microguide testing Flashcards
severity markers for c.difficile
temperature >38.5
suspicion of PMC, toxic megacolon and ileus
-evidence of severe colitis in CT scan and x-ray
-wbc >15 cells
-acute rising serum creatinine >1.5 x baseline
treatment of c.difficile with no severity marker
metronidazole oral
treatment of c.diff with one severity marker
vancomycin oral
treatment of c.diff with one severity marker but oral route is not available or an ileus is detected
metronidazole iv and vancomycin
treatment of intra-abdominal infection eg peritonitis and diverticulitis
amoxicillin iv
and
gentamicin
and metronidazole oral
acute cholecystitis and cholangitis treament
amoxicillin iv and gentamicin and metronidazole oral
treatment of penicillin allergy intra abdo infection
vancomycin and gentamicin and metronidazole oral
spontaneous bacterial peritonitis treatment
amoxicillin iv and temocillin and metronidazole oral
sbp treatment with penicillin allergy
ciprofloxacin oral and vancomycin and metronidazole oral
h.pylori treatment
amoxicillin oral and clarithromycin oral or metronidaolze oral and omeprazole oral
h.pylori treatment if penicillin allergy
omeprazole and clarithromycin oral and metronidazole oral
CAP severity scoring
confusion >8 altered mental state urea >7 rr>30 bp <90 or <60 >65
pathogens that cause cap
typicals: s.pneum and h.influezae and s.aureus and m.catarhalis
atypicals: m.pneumonia, legionella, chlamydia, coxiella
cap 0-1 treatment
amoxicillin oral
cap 0-1 treatment with pen allergy
doxycycline oral
cap 2 treatment
amoxicillin and clarithromycin oral
cap 2 with pen allergy
doxycylin or clarithromycin
cap 3-5 treatment
co-amoxiclav iv
and
clarithromycin iv
treatment cap 3-5 with pen allergy
ciprofloxacin oral
and
vancomycin
HAP severity scoring
sepsis temp <36 or >38 wcc <4 or >12 hr >90 rr>20 organ dysfunction
early onset hap <5 days
treat as CAP
hap >5 day onset with 1 severity marker
doxycycline oral
hap >5 days with 2 severity markers
amoxicillin and gentamicin iv
pathogens of hap
gram positive: s.aureus , s.pneumoniae
gram negatives: h.influenzae
treatment of hap >5 days 2 severity markers with a pen allergy
gentamicin and vancomycin iv
treatment of aspiration pneumonia
-metronidazole and amoxicillin oral
pen allergy for aspiration pneumonia
doxycycline
or
co-trimoxazole
and metronidazole
pneumocystis jiroveci treatment
co-trimoxaozole
bacterial meningitis treatment
ceftriaxone iv
and dexamethasone iv
and if >50 immunocomp or pregnant or on steroids then give amoxi iv
bacterial meningitis pathogens
strep pneum and Neisseria meningitidis
cerebral abscess treatment
ceftriaxone iv and metronidazole oral
viral encephalitis treatment
aciclovir iv
cellulitis treatment
flucoxacillin oral/ iv if severe
vanc if mrsa severe
pen allergy treatment of cellulitis or mild mrsa
doxycycline or clarithromycin
treatment of human and animal bites
co-amoxiclav oral
treatment of human and animal bites in elderly and pen allergy
doxycycline oral and metronidazole oral
necrotising fasciitis
ben pen flucox clinda metro genta all iv
necrotising fasciitis pen allergy not severe
ceftriaxone clinda genta metro all iv
necrotising fasciitis pen allergy severe
van
clinda
ciprofloxacin
metro
septic arthritis treatment
flucox iv
septic arthritis and risk of gram negative treatment
flucox iv and ciprofloxacin oral
osteomyelitis treament
fluxoc iv or vanc if mrsa
