Antibiotic Man

Question 1

Epiglottitis bacteria and treatment

Answer 1

Haemophilus influenzae
Streptococci
IV ceftriaxone

Question 2

Tonsillitis bacteria and treatment

Answer 2

Group A strep - Strep pyogenes

Penicillin

Question 3

Sinusitis bacteria and treatment

Answer 3

S pneumoniae

Amoxicillin (greater absorption than penicillin)

Question 4

Acute otitis media bacteria and treatment

Answer 4

S pneumonia, H influenzae

Amoxicillin

Question 5

Mild CAP bacteria and treatment

Answer 5

S pneumoniae, H influenzae

Amoxicillin (doxycycline if allergic)

Question 6

Severe CAP bacteria and treatment

Answer 6

S pneumoniae, H influenzae, coliforms, atypicals

Co-amoxiclav and doxycycline

Question 7

Acute exacerbation of COPD bacteria and treatment

Answer 7

S pneumoniae, H influenza

Amoxicillin if purulent sputum (prednisolone if not)

Question 8

Non-severe HAP bacteria and treatment

Answer 8

S pneumo, H inf, coliforms, sometimes legionella

Amoxicillin and metronidazole

Question 9

Severe HAP bacteria and treatment

Answer 9

IV amox + gent + met

Question 10

Native valve endocarditis bacteria and treatment

Answer 10

S aureus

IV flucloxacillin

Question 11

Native valve subacute endocarditis bacteria and treatment

Answer 11

S viridans, enterococci

IV amox + gent

Question 12

Prosthetic valve endocarditis bacteria and treatment

Answer 12

Coagulase negative staph (S epi), MRSA

IV vancomycin, gentamicin and oral rifampicin

Question 13

Mild C diff treatment

Answer 13

PO metronidazole

Question 14

Severe C diff treatment

Answer 14

PO vancomycin +/- metronidazole

Question 15

Intra-abdominal sepsis bacteria and treatment

Answer 15

Anaerobes, polymicrobial coliforms, enterococcus

IV amox + gent + met

Question 16

Spontaneous bacterial peritonitis (ascites) bacteria and treatment

Answer 16

Colifors +/- anaerobes, S pneumo

IV piperacillin, step down to PO co-trimoxazole

Question 17

Cellulitis bacteria and treatment

Answer 17

Staph aureus

Flucloxacillin

Question 18

Diabetic foot acute-on-chronic bacteria and treatment

Answer 18

S aureus, coliforms, anaerobes

Flucloxacillin and metronidazole

Question 19

Septic arthritis/osteomyelitis bacteria and treatment

Answer 19

Staph aureus

IV flucloxacillin

Question 20

Uncomplicated female UTI bacteria and treatment

What about if pregnant?

Answer 20

Coliforms and entrococci
Nitrofurantoin or trimethoprim oral 3 days
Pregnant - 1st/2nd trimester nitrofurantoin, 3rd trimester trimethoprim (also treat asymptomatic bacteriuria)

Question 21

Uncatheterised male UTI bacteria and treatment

Answer 21

Coliforms and enterococci

Nitrofurantoin or trimethoprim oral 7 days

Question 22

Complicated UTI/PN/urosepsis bacteria and treatment

Answer 22

Coliforms, enterococci, pseudomonas

IV amoxacillin + gentamicin, step down to oral co-trimoxazole

Question 23

Acute meningitis bacteria and treatment

Answer 23

Neonates - listeria
Children - H influenza
10-21 - N meningitides
>21 - S pneumo>N meningitides
>65 - S pneumo, listeria
<65y - IV ceftriaxone 2g bd
>65 - IV ceftrixone + amoxicillin
Penicillin allegy - IV chloramphenicol IV, add co-trimoxazole if listeria suspected
10mg IV steroids 15 mins before antibiotics

Question 24

Candida microorganism, diagnosis and treatment

Answer 24

Candida albicans (fungus)
High vaginal swab for culture
Topical clotrimazole pessary or cream, oral fluconazole if non-albicans

Question 25

Bacterial Vaginosis microorganism, diagnosis and treatment

Answer 25

Gardrenella vaginalis 'Whiff' test, wet mount (clue cells) Metronidazole

Question 26

Chlamydia microorganism, diagnosis and treatment

Answer 26

``` Chlamydia trachomatis (gram -ve intracellular bacteria) High vaginal swab or first pass urine for NAATS 7 days doxycycline 100mg BD ```

Question 27

Gonorrhoea microorganism, diagnosis and treatment

Answer 27

``` Neisseria gonorrhoea (gram -ve diplococcus) High vaginal swab or fist pass urine for NAATS 500mg ceftriaxone IM - test of cure recommended ```

Question 28

Prostatitis microorganism, diagnosis and treatment

Answer 28

Chlamydia/gonorrhoea | 28 days ciprofloxacin

Question 29

Syphilis microorganism, diagnosis and treatment

Answer 29

Treponema pallidum Serology - IgG and IgM ELISA IM benzylpenicillin

Question 30

Genital Herpes microorganism, diagnosis and treatment

Answer 30

``` Herpes simplex (usually HSV2, can be HSV1) Swab of deroofed blister for PCR Aciclovir, topical lidocaine, ```

Question 31

Genital warts microorganism, diagnosis and treatment

Answer 31

HPV 6 and 11 Clinical - cauliflower Topical podophyllin

Question 32

Trichomonas vaginalis microorganism, diagnosis and treatment

Answer 32

Trichomonas vaginalis (protozoal parasite) High vaginal swab for microscopy Oral metronidazole

Question 33

Pubic lice microorganism and treatment

Answer 33

Pthirus pubis | Malathion lotion