antibiotic treatment pathways Flashcards by Tapiwa Man

describe the treatment for sinusitis bacterial infection

first line: phenoxymethylpenicillin
if severe/ high risk of complications: co-amoxiclav

if allergic to penicillins: doxycycline or clarithromycin (erythromycin in pregnancy).

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describe the treatment for oral bacterial infections

first line: co-amoxiclav/ amoxicillin/phenoxymethylpenicillin
penicillin allergy: metronidazole/ macrolides (clarithromycin, erythromycin). erythromycin can be used in pregnancy)
anaerobic infections: metronidazole or doxycycline

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what is the only treatment for conjunctivitis

chloramphenicol

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describe the treatment for otitis EXTERNA

first line: flucloxacillin
allergic to pencillins: Clarithromycin/ azithromycin/ erythromycin (erythromycin can be used in pregnancy)
note Otitis externa is inflammation of the external ear canal triggered by bacterial infection*

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what is the treatment for otitis MEDIA

first line: amoxicillin
if symptoms worsening despite antibiotic: co-amoxiclav
penicillin allergy: clarithromycin or erythromycin (erythromycin can be used in pregnancy)

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describe the treatment for initial “blind” therapy for endocarditis (cardiovascular system infection)

initial “blind” therapy:

amoxicillin (or ampicillin). consider adding low dose gentamicin
penicillin allergy/MRSA suspected/sepsis: use vancomycin + low-dose gentamicin

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how do you treat endocarditis (cardiovascular system infection) caused by STAPHYLOCOCCI

first line: flucloxacillin

- if penicillin allergy or MRSA: vancomycin + rifampicin

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how do you treat endocarditis (cardiovascular system infection) caused by STREPTOCOCCI

first line: Benzylpenicillin sodium

- if penicillin allergy or MRSA: vancomycin (or teicoplanin) + low-dose gentamicin

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describe the treatment for septicaemia (hospital + community acquired)

first line treatment: piperacillin with tazobactam / ticarcillin with clavulanic acid / a broad-spectrum cephalosporin (e.g. cefuroxime)
if MRSA suspected: add vancomycin/ teicoplanin
anaerobic infection: add metronidazole to broad-spectrum cephalosporin
other resistant microorganisms suspected: meropenem

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how do you treat Campylobacter enteritis (gastro-intestinal infection)

first line: Clarithromycin (or azithromycin or erythromycin)
alternative: ciprofloxacin

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how do you treat: Salmonella, Shigellosis, Biliary-tract infection, Typhoid fever

first line: ciprofloxacin

alternatives: azithromycin, cefotaxime, gentamicin

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what is the treatment for clostridium difficile (c.diff) infection

first line: vancomycin
2nd line: Fidaxomicin

*note: if life-threatening infection of c.diff, specialist may offer oral vancomycin with intravenous metronidazole)

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what is the treatment for bacterial vaginosis

first line: metronidazole (oral or topical)

2nd line: clindamycin (topical)

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what is the treatment for chlamydia

first line: Azithromycin or doxycycline

alternative: erythromycin

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what is the treatment for Gonorrhoea

first line: I.M ceftriaxone or oral ciprofloxacin

alternatives: oral azithromycin,

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what is the treatment for syphilis

first line: Benzathine benzylpenicillin

Alternatively: doxycycline (also used in asymptomatic) or erythromycin

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what is the treatment for Lower urinary-tract infection in NON-PREGNANT women

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first line non-pregnant: Nitrofurantoin, or trimethoprim

if no improvement: Nitrofurantoin (if not used first line), fosfomycin, pivmecillinam

what is the treatment for Lower urinary-tract infection in PREGNANT women

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first line: Nitrofurantoin

if no improvement or pregnant at full term: Amoxicillin or cefalexin

catheter-pregnant: Cefalexin

Note: Nitrofurantoin is contraindicated in women is pregnant at full term so can only use it for UTI, if pregnancy is not at full term

what is the treatment for Lower urinary-tract infection in men

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First line: Nitrofurantoin, or trimethoprim

describe the treatment for diabetic foot infection

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Oral first line: Flucloxacillin
Alternative in penicillin allergy/ flucloxacillin unsuitable: clarithromycin, doxycycline, or erythromycin (in pregnancy).

what is the treatment for the Musculoskeletal system infections: Osteomyelitis + Septic arthritis

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First line: Flucloxacillin

If penicillin-allergic, clindamycin

what is the treatment for Meningitis caused by MENINGOCOCCI

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first line: Benzylpenicillin sodium/ cefotaxime (or ceftriaxone)
If history of immediate hypersensitivity reaction to penicillin or to cephalosporins, chloramphenicol

what is the treatment for Meningitis caused by PNEUMOCOCCI

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first line: Cefotaxime or ceftriaxone (consider adding dexamethasone)

2nd line: benzylpenicillin sodium. if penicillin allergy (cephalosporin + vancomycin)

what is the treatment for Meningitis caused by HAEMOPHILUS INFLUENZAE

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first line: Cefotaxime or ceftriaxone (consider adding dexamethasone)

if allergy to penicillin/ cephalosporins, or if microorganism resistant to cefotaxime: chloramphenicol

what is the treatment for Meningitis caused by LISTERIA

first line: Amoxicillin (or ampicillin) + gentamicin penicillin allergy: co-trimoxazole

what is the treatment for Epiglottitis (Haemophilus influenzae)

first line: Cefotaxime (or ceftriaxone) penicillin/cephalosporin allergy: chloramphenicol

what is the treatment for COPD infection

Oral first line: Amoxicillin, clarithromycin, or doxycycline alternatives: co-amoxiclav, or levofloxacin.

what is the treatment for an acute cough infection

First line: Doxycycline. (Alternative first line choices: amoxicillin, clarithromycin, or erythromycin) - Choice during pregnancy: Amoxicillin or erythromycin.

what is the treatment for Pneumonia (community-acquired)

Oral first line: Amoxicillin Alternative in penicillin allergy or amoxicillin unsuitable: clarithromycin, doxycycline, or erythromycin (in pregnancy)

what is the treatment for impetigo

Topical first line: hydrogen peroxide 1% cream (alternative fusidic acid) Oral first line: Flucloxacillin penicillin allergy: clarithromycin or erythromycin (in pregnancy).

what is the treatment for cellulitis, leg ulcers

Oral or Intravenous first line: Flucloxacillin Alternative in penicillin allergy or flucloxacillin unsuitable: clarithromycin, oral erythromycin (in pregnancy), or oral doxycycline

what is the treatment for a skin infection due to Human and animal bites

Oral + I.V first line: Co-amoxiclav Alternative in penicillin allergy or co-amoxiclav unsuitable: doxycycline with metronidazole *note: seek specialist advice in pregnancy*

what is the treatment for Mastitis during breast-feeding

first line: Flucloxacillin If penicillin-allergic: erythromycin

what are the 2 stages of tuberculosis treatment

1. initial stage: a combination of 4 drugs are used to reduce population of Mycobacterium tuberculosis bacteria. usually taken for two months 2. continuous phase: once initial phase finished, 2 drugs are taken for four months

which 4 drugs are used during the "initial stage" of tuberculosis treatment acronym: RIPE

Rifampicin, Isoniazid, Pyrazinamide and Ethambutol – (RIPE) These are taken daily for 2 months

name the 2 drugs used during the "continuous phase" of tuberculosis treatment

Isoniazid and Rifampicin these are taken daily for 4 months

what are the side effects of the drugs used on tuberculosis treatment: Rifampicin, Isoniazid, Pyrazinamide and Ethambutol – (RIPE)

- Rifampicin, Isoniazid, Pyrazinamide : liver toxicity - Isoniazid: peripheral neuropathy - ethambutol: ocular toxicity (visual disturbances) - rifampicin: orange/red discolouration of body secretions

what monitoring should occur during tuberculosis treatment

- drug levels (e.g ethambutol peak and trough levels) - visual acuity testing - blood counts - liver and kidney function - urinalysis - plasma levels - auditory function in elderly

why is pyridoxine often given in tuberculosis treatment

to prevent peripheral neuropathy caused by Isoniazid

why should patients taking rifampicin not wear soft contact lenses

rifampicin discolours soft contact lenses

what are the signs of liver toxicity/disorder you can advise patients to look out for (e.g when taking RIPE treatment for tuberculosis)

seek immediate medical attention if symptoms such as: - persistent nausea/ vomiting - malaise - jaundice develop

antibiotic treatment pathways Flashcards

(41 cards)