Tayside Hospital Antibiotic Man Flashcards
Mild/moderate community acquired pneumonia (0-2 CURB65)
Amoxicillin 1g tds IV/PO (5 days)
(If penicillin allergic:Doxycycline PO 200mg on day 1 then 100mg od or IV Clarithromycin if NBM)
Severe community acquired pneumonia (3-5 CURB65)
Co-amoxiclav IV 1.2g tds + Doxycycline PO 100mg bd
(If penicillin allergic: IV Levofloxacin 500mg bd monotherapy)
non severe hospital acquired pneumonia:
PO Amoxicillin
(If penicillin allergic: Doxycycline 100mg bd)
TOTAL 5 days
severe hospital acquired pneumonia:
IV Amoxicillin + Gentamicin
(If penicillin allergic:IV Co-trimoxazole + Gentamicin)
Step down: PO Co-trimoxazole
TOTAL IV/PO 7 days
Non severe aspiration pneumonia:
PO Amoxicillin + Metronidazole
(If penicillin allergic: PO Doxycycline 100mg bd + Metronidazole)
TOTAL 5 days
severe aspiration pneumonia:
IV Amoxicillin + Metronidazole + Gentamicin
(If penicillin allergic: replace amoxicillin with PO Doxycycline or IV Clarithromycin)
Step down: PO Amoxicillin + Metronidazole
(If penicillin allergic: Doxycycline 100mg bd + Metronidazole)
TOTAL IV/PO 7 days
Acute exacerbation of COPD:
Give antibiotics if high sputum purulence. If no sputum purulence then no antibiotics unless consolidation on CXR or
signs of pneumonia.
1ST LINE Amoxicillin 500mg tds 2ND LINE Doxycycline 200mg on day 1 then 100mg od (5days)
Acute cough / acute bronchitis:
Antibiotics give no significant benefit in clinical improvement but may be considered in the frail elderly.
1ST LINE Amoxicillin 500mg tds 2ND LINE Doxycycline 200mg on day 1 then 100mg od (5 days)
Endocarditis Native valve indolent (Subacute):
Amoxicillin IV 2g 4 hourly + Gentamicin
Endocarditis Native valve severe sepsis (Acute):
Flucloxacillin IV 2g 6 hourly (4 hourly if >85kg)
Endocarditis Prosthetic valve or Suspected MRSA:
Vancomycin IV + Gentamicin (See synergistic gentamicin guidance)
+ when therapeutic vancomycin levels reached add Rifampicin PO 600mg bd
C difficile infection:
Vancomycin 125mg qds (10 days)
Recurrant c difficile in previous 12 weeks
fidaxomicin
Peritonitis / Biliary Tract / Intra-abdominal
IV Amoxicillin + Metronidazole + Gentamicin
Step down: PO Co-trimoxazole + Metronidazole
(If penicillin allergic: IV Vancomycin + Metronidazole + Gentamicin
Step down: PO Co-trimoxazole + Metronidazole)
Acute gastroenteritis:
No antibiotic treatment required. Seek advice if severe.
