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Infections Flashcards

1
Q

Human and animal bites

A

Co-amoxiclav

pen allergy - doxycycline AND metronidazole

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2
Q

Human and Animal bites
prophylaxis duration

A

3 days

  • bitten no signs of infection
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3
Q

Human and Animal bites
treatment duration

A

5 days

bitten and signs of infection

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4
Q

Human and Animal scratches

A

Flucloxacillin

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5
Q

Tick bites (Lyme disease)

A
  1. Doxycycline 100mg BD
  2. Amoxicillin 1000mg TDS
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6
Q

Tick bites (Lyme disease)- duration of treatment

A

21 days

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7
Q

Mild diabetic foot infection

A

mild= less than 2 cm
- flucloxacillin
- pen allergic= clarithro/erithro/doxy

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8
Q

Mod-severe diabetic foot infection

A

Flucloxacillin or co-amoxiclav +/- gentamicin

Penicillin allergy: co-trimoxazole +/- gentamicin

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9
Q

Cellulitis

A

flucloxacillin

Penicillin allergy or if flucloxacillin unsuitable

  • Clarithromycin or erythromycin (eryth in pregnancy)
  • Doxycycline
  • Co-amoxiclav
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10
Q

Cellulitis- near eyes or nose

A

Co-amoxiclav

Penicillin allergy: clarithromycin AND metronidazole

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11
Q

CAP- low severity

A

amoxicillin
doxy/clarithro/erythro (pregnant)

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12
Q

CAP- moderate severity

A

First line: amoxicillin AND clarithromycin (erythromycin in pregnancy)

Doxycycline or clarithromycin

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13
Q

CAP- high severity

A

First line: co-amoxiclav AND clarithromycin (erythromycin in pregnancy)

Second line: levofloxacin

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14
Q

C.diff

A

vancomycin
fidaxomicin

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15
Q

C.diff life threatening

A

Vancomycin and IV metronidazole

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16
Q

Travellers diarrhoea

A

Standby: azithromycin

prophylaxis/treatment: Bismuth Subsalicylate

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17
Q

Otitis media

A

amoxicillin

worsening despite 2-3 days treatment= co-amoxiclav

pen allergy= clarithro/erythro (pregnancy)

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18
Q

Otitis externa

A

topical acetic acid
Second line: topical neomycin sulphate with corticosteroid
If systemic treatment needed: flucloxacillin

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19
Q

H.pylori
diagnostic tests

A

The urea (13C) breath test, Stool Helicobacter Antigen Test (SAT), or laboratory-based serology

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20
Q

What can adversely effect the results of a h.pylori diagnostic test? and which tests are effected?

A

The urea (13C) breath test, Stool Helicobacter Antigen Test (SAT)

PPI- 2 weeks before test
ABX- 4 weeks before

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21
Q

H.pylori- triple therapy

A

PPI+ 2 abx

Amoxicillin/Metronidazole/Clarithromycin
any PPI

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22
Q

H.pylori- triple therapy

doses of abx

A

amox- 1g BD
met- 400mg BD
Clarithro - 500mg BD

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23
Q

H.pylori- triple therapy

duration of treatment

A

7 days

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24
Q

HAP- non-severe

A

First line: co-amoxiclav

Second line (adults): doxycycline, or cefalexin, or co-trimoxazole, or levofloxacin

Second line (children): clarithromycin
-no doxy under 12

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25
Q

Impetigo - localised non bollous

A

First line: hydrogen peroxide 1%

Second line: fusidic acid (mupirocin 2% and resistance suspected)

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26
Q

Impetigo - widespread non bollous

A

First line: fusidic acid (mupirocin 2% if fusidic acid is suspected to be resistant)

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27
Q

Impetigo- Bullous or patients who are systemically unwell

A

First line: flucloxacillin

Second line: clarithromycin (erythromycin in pregnancy)

28
Q

UTI - ABx and duration
men

A

First line: nitrofurantoin or trimethoprim

Treatment duration: 7 days

29
Q

UTI - ABx and duration
non-pregnant women

A

First line: nitrofurantoin or trimethoprim

Second line: pivmecillinam or Fosfomycin

Treatment duration: 3 days if uncomplicated

30
Q

UTI - ABx and duration
pregnant women

A

First line: nitrofurantoin

Second line: cefalexin or amoxicillin

**Trimethoprim is avoided as it is anti-folate **

Treatment duration: 7 days treatment

31
Q

UTI -duration
Catheter associated

32
Q

at what eGFR should Nitro be avoided

33
Q

Strep/scarlett fever

A

pen V

  • normally 5 days treatment for strep
  • adults= 500mg QDS for 5 days
34
Q

Acne Vulgaris

A

Adapalene, clindamycin, benzoyl peroxide, lymecycline

35
Q

Acne Vulgaris- what should be co-prescribed with an abx

A

topical retinoid

* NOT topical ABX*

36
Q

Acne Vulgaris- when should patients abx (topical and oral) be reviewed?

A

3 monthly intervals
treatment no more than 6 months

37
Q

Bacterial vaginosis and trichomoniasis

A

Usually anaerobic infections = Metronidazole

38
Q

Chlamydia

A

Doxycycline

39
Q

Conjunctivitis and blepharitis

A

Chloramphenicol

OTC not to <2 years old or pregnant women

40
Q

Dental abscess

A

Amoxicillin or metronidazole

41
Q

Gonorrhoea

A

Ceftriaxone or ciprofloxacin

42
Q

Meningitis- meningococci

A

Benzylpenicillin
cefotaxime

7 days

43
Q

Meningitis- pneumococci

A

Cefotaxime (or ceftriaxone)

If micro-organism highly penicillin- and cephalosporin-resistant, add vancomycin and if necessary rifampicin.

14 days

44
Q

Meningitis- Haemophilus influenzae

A

Cefotaxime (or ceftriaxone)

Pen allergy
cefotaxime, chloramphenicol

10 days

45
Q

Meningitis- Listeria

A

Amoxicillin (or ampicillin) + gentamicin
Suggested duration of treatment 21 days.
Consider stopping gentamicin after 7 days.

penicillin allergy
co-trimoxazole
Suggested duration of treatment 21 days.

46
Q

Scabies

A

permethrin

  • whole body
  • another application 7 days after
  • creams- leave on for 8-12 hours
  • all close contacts need to be treated
47
Q

Sinusitis

A

Pen v

Doxy

48
Q

Threadworm

A

mebendazole

Do not give to <2 years old pregnant women/BF

** hygiene measures only for Pregnancy and under 2, for at least 6 weeks **

49
Q

Common pathogen
CAP

A

Streptococcus Pneumoniae

50
Q

Common pathogen
UTI

51
Q

Common pathogen
Cellulitis/skin

A

Staphylococcus Aures

52
Q

Common pathogen
Meningitis

A

Streptococcus Pneumoniae

53
Q

Gentamicin- active against

A

Gram-negative bacteria including
Pseudomonas, Proteus, Escherichia coli, Klebsiella pneumoniae, Enterobacter aerogenes, Serratia

Gram-positive Staphylococcus.

54
Q

Gentamicin- Peak and trough serum conc (not endocarditis)

A

Peak serum concentration 5-10mg/L

Trough serum concentration: <2mg/L

55
Q

Gentamicin- Peak and trough serum conc (endocarditis)

A

peak- 3-5mg/L

Trough- <1mg/L

56
Q

Gentamicin- action if:
High trough

A

Increase interval

57
Q

Gentamicin- action if:
high peak

A

reduce dose

58
Q

Gentamicin- action if:
renal impairment

A

increase interval

severe= increase dose interval and reduce dose as well

59
Q

Gentamicin- MHRA warnings

A

ototoxicity

60
Q

Gentamicin- interaction with ototoxic drugs

A

Cisplatin

Loop diuretics (furosemide, bumetanide, torasemide)

Vancomycin

Vinka Alkaloids

61
Q

Gentamicin dose calculation- Obese patient

  • what weight is used?
A

Use ideal body weight based on height to calculate parenteral dose

Use actual: toxicity

Aminoglycosides: hydrophilic

62
Q

Examples of glycopeptides

A

Dalbavancin, teicoplanin, telavancin, vancomycin

63
Q

Glycopeptides-

A

Initial doses based on body weight, then dose adjustments based on serum-vancomycin concentrations

64
Q

Glycopeptides- what weight is used to calculate dose

A

Initial doses based on body weight, then dose adjustments based on serum-vancomycin concentrations

65
Q

Vancomycin- trough concentration

A

15-20mg/L around hour before next dose

66
Q

Vancomycin S/E

A

Red man syndrome

Severe cutaneous adverse reactions – Steven Johnson’s Syndrome

Blood dyscrasias: agranulocytosis, eosinophilia, neutropenia

Pre-reg (13 decks)

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