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Revision lectures > Tayside Hospital Antibiotic Man > Flashcards

Tayside Hospital Antibiotic Man Flashcards

1
Q

Meningitis

A

Ceftriaxone IV 2g BD + Dexamethasone IV 10mg QDS for 4 days started with or just before first dose of antibiotics

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2
Q

Meningitis + suspected encephalitis

A

Aciclovir IV (10mg/kg) TDS

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3
Q

Meningitis of over 60yrs or immunocompromised

A

Ceftriaxone IV 2g BD + Dexamethasone IV 10mg QDS for 4 days started with or just before first dose of antibiotics

PLUS

Amoxicillin IV 2g 4hourly

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4
Q

Epiglottitis/Supraglottitis

A

Ceftriaxone IV 2g OD

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5
Q

CAP 0-2

A

Amoxicillin 1g TDS IV/PO

5 days

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6
Q

CAP 0-2 Penicillin Allergic

A

Doxycycline PO 200mg on day 1 then 100mg OD

Or IV Clarithryomycin if NBM

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7
Q

CAP 3-5

A

Co-Amoxiclav IV 1.2g TDS
PLUS
Doxycycline PO 100mg BD

STEP DOWN
Doxycycline 100mg BD for all patients with severe CAP

TOTAL IV/PO 7 days

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8
Q

CAP 3-5 Penicillin allergy

A

IV Levofloxacin 500mg BD

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9
Q

CAP 3-5 ICU/HDU/NBM

A

Co-amoxiclav IV 1.2g TDS
PLUS
Clarithromycin IV 500mg BD

STEP DOWN
Doxycycline 100mg BD for all patients with severe CAP

Total IV/PO 7 days

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10
Q

HAP Severe

A

IV Amoxicillin + Metronidazole + Gentamycin

STEP DOWN
PO Co-trimoxazole + Metronidazole

TOTAL IV/PO 7 days

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11
Q

HAP Severe + Penicillin allergy

A

IV Co-trimoxazole + Metronidazole +/- Gentamycin

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12
Q

HAP Non severe

A

PO Amoxicillin + Metronidazole

TOTAL 5days

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13
Q

HAP non severe + penicillin allergy

A

PO Co-trimoxazole + Metronidazole

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14
Q

HAP + previous ICU admission or history of MRSA

A

Seek advice

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15
Q

Acute exacerbation of COPD

A

Increased sputum purulence
Antibiotics

No increased sputum purulence then no antibiotics UNLESS consolidation CXR or signs or pneumonia

1st line Amoxicillin 500mg TDS
2nd line Doxycycline 200mg on day 1 then 100mg daily
5 DAYS

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16
Q

Acute Cough/Acute Bronchitis

A

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 daily
5 days

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17
Q

Endocarditis General Management

A

Take blood cultures
Start empirical therapy and refer to ID/Microbiology
Check full endocarditis guidance for gentamicin/vancomycin dosing especially in reduced renal function
Do not use gentamicin chart

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18
Q

Endocarditis

Native valve indolent (subacute)

A

Amoxicillin IV 2g 4hourly + Gentamicin 1mg/kg BD (use actual body weight - max 120mg/dose)

19
Q

Endocarditis

Native valve severe sepsis (acute)

A

Flucloxacillin IV 2g 6hourly

4 hourly if >85kg

20
Q

Endocarditis

Prosthetic valve or suspected MRSA

A

Vancomycin IV + Rifampicin PO 600mg BD + Gentamicin IV 1mg/kg BD (use actual body weight - max 120mg/dose)

21
Q

Endocarditis

Native severe sepsis + risk factors for resistant pathogens

A

See full guidance

Vancomycin IV + Meropenem IV 2g TDS (requires ID/Micro approval)

22
Q

Acute gastroenteritis

A

No antibiotics. Seek advice if severe

23
Q

C Diff Non severe

A

Metronidazole PO 400mg TDS

10days

24
Q

C Diff Severe

A

Vancomycin 125mg QDS PO/NG
+/-
IV Metronidazole

10days

25
Q

C Diff Recurrent

A

Positive CDI in previous 8 weeks- see guidance

26
Q

Acute Pancreatitis

A

Antibiotics unlikely to affect outcome. Seek advice

27
Q

Peritonitis/Biliary Tract/Inta-Abdominal

A

IV Amoxicillin + Metronidazole + Gentamicin

STEP DOWN
PO Co-trimoxazole + Metronidazole

TOTAL IV/PO 7-10days

28
Q

Peritonitis/Biliary Tract/Inta-Abdominal + Penicillin Allergy

A

IV Vancomycin + Metronidazole + Gentamicin

STEP DOWN
PO Co-trimoxazole + Metronidazole

TOTAL IV/PO 7-10days

29
Q

Proven spontaneous bacterial peritonitis - Severe

A

Piperacillin/Tazobactam IV 4.5g TDS

STEP DOWN
PO Co- trimoxazole

5-7days

30
Q

Proven spontaneous bacterial peritonitis - mild disease (incidental diagnosis on routine tap)

A

PO Co-trimoxazole

5-7days

31
Q

Catheterised patients

A

Do not use urinalysis

Do not treat unless clinical signs/symptoms of infection

If definite infection treat as per complicated UTI

32
Q

Uncomplicated Female Lower UTI

A

Nitrofurantoin 50mg QDS

OR

Trimethoprim 200mg BD

3days

33
Q

Uncatheterised Male UTI

A

Nitrofurantoin 50mg QDS

OR

Trimethoprim 200mg BD

7mg

34
Q

Complicated UTI/Pyelonephritis/Urosepsis

A

IV Amoxicillin + Gentamicin

Step down to co-trimoxazole or as per sensitivities

Total IV/PO 7 days

35
Q

Complicated UTI/Pyelonephritis/Urosepsis + Penicillin allergy

A

IV Co-trimoxazole + Gentamicin

Step down to co-trimoxazole or as per sensitivities

Total IV/PO 7 days

36
Q

Cellulitis

A

Flucloxacillin 1g QDS

TOTAL IV/PO 7 days

37
Q

Cellulitis + Penicillin allergy

A

Doxycycline 100mg BD PO

TOTAL IV/PO 7 days

38
Q

Diabetic Foot Infection Mild

A

Flucloxacillin 1g QDS

OR

Doxycycline 100mg BD

TOTAL 7 days

39
Q

Diabetic Foot Infection Moderate

A

Flucloxacillin 1g QDS + Metronidazole 400mg TDS

OR

Doxycycline 100mg BD + Metronidazole 400mg TDS

TOTAL 7 days

40
Q

Acute septic arthritis/Osteomyelitis

A

Seek ID advice

IV Flucloxacillin 2g QDS

41
Q

Open fracture prophylaxis

A

IV Co-amoxiclav 1.2 TDS (or IV Co-trimoxazole 960mg BD + Metronidazole 500mg TDS)

Start within 3 hours for max 72hours

42
Q

Unknown source

A

IV Amoxicillin + Metronidazole + Gentamicin (consider adding Flucloxacillin/Vancomycin if concerns re staphylococci)

43
Q

Unknown source + penicillin allergy

A

IV Vancomycin + Metronidazole + Gentamicin

Revision lectures (15 decks)

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