Tayside Primary Care Antibiotic Man Flashcards
Dental abscess:
Penicillin V 500mg qds or Metronidazole 400mg tds (5 days)
Tonsillitis / Pharyngitis / Sore Throat
Only consider antibiotic if severe (at least 4 on FeverPAIN score). most are viral.
1st LINE Penicillin V 1g bd or 500mg qds (5 days) 2nd LINE Clarithromycin 500mg bd (5 days, penicillin allergy only)
Sinusitis:
If >10 days multiple or worsening symptoms consider back up antibiotic.
1st LINE Penicillin V 500mg qds or 1g bd (5days) 2nd LINE Doxycycline 200mg day 1 then 100mg daily (5 days total)
Epiglottitis / Supraglottitis:
Medical emergency – transfer to hospital immediately
Oral Candidiasis:
1ST LINE Miconazole gel qds or Nystatin 1ml qds
2ND LINE Fluconazole 50mg daily (Immunocompromised 100mg) (7 days)
Acute exacerbation of COPD:
Treat if high sputum purulence. If no sputum purulence no antibiotics unless pneumonia or consolidation on CXR.
1st LINE Amoxicillin 500mg tds 2nd LINE Doxycycline 200mg day 1 then 100mg daily (5 days total)
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 day 1 then 100mg daily (5 days total)
Community acquired pneumonia CURB65 score 0:
Usually treat at home.
Amoxicillin 1g tds or Doxycycline 200mg day 1 then 100mg daily (5 days)
Community acquired pneumonia CURB65 score 1-2:
Usually treat at home.
Consider hospital referral (in particular if major co-morbidity)
Community acquired pneumonia CURB65 score 3-4:
Urgent hospital admission
Give Amoxicillin 1g oral or Benzylpenicillin 1.2g IV before transfer (withhold if known anaphylaxis)
C Difficile infection:
Oral Vancomycin (if unavailable: metronidazole)
Recurrant C difficile infection in 12 weeks:
fidaxomycin
Acute gastroenteritis:
No antibiotic required unless systemically unwell or post antibiotic
Diverticulitis:
Uncomplicated acute diverticulitis may respond to analgesia and dietary modification.
If antibiotics are indicated use Metronidazole 400mg tds plus Co-trimoxazole 960mg bd 5 days
(or co-amoxiclav 625mg tds if unable to take cotrimoxazole)