Infections and treatments Flashcards
What are the pressure area grades?
1 - discolouration
2 - skin disturbance
3 - necrosis of skin
4 - necrosis of underlying structures
What does it mean if someone is GDH positive?
It means they are colonised with the glutamate dehydrogenase enzyme (found in their faeces) and means they are colonised with C. diff
What are 2 organisms that commonly cause soft tissue infection?
What could you use to treat them?
staph aureus and haemolytic Group A strep
SA - flucloxicillin, co-amoxiclav, carbapenems
Group A strep - any beta lactam/penicillin family
What does MRSA stand for?
methicillin resistant staphlococcus aureus
What is first line for treatment of MRSA?
Glycopeptide - vancomycin or teicoplanin
can use others but have to check sensitivity
What does ESBL stand for? How would you treat it?
Extended Spectrum Beta Lactamase
carbapenems (ertapenem, meropenem)
Name 4 bacteria that cause gastroenteritis? (B for bloody diarrhoea)
Salmonella, Shigella, E. coli (B), campylobacter (B)
What are 2 viruses that cause diarrhoea?
rotavirus, norovirus, adenovirus
What are 3 bacteria that cause community acquired pneumonia? How would you treat a CAP?
staph aureus, strep pneumo, haem influenza
amoxicillin
add flucloxicillin if staph
What are two organisms that might cause atypical pneumonia?
mycoplasma pneumoniae, legionelle pneumophilia, chlamydia
What should be prescribed as first line for persistant diarrhoea due to clostridium difficile?
Vancomycin 125mg qds for 14 days
What are alternative treatments for clostridium difficile?
reducing dose for 6 weeks
feducimycin
fecal transplant
Can you use trimethoprim and nitrofurantoin to treat pyelonephritis? What do you use instead?
no, the antibiotics concentrate locally at bladder but will not work systemically for bacteraemia
cephalosporins or quinolones
What are indications for IV antibiotics?
sepsis, febrile + neutropenia, specific indications (e.g. endocarditis, septic arthritis, osetomyelitis, meningitis, necrotising fascitis), positive blood cultures, oral route compromised, no oral formulation
What do you need to use gentamicin nomogram?
need weight and height
Why should you use gentamicin cautiously?
nephrotoxic and ototoxic
Should not prescribe for longer than 48 hours without discussing with micro
What are common causative agents of skin/soft tissue infections?
Staph aureus
How would you treat staph aureus skin infection?
P - flucloxicillin, co-amoxiclav, carbapenems
NP - gentamicin, glycopeptides
What are the cephalosporins?
Cefuroxime, cefotaxime, ceftriaxone
What are the carbapenems?
Erapenem, meropenem, imipenem
What are the macrolides?
Erythromycin, clarithromycin, azithromycin
What are glycopeptides?
Vancomycin, teicoplanin
What are aminoglycosides?
Gentamicin, amikacin, tobramycin
What are common causative agents for lung infections?
Staph aureus, klebsiella pneumonia, anaerobic organisms, mycobacterium tb
How do you treat klebsiella pneumonia?
P - carbapenems
Culture - all other penicillin, aminoglycosides, cipro
What usually causes kidney infections?
E.coli or klebsiella
How do you treat e.coli or klebsiella kidney infections?
Carbapenems
Culture - all penicillin, ciprofloxacin, aminoglycosides
What are the normal causative agents for meningitis?
Neisseria meningitis, strep pneumonia, H. Influenza, listeria monocytogenes
How would you treat neisseria meningitidis meningitis?
P - Cephalosporins, meropenem
NP - chloramphenicol
How would you treat strep pneumonia meningitis?
P - all penicillin but not flucloxicillin
NP - levo/moxifloxacin, glycopeptide, linezoid, aminoglycosides
How would you treat H. Influenza meningitis?
P - cephalosporins, carbapenems
NP - cipro/levo/moxifloxacin, glycopeptide, linezolid
How would you treat an atypical pneumonia?
clarithromycin
How would you treat a HAP if they got it within 5 days of admission?
co-amoxiclav/cefuroxime
How would you treat a HAP if they got it after 5 days of admission?
tazocin /ciprofloxacin
Which antibiotics do you use to treat prostatitis?
trimethoprim or quinoloes (e.g. ciprofloxacin)
How would you treat C. diff?
first episode - metronidazole
further episodes - vancomycin
How do you treat campylobacter?
clarithromycine
How do you treat salmonella?
ciprofloxacin
How do you treat shigella?
ciprofloxacin
