- patient looks ill
- early warning score
- sign of infection
Where is the site of infection?
Where the inflammation is
What factors affect how a host responds to infection?
What are some examples of deep infections which are difficult to identify?
Endocarditis (generally unwell)
A NEWS2 score of >= __ indicates sepsis.
Once you've taken a history, examined and decided where the infection is, what do you do?
What must be done with any abscess or pus?
Drained (+/- by surgery)
antibiotics don't penetrate it
What indicates spontaneous peritonitis?
What indicates secondary bacterial peritonitis?
History (e.g trauma, perforated bowel)
Which organisms colonise the mouth?
Some Candida and Staph
What organisms colonise the colon?
E. coli, Klebsiella, Enterobacter
Are the bile ducts colonised by bacteria?
workhorse for coliforms, i.e gram -ves is gentamicin, alternative is aztreonam IV
step down is oral co-trimoxazole
don't use ciprofloxacin - C diff
clostridium - diff (4 cs), perfringens (gas gangrene), botulinum (botulism)
bacteroides (not really)
MRSA isn't killed by fluclox (related to methicillin)
amoxicillin for enterococci
gentamicin for gram negatives (coliforms)
metronidazole for anaerobes