Prescribing Antibiotics Flashcards
Key principles
1) Avoid antibiotics if safe to do so
2) Give self care & safety netting advice
3) Use decision aids and point of care tests
4) Consider a back up prescription where appropriate
5) Check for allergies, contraindications & interactions
6) Follow NICE & local antimicrobial prescribing guidelines
When to prescribe antibiotics…
When there’s evidence of spreading infection or systemic involvement
If patient has taken antibiotics <6 weeks prior to appointment…
Prescribe alternative as patient may be harbouring resistant bacteria
Dental abscesses are caused by…
Streptococcus spp or gram -ve organisms
Why won’t antibiotics work if abscess is localised to periradicular tissues?
It’s isolated from circulation so very little antibiotic circulation
1st line for dental abcesses
Amoxicillin 500mg TDS 5 days
Or if allergic to penicillin
Metronidazole 200mg TDS 5 days (works on anaerobic bacteria)
2nd line for dental abcesses
Clindamycin 150mg QDS 5 days (Gram+ve cocci bacteria) Comaxiclav 250mg TDS 5 days (Beta-lactamase producing bacteria) Clarithromycin 250mg x2 7 days (Beta-lactase producing bacteria)
ANUG & Pericoronitis
Metronidazole 200mg TDS 3 days
Or
Amoxicillin 500mg TDS 3 days
Sinusitis
Self limiting lasts 2 weeks
Local measure= steam inhalation
Then if drugs needed=
Epinedrine nasal drops 1 drop each nostril TDS
Amoxicillin 500mg TDS 7 days
Or
Doxycycline 100mg, 2 on 1st day then 1 everyday for 7 days.
Do we prescribe prophylactic antibiotics in cases for patients with Infective endocarditis…?
No In 2008 NICE issued clinical guidance which stated antibiotic prophylaxis isn’t recommended.
Reviewed in 2015 and backed it up
What are macrolide antibiotics…?
Azithromycin, clarithromycin, erythromycin, roxithromycin
Drug interactions…
NSAIDS, carbamazepine, azole antifungals, metronidazole, macrolide antibiotics W/ warfarin
Azoles & clarithromycin W/ statins
Athsma exacerbated W/ use of NSAIDS
