URTI & LRTI

Question 1

CAP, no comorbidities

Answer 1

PO Amoxicillin 1 g q8 hours or
PO Levofloxacin 750 mg OD or
PO Moxifloxacin 400 mg OD

Question 2

Outpatient CAP, with comorbidities

Answer 2

PO Augmentin 625 mg TDS or PO Cefuroxime 500 mg BD +
PO Clarithromycin 500 mg BD or PO Azithromycin 500 mg OD or PO Doxycycline 100 mg BD

or

PO Levofloxacin 750 mg OD or PO Moxifloxacin 400 mg OD

Question 3

CAP, inpatient non-severe

Answer 3

PO Augmentin 625 mg TDS or PO Cefuroxime 500 mg BD +
PO Clarithromycin 500 mg BD or PO Azithromycin 500 mg OD or PO Doxycycline 100 mg BD

(if MRSA) IV Vancomycin or IV/PO Linezolid 600 mg q12 hours

(If Psuedomonas) Change to Pip/tazo or Cefepime or Ceftazidime or Meropenem or Levofloxacin

Question 4

CAP, inpatient severe

Answer 4

IV Augmentin 1.2 g q8 hours or IV Crystalline Pen G 1-3 MU q4-6 hours +
IV Ceftazidime 2 g q8 hours +
IV Clarithromycin 500 mg BD or IV Azithromycin 500 mg OD

or

IV Levofloxacin 750 mg OD or IV Moxifloxacin 400 mg OD +
IV Ceftazidime 2g q8 hours

(if MRSA) IV Vancomycin or IV/PO Linezolid 600 mg q12 hours

Question 5

HAP/VAP with no MRSA risk but high resistance rate for Pseudomonas

Answer 5

IV Pip/tazo 4.5 g q6-8 hours or IV Cefepime 2 g q8 hours or IV Meropenem 1 g q8 hours or IV Imipenem 500 mg q6 hours

AND

IV Levofloxacin 750 mg OD

OR

IV Gentamicin 5 mg/kg/day or IV Amikacin 15 mg/kg/day

Question 6

HAP/VAP with MRSA risk and high resistance rate for Pseudomonas

Answer 6

IV Pip/tazo 4.5 g q6-8 hours or IV Cefepime 2 g q8 hours or IV Ceftazidime 2g q8 hours or IV Meropenem 1 g q8 hours or IV Imipenem 500 mg q6 hours

AND

IV Levofloxacin 750 mg OD or IV Ciprofloxacin 500 mg BD

OR

IV Gentamicin 5 mg/kg/day or IV Amikacin 15 mg/kg/day

AND

IV Vancomycin or IV/PO Linezolid 600 mg q12 hours

Question 7

Pharyngitis

Answer 7

PO Pen VK 250 mg q6 hours x 10 days or
PO Amoxicillin 500 mg q12 hours x 10 days or
PO Cephalexin 500 mg q12 hours x 10 days or
PO Clarithromycin 250 mg BD x 10 days or
PO Azithromycin 500 mg OD x 5 days or
PO Clindamycin 300 mg q8 hours x 10 days

Question 8

Rhinosinusitis

Answer 8

PO Amoxicillin 500 mg q8 hours or
PO Augmentin 625 mg q8 hours or
PO Cefuroxime 500 mg q12 hours or
PO Levofloxacin 500 mg OD or
PO Moxifloxacin 400 mg OD

x 5-7 days

Question 9

Indication for treatment of bacterial pharyngitis

Answer 9

1. Fever >38
2. Swollen lymph nodes
3. Tonsillar exudates
4. Absence of cough
5. Age

3-14 y.o. = 1
14-44 y.o.: 0
45 y.o. = -1

2-3 points: Culture directed
4 and above: Empiric Abx