Antibiotics

Question 1

Treatment for mild/moderate cellulitis?

Answer 1

Oral Penicillin V and fluclox

Question 2

Abx for severe cellulitis?

Answer 2

IV benpen and fluclox

Question 3

3 organisms which cause osteomyelitis/joint infections?

Answer 3

Staph. Aureus
Streptococci
Staph Epidermidis

Question 4

2 Abx options in bone/joint infections?

Answer 4

IV Flucloxacillin (+ fusidic acid for osteomyelitis)
or Clindamycin alone

Question 5

Which drug to use in cellulitis if penicillin allergic?

Answer 5

Erythromycin

Question 6

Abx for sore throat (if bacterial)?

Answer 6

Phenoxymethylpenicillin (aka Penicillin V) Erythromycin or other macrolides if allergic.

Question 7

Organisms causing CA pneumonia?

Answer 7

Pneumococcus (Strep. pneumoniae) - main
Haemophilus
‘Atypicals’
Mycoplasma pneumoniae Chlamydia pneumoniae Legionella

Question 8

Abx for severe CAPneumonia?

Answer 8

Co-amoxiclav (IV) or

2nd/3rd gen. cephalosporin + Macrolide

Question 9

Abx for mild/moderate CAPneumonia?

Answer 9

Amoxycillin
+ macrolide (if ‘atypical suspected’)
or macrolide alone if penicillin allergic

Question 10

Organisms which cause COPD exacerbations?

Answer 10

Pneumococcus (Strep. pneumoniae) Haemophilus influenzae

Moraxella catarrhalis

Question 11

Rx for COPD infective exacerbations?

Answer 11

Amoxycillin
(Or Clarithromycin
Or Tetracycline)

Question 12

SEs of tetracyclines

Answer 12

 Deposited in bone and teeth (grey staining)
 Avoid in pregnancy and breast feeding and children < 12 years
 May exacerbate renal impairment

Question 13

Bacterial causes of infective diarrhoea?

Answer 13

E. Coli
Salmonella Campylobacter
Shigella
S Aureus
CLOSTRIDIUM DIFFICILE

Question 14

Which bugs (diarrhoea) is ciprofloxacin used for?

Answer 14

Campylobacter
Salmonella
Typhoid fever

Question 15

Standard management of gastroenteritis?

Answer 15

Often viral and self-limiting

No antibiotic usually indicated (unless systemic symptoms)

Question 16

When are quinolones used?

Answer 16

Prophylaxis for meningococcus, some activity against Pseudomonas

Question 17

What type of bugs is metronidazole used for?

Answer 17

ANAEROBES! eg. as part of triple therapy for H. pylori if pen. allergic

Question 18

Drug options for GI infections/peritonitis post surgeryBugs most likely to be causing infection/peritonitis post GI surgery?

Answer 18

2nd/3rd gen. cephalosporin + metronidazole
or
Co-amoxiclav alone

Question 19

Best ceph for meningococcus?

Answer 19

Ceftriaxone

Question 20

Best ceph for pseudomonas?

Answer 20

Ceftazidime

Question 21

Main bugs causing UTI?

Answer 21

E. Coli (60-90%)
Proteus (10%)
Klebsiella
Staph aureus

Question 22

Treating a mild-moderate UTI? Which route, and how long for?

Answer 22

Oral Abx = fine. A 3-day course is usually sufficient
Trimethoprim (unless pregnant)
or Amoxycillin / Nitrofurantoin /Ciprofloxacin

Question 23

Treating a severe UTI?

Answer 23

IV.
Co-amoxiclav or
2nd/3rd gen. cephalosporin
± gentamicin

Question 24

When should trimethoprim not be used?

Answer 24

Avoid in pregnancy

Question 25

3 bugs which cause meningitis?

Answer 25

Meningococcus (N. meningitidis) Pneumococcus (Strep. pneumoniae) Haemophilus influenzae

Question 26

Abx for meningitis?

Answer 26

Ceftriaxone IV - all cases are severe

Question 27

Prophylaxis for meningitis contacts?

Answer 27

Rifampicin or cipro

Question 28

When to change an antibiotic?

Answer 28

No improvement Clinical deterioration Sensitivity low or absent Adverse effects

Question 29

Egs of gram -ve aerobic bacilli?

Answer 29

Gut bacteria: | E. Coli Proteus Klebsiella Salmonella

Question 30

Gram -ve aerobic coccus?

Answer 30

Neisseria

Question 31

2 most famous groups of Gram +ve aerobic cocci?

Answer 31

Staphs (clusters) and streps (chains)

Question 32

3 atypicals?

Answer 32

Mycoplasma Legionella Chlamydia

Question 33

Resistance to penicillins is based on: | Which types are resistant?

Answer 33

Destroyed by beta-lactamase (S. aureus and some anaerobes) except fluclox & co-amoxiclav

Question 34

How is fluclox different from normal penicillin?

Answer 34

FLUCLOXACILLIN - beta-lactamase resistant

Question 35

How is co amoxiclav different from penicillin? | Side effect?

Answer 35

AMOXYCILLINCLAVULINIC ACID - beta-lactamase inhibitor, may cause jaundice

Question 36

Is penicillin safe in pregnancy?

Answer 36

Yes