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Antibiotics And Indications > Treatments > Flashcards

Treatments Flashcards

1
Q

Community acquired septicaemia

A

1) a broad spectrum antipseduomonal penicillin (e.g. piperacillin with tazibactam) or Broad spectrum cephalosporin (e.g. cefuroxime)
2) if MRSA- Add vancomicin
3) if anaerobic- add metronidazole
4) if other resistance- more broad spectrum beta lactate (meropenem)

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2
Q

Hospital acquired septicaemia

A

1) broad spectrum antispedomonal
2) if MRSA- add vancomicin or teicoplanin
3) if anaerobic- add metronidazole

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3
Q

Septicaemia related to vascular catheter

A

1) vancomicin (or teicoplanin)
2) if gram neg- add broad spectrum antipseudomonal beta lactate
3) consider removal of catheter

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4
Q

Meningococcal septicaemia

A

Single dose benzylpenicillin ( or cefotaxime in PA/ chloramphenicol in hypersensitivity) before hospital
Then, ciprofloxacin/ rifampicin/ ceftriaxone to eliminate nasal carriage

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5
Q

Endocarditis initial (blind) therapy if native valve

A

Amoxicillin
Consider adding low dose gentamicin
If MRSA/ severe sepsis- use vancomicin and low dose gentamicin
If severe sepsis with risk factors for gram neg- vancomicin and meropenem

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6
Q

Initial blind therapy for endocarditis with prosthetic heart valve

A

Vancomicin+ rifampicin+ low dose gentamicin

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7
Q

Endocarditis that is caused by staphylococci (native)

A

Flucloxacillin for 4-6 weeks
If PA/MRSA- vancomicin + rifampicin

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8
Q

Endocarditis caused by staphylococci (prosthetic)

A

Flucloxacillin+ rifampicin + low dose gentamicin
For 6 weeks (review gent at 2 weeks)

In PA or MRSA- vancomicin + rifampicin + low dose gentamicin
For 6 weeks (review gent at 2 weeks)

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9
Q

Endocarditis is strep and fully sensitive

A

Benzypenicillin 4-6 weeks
In PA- vancomicin + low dose gentamicin

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10
Q

Endocarditis caused by less sensitive steptococci

A

Benzylpenicillin + low dose gentamicin 4-6 weeks
If PA or MRSA- vancomicin + gentamicin

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11
Q

Endocarditis caused by enterococci

A

Amoxicillin + low dose gentamicin
or
benzylpenicillin + low dose gentamicin
Or if PA or MRSA
Vancomicin + low dose gent
or if gentamicin resistance
Amoxicillin with streptomicin (if susc- for 2 weeks)

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12
Q

Endocarditis caused by HACEK organisms

A

Amoxicillin (4 weeks) + low dose gentamicin (2 weeks)
Or
If amoxicllin resistant- ceftiaxone + low dose gentamicin

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13
Q

Hacek organisms

A

Haemophilus, actinobacillus,cardiobacterium, eikenella, kingella

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14
Q

Meningitis blind therapy first step

A

Benzylpenicillin ASAP (cefoxamine/ chloramphenicol if PA or hypersensitivity)
Dexamethosone within 12 hours (unless shock/ septic/ immunocompromised)

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15
Q

Blind hospital treatment of meningitis if 3months- 50 years old

A

Cefotaxime
+/- vanxomicin
10 days

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16
Q

Blind hospital treatment of meningitis if >50 years old

A

Cefotaxime + amoxicillin
+/- vancomicin
10 days

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17
Q

Meningitis caused by meningococci

A

Benzylpenicillin or cefotaxime (or chloramphenicol if hypersensitivity)
7 days

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18
Q

Meningitis caused by pneumonococci

A

Cefotaxime
Or benzylpenicillin if susc
If very resistant- + vancomicin +/- rifampicin
14 days

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19
Q

Meningitis caused by haemophilus influenzae

A

1)Cefotaxime
2) chloramphenicol if resistant
10 days
If Hib- give rifampicin for 4 days before discharge

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20
Q

Meningitis caused by listeria

A

Amoxicillin (21 days) + gentamicin (7 days)
If hypersensitivity- co-trimoxazole (21 days)

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21
Q

Mild diabetic foot infection (no pen allergy)

A

Oral flucloxacillin

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22
Q

Moderate to severe diabetic foot infection (no pen allergy)

A

Flucloxacillin +/- iv gentamicin +/- metronidazole
Or
Co-amoxiclav +/- iv gentamicin
Or
Iv ceftriaxone + metronidazole

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23
Q

Moderate to severe diabetic foot infection (pen allergy)

A

Co-trimoxazole +/- iv gentamicin +/- metronidazole

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24
Q

Mild diabetic foot infection (pen allergy)

A

clarithromicin/ doxycycline/ erythromycin (preg)

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25
Q

Otitis externa is caused by which 2 bacteria

A

Psedomonas aureginosa
Staphylococcus aureus

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26
Q

Otitis externa if psedomonas suspected

A

Ciprofloxacin

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27
Q

Otitis externa if no pen allergy

A

Flucloxacillin

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28
Q

Otitis externa if pen allergy

A

Clarithromycin

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29
Q

Otitis media caused by which bacteria

A

Haemophilus influenza, streptococcus pneumonia, streptococcus pyrogenes, moraxella catarrhalis

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30
Q

Otitis media in children

A

Amoxicillin
If worsening after 2-3 days- co-amoxiclav

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31
Q

Otitis media with pen allergy

A

Clarithromycin or erythromycin in preg

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32
Q

Conjunctivitis

A

Chloramphenicol eye drops

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33
Q

Campylobacter enteritis if immonucompromised or severe

A

Clarithromycin
Or
Ciprofloxacin

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34
Q

Acute uncomplicated diverticulitis

A

Oral co-amoxiclav
Or if PA cefalexin + metronidazole / trimethoprim + metronidazole/ ciprofloxacin + metronidazole

35
Q

Complicated acute diverticulitis

A

Iv co-amoxiclav / cefuroxime + metronidazole /
Or
amoxicillin + gentamicin + metronidazole

36
Q

Complicated acute diverticulitis with PA

A

Ciprofloxacin + metronidazole

37
Q

Salmonella

A

Ciprofloxacin/ cefotaxime

38
Q

Shigellosis

A

Ciprofloxacin/ azithromycin
Or is susc- amoxicillin / trimethoprim

39
Q

Typhoid fever

A

Cefotaxime
Or if Mild/ moderate can use azithromycin
Or Ciprofloxacin if susc

40
Q

Drugs increase the risk of c diff sec infection

A

Clindamyxin, cepgakosporins (especially 3rd and 4th gen), fluoroquinoloned, broad spec penicillins, ppis

41
Q

First episode of c diff

A

1)Oral vancomycin
2) oral fidaximixin

42
Q

C.diff recurrence within 12 weeks of resolution

A

Oral fidaxomicin

43
Q

C.diff recurrence > 12 weeks after resolution

A

Oral vancomicin or fidaxomicin

44
Q

Lifethreatening c diff

A

Specialist- oral vancomicin with iv meteonidazole

45
Q

Biliary tract infection

A

Ciprofloxacin/ gentamicin/ cephalosporin

46
Q

Peritonitis

A

Cephalosporin + metronidazole
Or
Gentamicin+ metronidazole
Or
Gentamicin + clindamicin
Or
Piperacillin with tazobactam alone

47
Q

Bacterial vaginosis

A

Oral metronidazole 5-7 days
Or topical metronidazole 5 days
Or topical clindamycin 7 days

48
Q

Genital infection (e.g. Chlamydia)

A

Azithromycin/ doxycycline 7 days
Or
Erythromycin 14 days

49
Q

Uncomplicated gonorrhea within 14 days of exposure

A

1) IM ceftriaxone
If susc oral ciprofloxacin

2)IM gentamicin + azithromycin
3) oral only- oral cefixime + oral azithromycin
4) oral azithromycin

50
Q

Pelvic inflammatory disease (non severe)

A

Doxycycline + metronidazole + single dose IM ceftiaxone
or Ofloxacin + metronidazole
14 days

51
Q

Pelvic inflammatory disease (severely ill)

A

doxycycline + IV ceftisxone + IV metronidazole -> oral switch to doxycycline + metronidazole

52
Q

Early syphillis ( less than 2 years)

A

Benzanthine benzylpenicillin (single dose + 1 dose 7 days after if third trimester)
Or doxycycline / erythromycin
14 days

53
Q

late latent syphillis ( more than 2 years)

A

Benzanthine benzylpenicillin once a week for 2 weeks
or
doxycycline 28 days

54
Q

asymptomatic contacts of syphillis

A

doxycycline 14 days

55
Q

osteomyelitis no PA

A

flucloxacillin
consider +/- fucidic acid/ rifampicin for first 2 weeks
If MRSA- vancomycin

56
Q

osteomyelitis PA

A

clindamycin
consider +/- fucidic acid/ rifampicin for first 2 weeks

57
Q

septic arthritis

A

flucloxacillin 4-6 weeks
MRSA- vancomycin 4-6 weeks
if gonococcal- cefotaxime

58
Q

septic arthritis with PA

A

clindamycin 4-6 weeks

59
Q

sinusitis (non-life threatening)

A

phenoxymethylpenicillin
no improvement in 2-3 days- co-amoxiclav

60
Q

sinusitis very unwell

A

co-amoxiclav

61
Q

sinusitis PA

A

doxycycline/ clarithomycin/ erythromycin

62
Q

epiglottitis

A

cefotaxime
hypersensitivity- chloramphenicol

63
Q

Bronchiectasis non severe

A

oral co-amoxiclav
7-14 days

64
Q

Bronchiectasis non severe PA

A

doxycycline/ cefalexin/ co-trimoxazole/ levofloxacin

65
Q

Bronchiectasis severe / high resistance

A

IV piperacillin with tazobactam/ ceftazidime/ ceftriaxone/ cefuroxime/ levofloxacin/ meropenem
if MRSA- add vancomycin/ linezolid/ teicoplanin

66
Q

Empitigo topical treatments

A

1) hydrogen peroxide
2) fucidic acid or mupirocin

67
Q

Empitigo oral treatments

A

1) flucloxacillin
PA- clarithromycin/ erythromycin

68
Q

Cellulitis and Erysipelas (not near eyes or nose)

A

Flucloxacillin
PA- clarithromycin. erythromycin/ doxycyline

69
Q

Cellulitis and Erysipelas (near eyes or nose)

A

Co-amoxiclav
PA- clartithromycin + metronidazole

70
Q

Severe infection of cellulitis or erysipelas

A

Co-amoxiclav/ clindamycin/ IV cefuroxime/ IV ceftriaine
If MRSA- add vancomycin/ teicoplanin/ linezolid

71
Q

Leg ulcer- not severely unwell no PA

A

1) Flucloxacillin
2) Co-amoxiclav

72
Q

Leg ulcer- not severely unwell- PA

A

1)doxycycline/ clarithromycin/ erythromycin
2) co-trimoxazole

73
Q

Leg ulcer- severely unwell no PA

A

1) IV flucloxacillin +/- IV gentamicin +/- metronidazole
Or
IV co-amoxiclav +/- gentamicin
2) piperacillin with tazobactam
or
IV ceftiaxone +/- metronidazole

74
Q

Leg ulcer- severely unwell- PA

A

IV co-trimoxazole +/- IV gentamicin +/- IV metronidazole

75
Q

Human and animal bites- no PA

A

oral- co-amoxiclav
IV- coamoxiclav

76
Q

Human and animal bites- PA

A

oral - doxycyline + metronidazole
IV- cefuroxime
or
ceftriaxone + metronidazole

77
Q

Secondary infection of eczema

A

topical fucidic acid
oral flucloxacillin
PA- clarithromycin/ erythromycin

78
Q

Mastitis during breast feeding

A

flucloxacillin 10-14 days
PA- erythromycin 10-14 days

79
Q

UTI in non-preg women

A

1) Nitrofurantoin/ trimethoprim
2) nitrofurantoin/ fosfomycin
if susc- pivemecillinam/ amoxicillin

80
Q

UTI in men

A

nitrofurantoin/ trimethorpim
then treat as pyelonephritis

81
Q

UTI in preg women (or asymptomatic bactiriuria).

A

1) nitrofurantoin
2) amoxicillin or cefalexin

82
Q

Acute prostatitis (oral tx)

A

1) ciprofloxacin/ ofloxacin
2) levofloxacin/ co-trimoxazole

83
Q

acute prostatitis (IV tx)

A

amikacin/ ceftriaxone/ cefuroxime/ ciprofloxacin/ gentamicin/ levofloxacin

84
Q
A

Antibiotics And Indications (3 decks)

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