Antibiotic Treatment Flashcards Preview

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Flashcards in Antibiotic Treatment Deck (32):
1

CURB 65

Confusion of recent onset
Urea >7 mmol/l
Resp rate =/> 30 per minute
Low systolic BP (<90)
Low diastolic BP (=/<60)
Age 65 or over

2

CURB65=2
Community acquired pneumonia

Amoxicillin 1g tds IV/PO 5 days

3

CURB65=4
Community acquired pneumonia

Co-amoxiclav IV + 1.2g tds + Doxycycline PO 100mg

4

ICU patient
CURB65=5
Community acquired pneumonia

Co-amoxiclav IV + 1.2g tds + Clarithromycin IV 500mg

Then step down to doxycycline 100mg

5

Penicillin allergic
CURB65=1
Community acquired pneumonia

Doxycycline 200mg on day 1 (PO)
100mg od or clarithromycin id NBM

6

CURB65=4 Penicillin allergic NBM
Community acquired pneumonia

IV Levofloxacin 500mg td

7

CURB65=5 Penicillin allergic
Community acquired pneumonia

IV Levofloxacin 500mg td

8

Hospital Acquired pneumonia CURB65=4

IV amoxicillin + Metronidazole + Gentamicin
Step down to PO co-trimoxazole + metronidazole (Total IV/PO 7 days)

9

Hospital Acquired pneumonia
CURB65=2

PO Amoxicillin + Metronidazole (5 days)

10

Hospital Acquired pneumonia
CURB65=2
Penicillin allergic

PO Co-trimoxazole+ Metronidazole

11

Hospital Acquired pneumonia
CURB65=5
Penicillin allergic

IV Co-trimoxazole + Metronidazole +/- Gentamicin
(Total IV/PO 7 days)

12

Hospital Acquired pneumonia
CURB65=5
Previous ICU admission

Seek advice

13

Hospital Acquired pneumonia
CURB65=5
Previous MRSA

Seek advice

14

Acute exacerbation of COPD
Increased sputum purulence

1st line Amoxicillin 500mg tds
2nd line Doxycycline 200mg on day one then 100mg daily (5 days)

15

Acute exacerbation of COPD
No increased sputum purulence
Consolidation on CXR

1st line Amoxicillin 500mg tds
2nd line Doxycycline 200mg on day one then 100mg daily (5 days)

16

Acute Cough/ Bronchitis
76 frail

1st line amoxicillin 500mg tds
2nd line doxycycline 200mg on day one then 100mg daily (5 days)

17

Endocarditis

Start empirical therapy and refer to ID/microbiology

18

Native valve indolent (Subacute)

Amoxicillin IV 2g 4 hourly + Gentamicin 1mg/kg bd (use actual body weight - max 120mg/dose)

19

Native valve severe sepsis (Acute)

Flucloxacillin IV 2g 6 hourly (4 hourly if >85kg)

20

Prosthetic valve or Suspected MRSA

Vancomycin IV + Rifampicin PO 600mg bd + Gentamicin IV 1mg/kg bd (use actual body weight - max 120mg/dose)

21

Native valve severe sepsis + risk factors for resistant pathogens (

Vancomycin IV + Meropenem IV 2g tds (requires ID/Micro approval)

22

Clostridium Difficile Infection risk factors

History of recent (<3m) or current antibiotic use
• Prolonged recent hospital stay
• Use of PPI
• Increasing age especially > 65y
• Surgical procedure (in particular bowel procedures) • Immunosuppression

23

What is the severity assessment for C.Diff?

One or more of the following severity markers:
Temperature > 38.5°C
Ileus, colonic dilatation >6cm on AXR/CT, toxic megacolon and/or pseudomembranous colitis
WCC >15 cells x 109L
Acute rising serum creatinine >1.5 x baseline
Has persisting CDI where the patient has remained symptomatic and toxin positive despote 2 courses of appropriate therapy

24

How would you treat non-severe c.diff

Metronidazole PO 400mg tds (10days)

25

How would you treat severe c diff?

Vancomycin 125mg qds PO/NG (10 days) +/- IV metronidazole

26

How would you treat recurrent c diff?

Positive CDI in previous 8 weeks- seek help

27

How would you treat peritonitis/biliary tract infections/ intraabdominal infections

IV amoxicillin + Metronidiazole + Gentamicin
then step down to PO Co-trimoxazole + metronidiazole

28

Peritonitis
Penicillin Allergic

IV Vancomyicn + Metronidazole + Gentamicin (then step down to PO Co-trimoxazole + metronidazole)

29

Acute Gastroenteritis

No antibiotic treatment required

30

Pancreatitis

Antibiotics unlikely to affect outcome

31

Proven severe spontaneous bacterial peritonitis

Piperacillin/Tazobactam IV 4.5g tds
then step down to Co-trimoxazole PO
(5 - 7 days)

32

Proven Mild spontaneous bacterial peritonitis

(incidental diagnosis on routine tap):
Co-trimoxazole PO
(5 - 7 days)