Infection treatment

Question 1

Treatment of sinus infection

Answer 1

1st line (non-life theratening): phenoxymethylpenicillin
2nd line (life-threatening/severe): Co-amoxiclav

Penicillin allergy:
doxy or clarithromycin

Pregnant - erthyromycin

Question 2

Treatment of oral infections

Answer 2

Broad spectrum penicillins (amoxicillin, phenoxymethylpenicillin and co-amoxiclav)
Cephalosporins (cefalexin and cefradine) - little adv over penicillins for dental infections
Metronidazole and tinidazole - pen allergic/defntal infection
Metro or doxy - peridonitis

Question 3

Treatment of conjunctivitius

Answer 3

Chloramphenicol

Question 4

Treatment for otitis externa

Answer 4

Flucloxacillin
Penicillin allergy/intolerance - clarithromycin (or azithromycin or erythromcin)
If pseudomonas suspected - ciprofloxacin (or an aminoglycoside)

Question 5

Treatment for otitis media
Who does it commonly effect
When should you offer tx

Answer 5

1st line: Amoxicillin
2nd line: co-amoxiclav
Penicillin allergy/intolerance - clarithromycin/eryhromycin (preferred in preg)

Commonly effects children (normally viral)
Offer tx in those systemically unwell, signs and sx of more serious illness who are at high-risk of serious complications due to pre-existing comobidities. Also considered if otorrhoea (discharge following perforation of eardrum present) in children <2

Question 6

Treatment of impetigo

Answer 6

Topical first line: hydrogen peroxide, if unsuitable or ineffective fusidic acid, alt mupirocin

Oral first line flucloxacillin
Alt if pen allergy: clarithromycin or erythromycin (preg)

Question 7

Treatment of cellulitis

Answer 7

Oral/IV First line: Flucloxacillin
Pen allergy: clarithromycin, oral erythromycin (preg) or oral doxy

If infection near nose or eyes:
Co-amox
pen allergy - clarithrmycin WITH metronidazole

Severe infection:
Oral/IV - Co-amox, clindamycin, cefuroxime, IV ceftriaxone,
MRSA sus - IV vanc, teic or linezolid

Question 8

Treatment of animal/human bite

Answer 8

Oral first line - co-amox
Pen allergy - doxy with metronidazole

IV first line - co-amoxiclav
Pen allergy - cefuroxime or cetriaxone WITH metronidazole

Question 9

Treatment of mastitis during BF (how long tx)

Answer 9

Flucloxacillin (10-14 days)

Pen allergy erythromycin (10-14 days)

Question 10

Treatment of endocarditis

Answer 10

Amoxicillin +/- low dose gentamicin
+ Vancomycin if MRA sus/pen allergy

Flucloxacillin in staphylococci
Benzylpenicillin in streptococci

Question 11

Treatment of meningitis

Answer 11

Benzylpenicillin

Pen allergic - cefotaxime

Question 12

Treatment of bacterial vaginosis + length of tx

Answer 12

Oral metronidazole (5-7 days)
Alt - topical metro (5 days), topical clindamycin (7 days)

Question 13

Treatment of chlamydia + length of tx

Answer 13

Azithromycin or doxy (single dose azithromycin or doxy 7 days)
Alternative: erythromycin (14 days)

Question 14

Treatment of gonorrhoea

Answer 14

Ceftriaxone(IM), oral cipro

alt: IM gent + oral azithromycin

Question 15

Treatment syphillis

Answer 15

Infection <2 years
Benzathine benzypenicillin (single dose), 7 days for pregnancy
Alt doxy or erythromycin (14 days)

Late latent syphillis (>2 years)
Benzathine benzypenicillin ow for two weeks
ALt doxy for 28 days

Question 16

Treatment of osteomyelitis

Answer 16

Flucloxacillin

alt pen allergy: clindamycin