: What is the causative organism for MRSA?

A
  • Methicillin-resistant staphylococcus aureus
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19
Q

Q70: What is the causative organism for colitis?

A
  • C.difficile,
  • Salmonella,
  • Campylobacter jejuni
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20
Q

Q71: What is the causative organisms for pneumonia?

A
  • Strep Pneumonia,
  • Klebsiella pneumonia,
  • Haemophilus influenzae,
  • Pneumocystis,
  • Pseudomonas Aeruginosa
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21
Q

Q72: What is the causative organisms for gonorrhoea?

A
  • Neisseria gonorrhoeae
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22
Q

Q73: What is the causative organism for UTIs?

A
  • Escherichia coli (most common cause),
  • Candida albicans
  • (infection rare in hospitalized immunocompromised patients or those with an indwelling catheter)
23
Q

Q74: What is the causative organism for whooping cough?

A
  • Bordatella pertusis (pertussis)
24
Q

Q75: What’s the most common treatment for anaerobic infections?

A
  • Metronidazole
25
Q

Q76: What is the most common antibiotics used for strep infections?

A
  • Phenoxymethyl penicillin
  • (Penicillin V)
26
Q

Q77: What is the most common antibiotic used for staph infections?

A
  • Flucloxacillin
27
Q

Q78: What is the most common antibiotic used for MRSA?

A
  • Vancomycin
28
Q

Q79: What is the most common antibiotic used for pseudomonas aeruginosa?

A
  • Gentamicin
29
Q

Q80: What is used for hospital and community acquired pneumonia based on severity?

A

[Information provided for different severity levels]

30
Q

Q81: What does CURB65 stand for and what is it used for?

A

** Used to assess the severity of pneumonia**

    • CURB65 stands for:
  • C = Confusion,
  • U = Urea levels,
  • R = Respiration rate,
  • B = blood pressure < 90/60 mmHg,
  • ## 65 = over 65
31
Q

Q82: How is CURB65 interpreted in terms of scores and what to do for each score?

A
  • Score interpretation (scored between 1-5): 0-1 → treat as outpatient, 2 → short stay in hospital or watch closely as outpatient, 3-5 → requiring hospitalization with consideration to admit to ICU
32
Q

Q83: Give examples of aminoglycosides?

A
    • Tobramycin,
  • amikacin,
  • gentamicin,
  • neomycin sulfate,
  • streptomycin
33
Q

Q84: How do aminoglycosides work?

A
  • All bactericidal,
  • active against some gram-positive and many gram-negative organisms,
  • act through inhibition of protein synthesis
34
Q

Q85: What’s the main aminoglycoside used in the UK?

A
  • Gentamicin
35
Q

Q86: What’s the main route of administration for aminoglycosides?

A
  • Needs to be given IV due to poor oral absorption
36
Q

Q87: What is the main side effects of aminoglycosides?

A
  • Dose-related, ototoxicity,
  • nephrotoxicity,
  • risk in pregnancy (auditory nerve damage in infants)
37
Q

Q88: What’s the main contraindication of aminoglycosides?

A
  • Myasthenia gravis
  • (aminoglycosides may impair neuromuscular transmission),
  • Patent grommet/perforated tympanic membrane (gentamicin when used by ear),
  • Topically in neonates (neomycin)
38
Q

Q89: What the main drug interactions to watch out for when dealing with aminoglycosides?

A
  • Loop diuretics,
  • vancomycin,
  • vinca alkaloids,
  • chemo drugs (“platins”) [ototoxicity],
  • cephalosporins,
  • NSAIDs, vancomycin, ciclosporin, methotrexate, vinca alkaloids, and chemo drugs (“platins”) [nephrotoxicity]
39
Q

Q90: What’s the main MHRA/CHM warning regarding aminoglycosides?

A
  • ## Ototoxicity(increased risk of deafness both orally or with ear drops in people with mitochondrial mutations),

Nephrotoxicity

40
Q

Q91: What’s the therapeutic range of aminoglycosides and what should be done if the levels are out of range?

A
  • Peak serum conc: 5-10 mg/L,
  • Trough serum conc: < 2 mg/L;
  • Adjust dosing interval or dose based on whether pre-dose/trough
  • or post-dose/peak concentrations are high or low
41
Q

Q92: What should be monitored for aminoglycosides?

A
  • Serum concentrations (especially in specific patient populations),
  • renal function,
  • auditory function
42
Q

Q93: What are the main signs of nephrotoxicity and ototoxicity?

A
  • OTOTOXICITY: tinnitus/ringing in the ear, hearing loss, dizziness, uncoordinated movements,
  • NEPHROTOXICITY: decreased urine output, shortness of breath, fluid retention (swelling in legs, ankles, or feet), fatigue
43
Q

Q94: What bacteria is gentamicin effective against?

A
  • Pseudomonas Aeruginosa
44
Q

Q95: Give examples of carbapenems?

A
  • Imipenem
  • (imipenem and cilastatin),
  • meropenem,
  • ertapenem
45
Q

Q96: How do carbapenems work?

A
    • Stick to penicillin binding proteins,
  • prevent cell wall synthesis,
  • bacterial death due to weak cell wall
46
Q

Q97: Which antibiotic classes are like carbapenems?

A
  • Structurally similar to penicillins and cephalosporins, all have a beta-lactam ring
47
Q

Q98: What carbapenem is affected by kidney enzymes and what is given to prevent this?

A
  • Imipenem is affected by kidney enzymes,
  • cilastatin is given to prevent this
48
Q

Q99: What are the main side effects of carbapenems?

A
    • Diarrhea, headache, nausea, vomiting,
  • avoid if history of immediate hypersensitivity reaction to beta-lactam antibacterials
  • (e.g., penicillin and cephalosporins)
49
Q

Q100: Give examples of 1st, 2nd, 3rd, and 5th generation cephalosporins.

A
  • 1st generation: Cefalexin, cefradine, cefadroxil, cefaclor<br></br>- 2nd generation: Cefaclor, cefuroxime<br></br>- 3rd generation: Cefixime, cefotaxime, ceftazidime<br></br>- 5th generation: Ceftaroline, cefiderocol
50
Q

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A

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51
Q

Q51: What is used for
MODERATE – severe
diabetic foot infections?

A

No penicillin Allergy:

Flucloxacillin ± IV gentamicin + Metronidazole.——————————————————– (upto 3 antibiotics)

Co-amoxiclav ± IV gentamicin + Metronidazole.

IV ceftriaxone + metronidazole

Penicillin Allergy:

Cotrimoxazole ± IV gentamicin + Metronidazole. ——————————————————-(upto 3 antibiotics)

Severe is always more intensive and requires more than 1 drug. IV Gentamicin metronidazole in moderate to severe.

52
Q

Q51: What is used for
MILD –MODERATE
diabetic foot infections?

A

Flucloxacillin————————No penicillin allergy

DEC (Doxy, Erythro, Clarithro)———Penicillin allergic:

Mild is always oral only and monotherapy (Flu DEC).

53
Q
A

Infections November 23 (5 decks)

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