Resp, cardio, GI

Question 1

Community acquired pneumonia - 0-2 CURB65

Answer 1

IV/PO amoxicillin 5 days

Doxycycline if penicillin allergic

Question 2

Community acquired pneumonia - 3-5 CURB65

Answer 2

IV co-amoxiclav + IV clarithromycin/ PO doxycycline
Levofloxacin if penicillin allergic
Step down to doxycycline for an IV/PO total of 7 days

Question 3

Hospital acquired/aspiration pneumonia - Severe

Answer 3

IV metronidazole + amoxicillin + gentamicin
Step down to PO metronidazole + co-trimoxazole for an IV/PO total of 7 days
Replace amoxicillin w/ co-trimoxazole if allergic

Question 4

Hospital acquired/aspiration pneumonia - Non-severe

Answer 4

PO metronidazole + amoxicillin 5 days

Replace amoxicillin w/ co-trimoxazole if allergic

Question 5

Hospital acquired/aspiration pneumonia - previous ICU admission/history of MRSA

Answer 5

Seek advice

Question 6

Acute exacerbation of COPD WITH increased sputum purulence

Answer 6

1st line amoxicillin

2nd line doxycycline

Question 7

Acute exacerbation of COPD WITHOUT increased sputum purulence

Answer 7

No antibiotics unless consolidation on CXR/signs of pneumonia

Question 8

Non-pneumonitic LRTI

Answer 8

Same as COPD

Question 9

Endocarditis - native valve, indolent (subacute)

Answer 9

IV amoxicillin + gentamicin

Question 10

Endocarditis - native valve, severe sepsis (acute)

Answer 10

IV flucloxacillin

Question 11

Endocarditis - prosthetic valve/suspected MRSA

Answer 11

IV vancomycin + gentamicin + PO rifampicin

Question 12

Endocarditis - native valve, severe sepsis + risk factors for resistant pathogens

Answer 12

IV vancomycin + meropenem

Question 13

C. diff - non-severe

Answer 13

PO metronidazole 10 days

Question 14

C. diff - severe

Answer 14

PO/NG vancomycin ± IV metronidazole 10 days

Question 15

Peritonitis

Answer 15

IV metronidazole + amoxicillin + gentamicin
Step down to PO metronidazole + co-trimoxazole for an IV/PO total of 7-10 days
Replace amoxicillin with vancomycin if allergic

Question 16

Biliary tract

Answer 16

IV metronidazole + amoxicillin + gentamicin
Step down to PO metronidazole + co-trimoxazole for an IV/PO total of 7-10 days
Replace amoxicillin with vancomycin if allergic

Question 17

Intra-abdominal

Answer 17

IV metronidazole + amoxicillin + gentamicin
Step down to PO metronidazole + co-trimoxazole for an IV/PO total of 7-10 days
Replace amoxicillin with vancomycin if allergic

Question 18

Acute gastroenteritis

Answer 18

No antibiotic treatment required. Seek advice if severe

Question 19

Acute pancreatitis

Answer 19

Antibiotics unlikely to affect outcome. Seek advice

Question 20

Spontaneous bacterial peritonitis - severe

Answer 20

IV piperacillin/tazobactam

Step down to PO co-trimoxazole for an IV/PO total of 5-7 days

Question 21

Spontaneous bacterial peritonitis - non-severe

Answer 21

PO co-trimoxazole

Question 22

Legionella pneumophila

Answer 22

Erythromycin, clarithromycin

Question 23

Amoeba infections

Answer 23

Metronidazole

Question 24

Giardia infections

Answer 24

Metronidazole