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Infection prescribing pathways Flashcards

1
Q

for human and animal bites whats the first line tx?

A

co-amoxiclav

useful due to it being harder for bacteria (B lactamase) to break down abx

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2
Q

for human and animal bites whats the second line tx? why, how do they work

A

doxycycline and metronidazole
e.g. due to pen allergy
doxycycline: also broad spec, tackles most infection AND
metronidazole: tackle anaerobic bacteria

-> ensures whole infection treated

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3
Q

for human and animal bites whats the prophylaxis timeframe? and treatment timeframe?

A

prophylaxis 3 days i.e. bitten by dog and no sign of infection

treatment: 5 days eg bitten by cat and signs of infection

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4
Q

first line tx for tick bites (lyme disease) and dose?

A

doxycycline 100mg BD

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5
Q

second line tx for tick bites (lyme disease) and dose?

A

amoxicillin 1g TDS

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6
Q

how long to treat lyme disease tick bites

A

21 days

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7
Q

DIABETIC FOOT INFECTION- TREATMENT
MILD (<2cm) 1st line?

If penicillin allergy..?

A

1st line? Flucloxacillin

If penicillin allergy.. Clarithromycin/ Erythromycin/ Doxycycline

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8
Q

DIABETIC FOOT INFECTION- TREATMENT

MODERATE/SEVERE (abscess, osteomyelitis)

1st line?

2nd line?

A

1st line? FLUCLOXACILLIN or CO-AMOXICLAV with/without GENTAMICIN

2nd line? (Penicillin allergy) CO-TRIMOXAZOLE with/without GENTAMICIN

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9
Q

CELLULITIS tx
first line?
pen allergy?

A

first line? flucloxacillin

pen allergy? Clarithromycin OR
Erythromycin (in pregnancy)
Doxycycline

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10
Q

CELLULITIS- TREATMENT
INFECTION NEAR EYES/NOSE

1st LINE?

PENICILLIN ALLERGY? CAM

A

1st LINE? Co-amoxiclav

PENICILLIN ALLERGY? Clarithromycin & Metronidazole

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11
Q

3 types of CAP community acquired pneumonia

A

LOW SEVERITY
MODERATE SEVERITY
HIGH SEVERITY

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12
Q

for low severity CAP, whats the first line tx, and second line tx?

A

1st line? Amoxicillin

2nd line? Doxycycline OR Clarithromycin OR Erythromycin (in pregnancy)

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13
Q

for moderate severity CAP, whats the first line tx, and second line tx?

A

1st line? Amoxicillin OR Erythromycin in pregnancy

2nd line? Doxycycline OR Clarithromycin

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14
Q

in mod severity CAP, when would you prescribe clarithromycin with amoxicillin as first line?

A

if atypical pathogens present

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15
Q

for high severity CAP, whats the first line tx, and second line tx?

A

1st line? Co-amoxiclav w/ Clarithromycin (OR Erythromycin in pregnancy)

2nd line? Levofloxacin

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16
Q

whats the CURB65 score stand for

A

CONFUSION
UREA >7mmol/L
RAISED RESP. RATE>/= 30breaths/min
low BP systolic <90, diastolic </= 60
>65 years

1 point for each

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17
Q

what is CURB65 score used to categorise

A

CAP

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18
Q

what CURB65 = low severity

A

0-1

low risk, consider home tx

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19
Q

what CURB65 = moderate severity

A

2

possible admin vs close outpatient management

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20
Q

what CURB65 = high severity

A

3-5

admission manage as serious

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21
Q

how long does diarrhoea tx last for targeting C Diff?

A

10 days
(C. Difficile = 10 letters)

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22
Q

C Diff diarrhoea tx first and second line?

A
  1. oral vancomycin
  2. fidaxomicin
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23
Q

tx for life threatening C diff diarrhoea

A

vancomycin + IV metronidazole

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24
Q

what drug class should pt stop if they have C. Diff?

A

PPIs

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25
standby tx for travellers diarrhoea
azithromycin
26
prophylaxis/ tx for travellers diarrhoea
Bismuth Subsalicylate (pepto bismol otc)
27
Ear infections otitis media (inner, need systemix tx) first and second line (worsened symptoms after 2-3 days treatment) Penicillin allergy?
Can resolve itself if it’s not bad! so standard paracetamol, ibu, first initially, 3days-1week 1st LINE? Amoxicillin 2nd LINE? Co-amoxiclav Penicillin allergy? Clarithromycin (Erythromycin in pregnancy)
28
Ear infections otitis externa first and second line?
1st LINE? Topical Acetic Acid 2% (OTC earcalm 12+ yrs) 2nd LINE? Topical Neomycin Sulphate w/ Corticosteroid (eg hydrocortisone)
29
for otitis externa if systemic tx needed, what abx given?
flucloxacillin
30
triple therapy for H.Pylori infection PPI: omeprazole/ esomeprazole/ lansoprazole if pt on clopidogrel PLUS 2 of what?
Amoxicillin 1000mg BD OR Metronidazole 400mg BD OR Clarithromycin 500mg BD (always amox first in combination therapy unless pen allergy)
31
H.Pylori is diagnosed by Urea (13C) breath test. when SHOULDNT this be performed
within 2 weeks of taking PPIs- wait within 4 weeks of taking abx - wait can also do stool antigen
32
for non severe HAP (hospital acquired pneumonia) what is 1st LINE? 2nd LINE? (adults) DCCL 2nd LINE? (children)
1st LINE? Co-amoxiclav 2nd LINE? (adults): Doxycycline/ Cefalexin/ Co-trimoxazole/ Levofloxacin 2nd LINE? (children): Clarithromycin
33
Why do we avoid doxycycline in children<12?
Deposition in growing bone & teeth Binding to calcium Causes staining Dental hypoplasia also possible rash - allergy
34
IMPETIGO TREATMENT LOCALISED NON-BULLOUS 1st LINE? 2nd LINE?
1st LINE? Hydrogen Peroxide 1% 2nd LINE? Fusidic Acid (Mupirocin 2% if fusidic acid resistance suspected)
35
IMPETIGO TREATMENT WIDESPREAD NON-BULLOUS 1st LINE?
1st LINE? Fusidic Acid (Mupirocin 2% if fusidic acid resistance suspected) when it spreads to upper lip, near nose and down to chin
36
IMPETIGO TREATMENT BULLOUS or SYSTEMICALLY UNWELL 1st LINE? 2nd LINE?
1st LINE? Flucloxacillin 5 days 2nd LINE? Clarithromycin (OR Erythromycin in pregnancy)
37
LOWER UTI TREATMENT 1st line tx for men and non-pregnant women
Nitrofurantoin (eGFR > 45) OR Trimethoprim
38
lower UTI in men, if no improvement after 48hrs, what other conditions to consider?
pyelonephritis/ prostatis
39
lower UTI in men worsens -> prostatitis, whats the first and second line tx options?
1. ciprofloxacin, ofloxacin, trimethoprim 2. levofloxacin, co-trimoxazole
40
LOWER UTI TREATMENT 2nd line tx for non-pregnant women
Pivmecillinam OR Fosfomycin
41
why is trimethoprim AVOIDED in pregnancy
antifolate + teratogenic
42
what 3 does trimethoprim interact with
mtx phenytoin warfarin
43
LOWER UTI TREATMENT first and second line for pregnant women NCA
1. nitrofurantoin 2. cefalexin/ amoxicillin
44
Nitrofurantoin should only be used if eGFR is...?
≥ 45 mL/min
45
why should nitrofurantoin be avoided at term in preg women
neonatal haemolysis
46
how is pyelonephritis treated in men and non-preg women? preg women?
cefalexin, ciprofloxacin cefalexin
47
LOWER UTI TREATMENT - No. of days MEN? PREGNANCY? UNCOMPLICATED? CATHETER-ASSOCIATED?
MEN? 7 days PREGNANCY? 7 days UNCOMPLICATED? 3 days CATHETER-ASSOCIATED? 7 days
48
STREP THROAT and SCARLETT FEVER both caused by which bacteria?
Streptococcus
49
STREP THROAT/SCARLETT FEVER 1st LINE? 2nd LINE?
1st LINE? Phenoxymethylpenicillin 2nd LINE? Clarithromycin OR Erythromycin (in pregnancy)
50
SYMPTOMS OF SCARLETT FEVER?
- Flu-like: high temp, swollen neck glands - Red rash w/ small, raised bumps, rough feeling like sandpaper - White coating on tongue - strawberry-like
51
TREATMENT - ACNE VULGARIS?
Adapalene (Differin)/ Clindamycin/Benozyl Peroxide (Duac once daily) /Lymecycline
52
TREATMENT - BACTERIAL VAGINOSIS/TRICHOMONIASIS? (anaerobic)
Metronidazole 400mg BD 5-7 days
53
TREATMENT - CHLAMYDIA?
Doxycycline 100mg BD 14 days
54
TREATMENT - CONJUNCTIVITIS/BLEPHARITIS?
Chloramphenicol not suitable for <2yrs or pregnant OTC max tx 5 days
55
TREATMENT - DENTAL ABSCESS?
phenoxym OR Amoxicillin OR Metronidazole PAM
56
TREATMENT - GONORRHOEA?
Ceftriaxone/Ciprofloxacin (IM gent + azithromycin if allergy)
57
TREATMENT - MENINGITIS?
Benzylpenicillin
58
TREATMENT - SCABIES?
Permethrin - apply over whole body, including face, neck, scalp & ears and wash off after 8-12 hrs, if hands washed w soap then retreat
59
TREATMENT - SINUSITIS?
Phenoxymethylpenicillin Very unwell? Co-amoxiclav (pen allergy? Doxycycline/Clarithromycin/Ery in pregnancy)
60
TREATMENT - THREADWORM? OTC sale?
Mebendazole (ovex/ vermox) 2 YEARS+ MAX. SINGLE DOSE 100mg MAX. PACK SIZE 800mg
61
what pathogen causes CAP and meningitis?
Streptococcus Pneumoniae
62
what pathogen causes uti
e coli
63
what pathogen causes thrush
Candida Albicans
64
what pathogen causes cellulitis
Staphylococcus Aureus
65
which abx to prescribe for pt with CAP and pen allergy?
doxy/ clarithro/ erythro

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