Antibiotics - Antibiotic Man 2020

Question 1

Meningitis

Answer 1

Ceftriaxone IV 2g bd + Dexamethasone IV 10 mg

Question 2

Epiglottitis/Supraglottitis

Answer 2

Cefriaxone IV 2g od

Question 3

Tonsillitis

Answer 3

1st = Penicillin

IF PA = Clarithromycin 500 mg

Question 4

Sinusitis

Answer 4

1st Penicillin V 500 mg

2nd = Doxycycline 200 mg

Question 5

Acute Otitis Media

Answer 5

1st = Amoxicillin
2nd = Clarithromycin

Abx IF: doesn’t settle w/in 72 Hrs OR systemic features present w/ perfusion

Question 6

Community Acquired Pneumonia - Mild/Mod

Answer 6

Amoxicillin

IF PA = Doxycycline PO 200 mg on day.
IF NBM = IV Clarithromycin

Question 7

Community Acquired Pneumonia - Severe

Answer 7

Co-Amoxiclav IV 1.2g + Doxycycline

IF PA = IV Levofloxacin 500 mg bd

Question 8

Community Acquired Pneumonia - ICU/HDU or NBM

Answer 8

Co-Amoxiclav IV 1.2g + Clarithromycin 500 mg

IF PA = IV Levofloxacin 500 mg bd

Question 9

Hospital Acquired Pneumonia - non-severe

Answer 9

PO Amoxicillin + Metronidazole

IF PA = Doxycycline 100 mg bd x 5 days

Question 10

Hospital Acquired Pneumonia - Severe

Answer 10

IV Amoxicillin + Metronidazole + Gentamicin

IF PA = Amoxicillin  Doxycycline OR IV Clarithromycin

Step down: PO Co-Trimoxazole

Question 11

Aspiration Pneumonia: Non-severe

Answer 11

PO Amoxicillin + Metronidazole

IF PA: A –> Doxycycline

Question 12

Aspiration Pneumonia: Severe

Answer 12

IV Amoxicillin + Metronidazole + Gentamicin

IF PA = Amoxicillin  Doxycycline OR IV Clarithromycin

Step down: PO Amoxicillin + metronidazole

Question 13

Acute Exacerbation of COPD

Answer 13

1st line = Amoxicillin 500 mg
2nd line = Doxycyline 500 mg

Only start Abx IF ↑ sputum purulence. NO sputum purulence = no Abx unless CXR consolidation

Question 14

Acute Cough/Acute bronchitis

Answer 14

1st line = Amoxicillin 500 mg

2nd line = Doxycyline 500 mg

Question 15

Endocarditis - Native valve/recent dental work

Answer 15

Amoxicillin IV 2g + Gentamicin 1mg/kg

Viridans Streptococci

Question 16

Endocarditis - Native valve/severe sepsis/IV drug user

Answer 16

Flucloxacillin IV 2g

Staphylococcus aureus

Question 17

Endocarditis = Prosthetic valve or suspected MRSA

Answer 17

Vancomycin IV + Gentamicin IV

Staphylococcus epidermidis

Once Vancomycin therapeutic range is met = change to Rifampicin PO

Question 18

Gut-bound bacterial endocarditis

Answer 18

Amoxicillin

Enterococcus faecalis + Streptococcus bouis

IF PA = Vancomycin + Gentamicin

Question 19

Clostridium difficile: Non-severe

Answer 19

Metronidazole PO 400 mg

Question 20

Clostridium difficile: Severe

Answer 20

Vancomycin +/- Metronidazole

Must give vancomycin orally!!

Question 21

Peritonitis/Biliary tract/Intra-abdominal infection

Answer 21

IV Amoxicillin + Metronidazole + Gentamicin

IF PA= Vancomycin

Step down: PO Co-Trimoxazole + Metronidazole

Question 22

Proven Spontaneous Bacterial Peritonitis: Mild

Answer 22

Co-Trimoxazole PO

Question 23

Proven Spontaneous Bacterial Peritonitis: Severe

Answer 23

Piperacillin/Tazobactam IV

Step down: Co-Trimoxazole

Question 24

Complicated UTI/Pyelonephritis/ Urosepsis

Answer 24

IV Amoxicillin + Gentamicin

IF PA = IV Co-Trimoxazole + Gent.
Step-Down: PO Co-Trimoxazole

Question 25

Uncomplicated Female UTI

Answer 25

Nitrofurantoin 100 mg OR Trimethoprim 200 mg 3 Days

Question 26

Uncatherised Male UTI

Answer 26

Nitrofurantoin 100 mg OR Trimethoprim 200 mg 7 Days

Question 27

Cellulitis

Answer 27

Flucloxacillin 1g qds IF PA = Doxycycline 100 mg PO

Question 28

Open Fracture Prophylaxis

Answer 28

IV Co-Amoxiclav 1.2g tds Start within 3 Hours for max 72 Hours

Question 29

Diabetic Foot Infection: Mild

Answer 29

Flucloxacillin 1g IF PA = Doxycycline

Question 30

Diabetic Foot Infection: Moderate

Answer 30

Flucloxacillin 1g + Metronidazole 400 mg IF PA = Doxycycline

Question 31

Acute Septic Arthritis/Osteomyelitis

Answer 31

IV Flucloxacillin 2g qds

Question 32

Severe Systemic Infection of Unknown Source

Answer 32

IV Amoxicillin + Metronidazole + Gentamicin IF PA = Amoxicillin --> Vancomycin

Question 33

Athlete's Foot

Answer 33

Topical 1% terbinafine - 7 days

Question 34

Dermatophyte Nail Infection

Answer 34

Terbinafine 250 mg ``` Fingers = 6 weeks Toes = 12 weeks ```

Question 35

Dog/Cat bite

Answer 35

1st = Co-Amoxiclav 625 mg 2nd = Metronidazole 400 mg + Doxycycline 100 mg

Question 36

Human Bite

Answer 36

1st = Co-Amoxiclav 625 mg 2nd = Metronidazole 400 mg + Clarithromycin 600 mg

Question 37

Impetigo

Answer 37

Localised lesions = Topical Fusidic acid Otherwise: 1st line = Flucloxacillin 500 mg 2nd = Clarithromycin