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4MB Medical Specialities > Infectious Diseases - Empirical Treatment (Antibiotic Man) > Flashcards

Infectious Diseases - Empirical Treatment (Antibiotic Man) Flashcards

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USMLE® Step 1 flashcards
1
Q

Meningitis treatment is with _______

A

Ceftriaxone IV 2g twice daily + dexamethasone IV 10mg QDS for 4days

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2
Q

Ceftriaxone is what type of antibiotic?

A

Cephalosporins

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3
Q

How do cephalosporins work?

A

Bacteriocidal. Targets the cell wall. interferes with the polymerisation of muramic acid to render the cell susceptible to osmotic lysis.

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4
Q

What type of antibiotic is a cephalosporin?

A

Beta-lactam

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5
Q

Name other examples of cephalosporins

A

Cephalexin
Cefuroxime
Cefixime

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6
Q

What should you add to ceftriaxone when treating for meningitis, if encephalitis is suspected?

A

Add aciclovir IV (10mg/kg 3xdaily)

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7
Q

What should you add to ceftriaxone in an immunocompromised or over 60 patient with meningitis?

A

Amoxicillin 2g IV 4hrly

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8
Q

What is the treatment for epiglottitis/supraglottitis?

A

Ceftriaxone IV 2g once daily

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9
Q

What is the CURB-65 score used for? What does it predict?

A

Used to decide treatment of pneumonia. Predicts mortality.

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10
Q

Empirical treatment for a CURB 0-2 CA pneumonia?

A

Amoxicillin 1g 3xdaily IV or PO for 5 days

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11
Q

If the patient is pen allergic, what should the treatment for a CURB 0-2 CA pneumonia be?

A

Doxycycline PO 200mg on day 1 then 100mg once daily.

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12
Q

CURB 3-5 CAP should be treated with…

A

IV co-amoxiclav 1.2g 3xdaily and doxycycline PO 100mg 2xdaily

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13
Q

In a pen-allergic patient CURB 3-5 CAP should be treated with…

A

IV levofloxacin 500mg 2xdaily

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14
Q

If the patient is nil by mouth what can you replace doxycycline with?

A

IV clarithromycin

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15
Q

What type of antibiotic is amoxicillin? How does it work?

A

It is a penicillin. Works similarly to cephalosporins. Prevents murmuric acid polymerisation to interfere with cell wall and cause osmotic lysis.

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16
Q

What is the difference between amoxicillin and co-amoxiclav?

A

Combination of amoxicillin and clavulanic acid; beta-lactamase inhibitor to overcome beta-lactamase resistance

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17
Q

What type of antibiotic is levofloxacin? Give an example of another drug in this class

A

Quinolones

Ciprofloxacin

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18
Q

How do quinolones work?

A

They affect DNA-gyrase to impair bacterial replication

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19
Q

What type of antibiotic is doxycycline?

A

Tetracyclines

20
Q

How do tetracyclines work?

A

Inhibit protein synthesis.

21
Q

What type of antibiotic is clarithromycin? Give examples of others in this class

A

Azithromycin

Erythromycin

22
Q

How do macrolides work?

A

Inhibit protein synthesis by blocking peptidyltransferase and also ribosomal translation

23
Q

How should a severe hospital acquired pneumonia be treated?

A

IV amoxicillin, metronidazole and gentamicin.

Step down to oral amoxicillin and metronidazole. Total of 7days IV/PO.

24
Q

If pen allergic how should a severe HAP be treated?

A

IV co-trimoxazole + metronidazole + gentamicin. Step down to oral co-tromoxazole and metronidazole. Total of 7days IV/PO.

25
Q

How should a non-severe hospital acquired pneumonia be treated?

A

Oral penicillin and metronidazole for 5days

26
Q

If pen allergic how should a non-severe hospital acquired pneumonia be treated?

A

Oral co-trimoxazole and metronidazole for 5days

27
Q

What is co-trimoxazole?

A

Combination of trimethoprim and sulfamethoxazole

28
Q

What are the indications for ABx in COPD?

A

1 of:

  • Increased sputum
  • Consolidation on CXR
  • features of pneumonia
29
Q

What is the first line ABx therapy for acute exacerbation of COPD?

A

Amoxicillin 500mg 3x daily

30
Q

What is the 2nd line therapy for acute exacerbation of COPD?

A

Doxycycline 200mg on day 1 then 100mg/day. 5 days total.

31
Q

antibiotic therapy in acute cough/bronchitis shows a lot/little clinical benefit

A

Little clinical benefit

32
Q

When might antibiotic therapy be of benefit in acute cough/bronchitis?

A

Frail elderly

33
Q

Antibiotic therapy for acute cough or bronchitis is…

A

Same as COPD; amoxicillin 500mg tds or doxycycline 200mg on day 1 and 100mg for 4 days.

34
Q

Non-severe C.diff infection should be treated with…

A

metronidazole PO 400mg 3xdaily

35
Q

How does metronidazole work?

A

Inhibits nucleic acid synthesis by disrupting DNA of microbial cells.

36
Q

How should severe C.diff be treated?

A

Vancomycin 125mg QDS for 10days +/- metronidazole.

37
Q

How should peritonitis/biliary tract infection/intra-abdominal infections be treated?

A

IV amoxicillin metronidazole + gentamicin. Step down to PO Co-trimoxazole. If pen allergic, vanc, met, gent.

38
Q

Acute gastroenteritis should be treated with which antibiotics?

A

Trick question. Shouldn’t be unless very severe and then, seek advice.

39
Q

Catheterised patients should be treated for UTI based on urinalysis. true/false

A

False- use clinical signs of infection.

40
Q

An uncomplicated female uti should be treated with…

A

Nitrofurantoin 500mg QDS or

trimethoprim 200mg BD (3days)

41
Q

Uncatheterised male UTI should be treated with…

A

Nitrofurantoin 500mg QDS or

trimethoprim 200mg BD (3days)

42
Q

Complicated UTI/Pyelonephritis/urosepsis should be treated with…

A

IV amoxicillin + gentamicin

Co-trimox and gent if pen allergic

43
Q

Cellulitis is treated with…

A

Flucloxacillin 1g QDS or doxycycline 100mg BD PO if allergic

7 days total.

44
Q

Septic arthritis or osteomyelitis should be treated with…

A

IV flucloxacillin 2g QDS and seek ID help.

45
Q

Sepsis of unknown origin is treated with

A

IV Amoxicillin + metronidazole + gentamicin
Consider adding vancomycin or flucloxacillin if concern RE staphylococci.
Allergy: vanc, met, gent.

4MB Medical Specialities (5 decks)

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