Infection - Prescribing Pathways

Question 1

What is the first line tx for human and animal bites?

duration for tx and prophylaxis

Answer 1

• co-amoxiclav
• tx - 5dy
• prophylaxis - 3dy

Question 2

What is the second line tx for human and animal bites?

duration for tx and prophylaxis

Answer 2

• doxycycline + metronidazole
• tx - 5dy
• prophylaxis - 3dy

Question 3

what do you use to tx human and animal scratches?

Answer 3

flucloxacillin

Question 4

what is 1st line for tick bites (lyme disease)

dose and duration

Answer 4

• doxycycline
• 100mg BD 21dy

Question 5

what is 2nd line for tick bites (lyme disease)

dose and duration

Answer 5

• amoxicillin
• 1g TDS 21dy

Question 6

1st line for diabetic foot infection less than 2cm

Answer 6

flucloxacillin

Question 7

2nd line or penicilin allergy for diabetic foot infection less than 2cm

3 option

Answer 7

• clarithyromycin
• erythromycin
• doxycycline

Question 8

1st line for diabetic foot infection - severe abscess or oestomyelitis

1st and 2nd line

Answer 8

1) flucloxacillin
2) co-amox +/- gentamicin

Question 9

2nd line or pen allergy for diabetic foot infection - severe abscess or oestomyelitis

Answer 9

co-trimoxazole +/- gentamicin

Question 10

1st line for cellulitis

Answer 10

flucloxacillin

Question 11

tx for cellulitis if pen allergy or if flucloxacillin unsuitable

4 options

Answer 11

• clarithyromycin
• erythromycin
• doxycycline
• co-amox

Question 12

tx if infection near nose/eyes

Answer 12

co-amox

Question 13

tx if infection near nose/eyes + pen allergy

Answer 13

clarithromycin + metronidazole

Question 14

tx for low severity community acquired pneumonia

1st and 2nd line

Answer 14

1) amox
2) doxy / clarithy / erytho

Question 15

tx for moderate severity community acquired pneumonia

1st and 2nd line

Answer 15

1) amox
2)amox + clarith

Question 16

tx for high severity community acquired pneumonia

1st and 2nd line

Answer 16

1) co-amox + clarith
2) levofloxacin

Question 17

c.diff tx

1st, 2nd line and life threatening

Answer 17

1) vancomycin
2) fidaxomicin
- life threatening = vanco + iv metronidazole

Question 18

travellers diarrhoea standby tx

Answer 18

azithromycin

Question 19

travellers diarrhoea prophylaxis tx

Answer 19

bismuth subsalicylate

Question 20

tx of otitis media

1st, 2nd line 3rd if unsuitable

Answer 20

1) amox
2) co-amox
3) clarith/erytho if allergy

Question 21

tx of otitis externa

1st, 2nd line and systemic

Answer 21

1) acetic acid 2%
2) topical neomycin + corticosteriod
- systemic = fluclox

Question 22

h.plyori tx

Answer 22

triple therapy
- PPI
- amox 1g BD
- metronidazole 400mg BD
- clarithromycin 500mg BD

Question 23

what do you not give omeprazole with

Answer 23

clopidogrel

Question 24

how do you diagnose h.pylori

and when not to give it

Answer 24

• urea 13C breath test
• x 2WK after PPI
• x 4WK after antibiotics

Question 25

non-severe hospital acquired pneumonia tx | 1st and 2nd line for adults and children

Answer 25

1) co-amox 2) **adults** doxycl, cefalexin, co-trimox or levofloxacin 2) **child** clarithromycin

Question 26

impetigo localised non-bullous | 1st and 2nd line

Answer 26

1) hydrogen peroxide 2) fusidic acid or mupirocin 2%

Question 27

impetigo wide spread non-bullous | 1st and 2nd line

Answer 27

1) fusidic acid 2) mupirocin

Question 28

impetigo bullous or systemically unwell | 1st and 2nd line

Answer 28

1) flucloxacillin 2) clarithyr

Question 29

lower uti men | 1st and 2nd line and duration

Answer 29

1) nitrofurantoin 2) trimethoprim - for 7DY

Question 30

lower uti non preg | 1st and 2nd line and duration

Answer 30

1) nitrofurantoin or trimethoprim 2) pivmecillinam or fosfomycin if uncomplicated 3DY

Question 31

lower uti pregn | 1st and 2nd line and duration

Answer 31

1) nitrofurantoin (if egfr >45) 2) cefalexin or amox 7DY tx

Question 32

what causes strep throat and scarlet fever and what is the tx? | 1st and 2nd line

Answer 32

**streptococcus** 1) phenoxymethylpenicillin 2) clarithromycin

Question 33

scarlet fever symptoms

Answer 33

**flu like symp** - high temp - swollen neck glands - red rash small raised bumps rough feeling = sandpaper - white coating on tongue

Question 34

tx of acne vulgaris | four OPTIONS

Answer 34

- adapalene - clindamycin - benzoyl peroxide - lymecycline

Question 35

tx of bacterial vaginosis + trichomoniasis

Answer 35

metronidazole

Question 36

tx of chlamydia

Answer 36

Doxycycline

Question 37

tx of conjunctivitis b+ blepharitis

Answer 37

choramphenicol x under 2 (POM) or pregn

Question 38

tx of dental absess

Answer 38

amox or metronidazole

Question 39

tx of gonorrhoea

Answer 39

ceftriaxone or ciprofloxacin

Question 40

tx of meningtisis

Answer 40

benzylpenicillin

Question 41

tx of scabies

Answer 41

permethrin ( whole body)

Question 42

tx of sinusitis

Answer 42

phenoxymethylpencillin or doxycl

Question 43

tx of threatworm

Answer 43

mebendazole x under 2 or pregn

Question 44

what pathogen causes community acquired pnuem

Answer 44

streptococcus pneumoniae

Question 45

what pathogen causes uti

Answer 45

e.coli

Question 46

what pathogen causes thrush

Answer 46

candida albicans

Question 47

what pathogen causes cellulitis

Answer 47

staphylococcus aures

Question 48

what pathogen causes meningitis

Answer 48

steptococcus pneumoniae