Antimicrobial Drugs2017Guide II Flashcards
What is the treatment for Necrotising Fasciitis?
Clindamycin 900MG TDS IV + Piperacillin-Tazobactam 4.5G QDS IV
What is the treatment for Cellulitis?
- Empirical treatment
- Outpatient treatment or follow-up therapy after IV therapy
Empirical treatment: Flucloxacillin 1G QDS IV
Outpatient treatment: Flucloxacillin 500MG QDS PO
What is the alternative therapy for patients with severe penicillin allergy and have Cellulitis?
Empirical treatment: IV Vancomycin or IV Teicoplanin
Outpatient treatment: Clarithromycin 500MG BD PO
What are the cautions of using Clindamycin for Cellulitis?
Why?
Avoid Clindamycin for cellulitis in hospital patients over 60 years old as it increases the risk of Clostridium Difficile.
If patient was previously positive for MRSA, what are the changes to the therapy of Cellulitis?
Add IV Vancomycin or IV Teicoplanin for inpatients, and instead of Flucloxacillin 500MG QDS PO for outpatients/Clarithromycin 500MG BD PO, give Doxycycline 100MG BD PO.
For post-operative wound infections, if it is non-severe, what is prescribed?
How about to those with history of severe penicillin allergy?
Non-severe post-operative wound infection: Co-amoxiclav 625MG TDS PO
If penicillin allergic: Doxycycline 100MG BD PO + Metronidazole 400MG TDS PO
For post-operative wound infections, if severe, what is prescribed?
How about for patients with penicillin allergy?
Severe post-operative wound infection: Co-amoxiclav 1.2G TDS IV
If penicillin allergy: Piperacillin-Tazobactam 4.5G TDS IV
For post-operative wound infections associated with GI/GU surgery, what is prescribed?
How about patients with penicillin allergy?
For post-operative wound infection associated with GI/GU surgery: Piperacillin-Tazobactam 4.5G TDS IV
If penicillin allergy: Ciprofloxacin 500MG BD + Metronidazole 400MG TDS
For human bite wounds, what should be checked?
Review Hepatitis B vaccination status and give Hepatitis B immunoglobulin where appropriate.
What is the first line treatment for bacterial meningitis?
For adults and children >40kg, Ceftriaxone 2G BD IV
For infants and children <40kg, Ceftriaxone 80MG/KG OD by IV infusion
In bacterial meningitis, which other bacteria must one be cautioned with in people aged over 50 years?
Who else will fall into this category?
In people aged >50 years old, consider Listeria as a potential cause of bacterial meningitis.
Also consider listeria in those who have alcohol dependency, in immunocompromised patients, and in neonates.
What is given as an empirical treatment for patients aged 50 years and above, for the immunocompromised, and for those with alcohol dependency, and are suspected of bacterial meningitis?
Ceftriaxone 2G BD IV + Amoxicillin 2G six times daily IV + Gentamicin 80MG TDS IV
If Herpes Simplex Encephalitis is suspected, what is the medication given?
Aciclovir 10MG/KG TDS IV for 21 days
What should be given to patients suspected of bacterial meningitis, in addition to the antibiotics?
Dexamethasone 10MG QDS IV should be given before, or up to 12 hours after, antibiotics are started.
What must be done before starting antibiotic therapy in patients suspected of infective endocarditis?
What if the patient has recently received antibiotics?
3 sets of blood cultures taken at 3 different sites at different times during peak of fever should be done before antibiotic therapy.
If patient has received recent antibiotic therapy, 6 sets of blood cultures will be required.
