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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
Otitis externa is caused by which 2 bacteria
Psedomonas aureginosa Staphylococcus aureus
26
Otitis externa if psedomonas suspected
Ciprofloxacin
27
Otitis externa if no pen allergy
Flucloxacillin
28
Otitis externa if pen allergy
Clarithromycin
29
Otitis media caused by which bacteria
Haemophilus influenza, streptococcus pneumonia, streptococcus pyrogenes, moraxella catarrhalis
30
Otitis media in children
Amoxicillin If worsening after 2-3 days- co-amoxiclav
31
Otitis media with pen allergy
Clarithromycin or erythromycin in preg
32
Conjunctivitis
Chloramphenicol eye drops
33
Campylobacter enteritis if immonucompromised or severe
Clarithromycin Or Ciprofloxacin
34
Acute uncomplicated diverticulitis
Oral co-amoxiclav Or if PA cefalexin + metronidazole / trimethoprim + metronidazole/ ciprofloxacin + metronidazole
35
Complicated acute diverticulitis
Iv co-amoxiclav / cefuroxime + metronidazole / Or amoxicillin + gentamicin + metronidazole
36
Complicated acute diverticulitis with PA
Ciprofloxacin + metronidazole
37
Salmonella
Ciprofloxacin/ cefotaxime
38
Shigellosis
Ciprofloxacin/ azithromycin Or is susc- amoxicillin / trimethoprim
39
Typhoid fever
Cefotaxime Or if Mild/ moderate can use azithromycin Or Ciprofloxacin if susc
40
Drugs increase the risk of c diff sec infection
Clindamyxin, cepgakosporins (especially 3rd and 4th gen), fluoroquinoloned, broad spec penicillins, ppis
41
First episode of c diff
1)Oral vancomycin 2) oral fidaximixin
42
C.diff recurrence within 12 weeks of resolution
Oral fidaxomicin
43
C.diff recurrence > 12 weeks after resolution
Oral vancomicin or fidaxomicin
44
Lifethreatening c diff
Specialist- oral vancomicin with iv meteonidazole
45
Biliary tract infection
Ciprofloxacin/ gentamicin/ cephalosporin
46
Peritonitis
Cephalosporin + metronidazole Or Gentamicin+ metronidazole Or Gentamicin + clindamicin Or Piperacillin with tazobactam alone
47
Bacterial vaginosis
Oral metronidazole 5-7 days Or topical metronidazole 5 days Or topical clindamycin 7 days
48
Genital infection (e.g. Chlamydia)
Azithromycin/ doxycycline 7 days Or Erythromycin 14 days
49
Uncomplicated gonorrhea within 14 days of exposure
1) IM ceftriaxone If susc oral ciprofloxacin 2)IM gentamicin + azithromycin 3) oral only- oral cefixime + oral azithromycin 4) oral azithromycin
50
Pelvic inflammatory disease (non severe)
Doxycycline + metronidazole + single dose IM ceftiaxone or Ofloxacin + metronidazole 14 days
51
Pelvic inflammatory disease (severely ill)
doxycycline + IV ceftisxone + IV metronidazole -> oral switch to doxycycline + metronidazole
52
Early syphillis ( less than 2 years)
Benzanthine benzylpenicillin (single dose + 1 dose 7 days after if third trimester) Or doxycycline / erythromycin 14 days
53
late latent syphillis ( more than 2 years)
Benzanthine benzylpenicillin once a week for 2 weeks or doxycycline 28 days
54
asymptomatic contacts of syphillis
doxycycline 14 days
55
osteomyelitis no PA
flucloxacillin consider +/- fucidic acid/ rifampicin for first 2 weeks If MRSA- vancomycin
56
osteomyelitis PA
clindamycin consider +/- fucidic acid/ rifampicin for first 2 weeks
57
septic arthritis
flucloxacillin 4-6 weeks MRSA- vancomycin 4-6 weeks if gonococcal- cefotaxime
58
septic arthritis with PA
clindamycin 4-6 weeks
59
sinusitis (non-life threatening)
phenoxymethylpenicillin no improvement in 2-3 days- co-amoxiclav
60
sinusitis very unwell
co-amoxiclav
61
sinusitis PA
doxycycline/ clarithomycin/ erythromycin
62
epiglottitis
cefotaxime hypersensitivity- chloramphenicol
63
Bronchiectasis non severe
oral co-amoxiclav 7-14 days
64
Bronchiectasis non severe PA
doxycycline/ cefalexin/ co-trimoxazole/ levofloxacin
65
Bronchiectasis severe / high resistance
IV piperacillin with tazobactam/ ceftazidime/ ceftriaxone/ cefuroxime/ levofloxacin/ meropenem if MRSA- add vancomycin/ linezolid/ teicoplanin
66
Empitigo topical treatments
1) hydrogen peroxide 2) fucidic acid or mupirocin
67
Empitigo oral treatments
1) flucloxacillin PA- clarithromycin/ erythromycin
68
Cellulitis and Erysipelas (not near eyes or nose)
Flucloxacillin PA- clarithromycin. erythromycin/ doxycyline
69
Cellulitis and Erysipelas (near eyes or nose)
Co-amoxiclav PA- clartithromycin + metronidazole
70
Severe infection of cellulitis or erysipelas
Co-amoxiclav/ clindamycin/ IV cefuroxime/ IV ceftriaine If MRSA- add vancomycin/ teicoplanin/ linezolid
71
Leg ulcer- not severely unwell no PA
1) Flucloxacillin 2) Co-amoxiclav
72
Leg ulcer- not severely unwell- PA
1)doxycycline/ clarithromycin/ erythromycin 2) co-trimoxazole
73
Leg ulcer- severely unwell no PA
1) IV flucloxacillin +/- IV gentamicin +/- metronidazole Or IV co-amoxiclav +/- gentamicin 2) piperacillin with tazobactam or IV ceftiaxone +/- metronidazole
74
Leg ulcer- severely unwell- PA
IV co-trimoxazole +/- IV gentamicin +/- IV metronidazole
75
Human and animal bites- no PA
oral- co-amoxiclav IV- coamoxiclav
76
Human and animal bites- PA
oral - doxycyline + metronidazole IV- cefuroxime or ceftriaxone + metronidazole
77
Secondary infection of eczema
topical fucidic acid oral flucloxacillin PA- clarithromycin/ erythromycin
78
Mastitis during breast feeding
flucloxacillin 10-14 days PA- erythromycin 10-14 days
79
UTI in non-preg women
1) Nitrofurantoin/ trimethoprim 2) nitrofurantoin/ fosfomycin if susc- pivemecillinam/ amoxicillin
80
UTI in men
nitrofurantoin/ trimethorpim then treat as pyelonephritis
81
UTI in preg women (or asymptomatic bactiriuria).
1) nitrofurantoin 2) amoxicillin or cefalexin
82
Acute prostatitis (oral tx)
1) ciprofloxacin/ ofloxacin 2) levofloxacin/ co-trimoxazole
83
acute prostatitis (IV tx)
amikacin/ ceftriaxone/ cefuroxime/ ciprofloxacin/ gentamicin/ levofloxacin
84

Antibiotics And Indications (3 decks)

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