Antibiotics

Question 1

4D’s of antimicrobial therapy

Answer 1

drug
dose
duration
de-escalation

Question 2

what does metronidazole cover?

Answer 2

anaerobes

Question 3

what does gentamicin cover?

Answer 3

gram -ve

Question 4

what does amoxicillin cover?

Answer 4

broad spectrum

Question 5

4C’s

Answer 5

cephalosporins
clindamycin
co-amoxiclav (amxocillins in general)
ciprofloxacin (quinolones)

Question 6

what is negative about the 4C’s?

Answer 6

broad spectrum agents that increase risk of C. diff

Question 7

risk of C. diff in antibiotics outwith the 4 C’s?

Answer 7

lower risk, not no risk

Question 8

recommendations in antibiotic prescribing

Answer 8

short intervals
narrowest antibiotics
jabs > tabs

Question 9

benefits of changing antibiotic preparation from IV to oral?

Answer 9

reduced hospital stay
less chance of infection at site
less time on preparation
patient happier

Question 10

what licenses antibiotics?

Answer 10

EMA/MHRA

then reviewed by Scottish medicine consortium

Question 11

general side effects of antibiotics

Answer 11

nausea
vomiting
diarrhoea
rashes
candida

Question 12

side effects of penicillin’s

Answer 12

hypersensitivity

skin reactions

Question 13

side effects of flucloxacillin and co-amoxiclav

Answer 13

cholestatic jaundice

Question 14

side effects of macrolides

Answer 14

GI
hepatitis
QT interval

Question 15

side effects of aminoglycosides/ glycopeptides

Answer 15

nephrotoxicity

ototoxicity

Question 16

which antibiotic needs monitoring?

Answer 16

gentamicin

Question 17

when to avoid gentamicin?

Answer 17

AKI
low eGFR
decompensated liver disease
ascites
burns

Question 18

adverse of vancomycin

Answer 18

“red man” syndrome
administered too quick
histamine-like reaction

Question 19

adverse of tetracyclines

Answer 19

hepatotoxicity
staining teeth
photosensitivity
dysphagia

Question 20

adverse of nitrofurantoin

Answer 20

peripheral neuropathy

pulmonary fibrosis

Question 21

adverse of chloramphenicol

Answer 21

aplastic anaemia

grey baby

Question 22

broad spectrum + OCP

Answer 22

contraceptive failure

Question 23

broad spectrum + warfarin

Answer 23

increased INR (increased risk of bleeding)

Question 24

metronidazole + alcohol

Answer 24

disulfram-like reaction

Question 25

types of allergy

Answer 25

``` adverse drug reaction anaphylaxis immediate accelerated non-immediate ```

Question 26

how much of the population is actually allergic to penicillin?

Answer 26

<0.5%

Question 27

what do all penicillin's contain in their structure?

Answer 27

beta lactam ring

Question 28

what other agents contain the beta lactam ring?

Answer 28

cephalosporins carbapenems aztreonam

Question 29

action of antibiotics that target the cell wall

Answer 29

disrupts cross-linking

Question 30

most likely organism in the CNS

Answer 30

strep pneumonia

Question 31

antibiotic of choice for CNS

Answer 31

amoxicillin as can cross BBB (so can cephalosporins)

Question 32

most likely organisms in resp tract

Answer 32

H. influenza strep pneumonia legionella

Question 33

antibiotic choice in resp tract

Answer 33

co-amoxiclav if severe | amoxicillin if moderate

Question 34

most likely organism in GI tract

Answer 34

E. coli | C. diff

Question 35

management of GI tract (E. coli)

Answer 35

amoxicillin gentamicin metronidazole

Question 36

management of C. diff

Answer 36

metronidazole | vancomycin if severe

Question 37

most common organism in GU tract?

Answer 37

E.coli

Question 38

antibiotic of choice in GU tract?

Answer 38

gentamicin

Question 39

common causative organisms in skin

Answer 39

staph aureus | staph epidermidis in prosthetics

Question 40

management of skin infections

Answer 40

flucloxacillin