Prescribing Pathways Flashcards
Bites
Human and animal bites -
First line - co- amoxiclav - Broad spectrum
Second line - Doxycycline and Metronidazole
Prophylaxis 3 days
Treatment days 5 days
Tick Bites- Lyme disease
- First line - Doxycycline(100mg BD)
- Second Line - Amoxicillin (1000mg TDS)
- Treatment for 21 days
Diabetic foot infection:
Mild - less than 2 cm// moderate or severe
Mild (less than 2 cm)
- Flucloxacilin
- Pencillin allergy - clarithromycin/ethrythromycin or doxycycline
Moderate or severe:
- Flucloxacillin or co- amoxicillin +/ gentamicin
- Penicillin allergy - co- trimoxozole +/- gentamicin
Cellulitis
First line: Flucloaxacillin
Penicillin allergy or if flucloxacillin unsuitable:
- Clarithromycin or erythromycin in pregnancy
- Doxycycline
- Co-amoxiclav
If infection near eye or nose:
- Co-amoxiclav
- Penicillin allergy:clarithromycin and metronidazole
Community acquired pneumonia-
LOW SEVERITY, Moderate,highhhhhh
Low severity:
1)amoxicillin
2)Doxycycline or Clarithromycin (erythrom’ycin in pregnancy)
Moderate
1)amoxicillin // and clarithromycin (erythromycin in pregnancy) together is atypical pathogens suspected
2)Doxycycline and clarithromycin
High-
1) co-amoxiclav and clarithromycin (Erythromycin in pregnancy)
2) levofloxacin
Diarrhoea:
Clostridium difficile
Clostridium Difficile (10 days treatment)
First line - vancomycin
Second line - fidaxomicin
Life threatening- Vancomycin and I’ve metronidazole
Travellers diarrhoea:
- Stand by azithromycin
- Prophylaxis/treatment - bismuth subsalicylate,ciprofloxacin can be used as prophylaxis but not recommended routinely
Ear infection:
Otitis media and external!!!
Otitis Media-
First line amoxicillin
Second line (worsening symptoms despite 2-3 days treatment): co-amxiclav
Penicillin allergy: clarithromycin -erythromycin in pregnancy
Otitis external:
First line - topical acetic acid 2%
Second line - topical neomycin sulphate with corticosteroid
If systemic treatment needed:flucloxacillin
Helicobacter Pylori:
Triple therapy:
PPI - Omeprazole,esomeprazole etc
-Two of the following antibiotics - Amoxicllin (1000mg BD) or Metronidazole(400mg BD) or clarithromycin(500mg BD)
- Amoxicillin tends to be included in triple therapy unless that patient has a penicillin allergy
Diagnosed by UREA 13C breath test: - shouldn’t be performed within 2 weeks of taking ppi - Shouldn’t be performed within 4 weeks of taking antibiotic
Hospital acquired Pneumonia-
Non severe:
Co…….2nd line - dox…A or chef or co trimazole or levofloxacin
2nd line kids —— basic
-First line - co-amoxiclav
-second line (Adults) doxycycline or CEFALAXIN or co-trimoxazole,levofloxacin
Second line - clarithromycin (children)
Impetigo(localised,widespread,systemic)
Localised non bullous:
- First line - hydrogen peroxide 1%
- Second line - fusidic acid (mupirocin 2% if fusidic acid resistance suspected)
Widespread non bullous- First line - fusidic acid (mupirocin2% if fusidic acid resistance suspected) Bullous or patient who are systemically unwell: First line - flucloxacillin Second line- clarithromycin (erythromycin in pregnancy)
Lower urinary tract infection:
Treatment in men-:
First line:nitrofuratoin or trimethoprim
Treatment in non pregnant women: First line:nitrofuratoin or trimethoprim Second line: pivmecillinam or fosfomycin Treatment in pregnant women: First line - nitrofuratoin Second line - cefalaxin or amoxicillin Nitro = should only be used if eGFR is greater than or equal to 45ml/min
Treatment no of days UTI
Men: 7day treatment
Pregnancy - 7 days
Uncomplicated = 3 days
Catheter associated -7 days
Step throat and Scarlett fever: streptococcus bacteria
- First line:phenoxymethylpenicillin
- Second line; clarithromycin or erythromycin (in pregnancy)
- Scarlett fever:
- Flu like symptoms,high temperature,swollen neck glands
- A red rash with small raised bumps,rough feeling like sand paper
- White coating on the tounge
Acne Vulgaris:
Adaplene,clindamycin,benzolperoxide,lymecycline
Bacterial vaginitis and trichomoniasis:
metronidazole
