Antibiotics for Specific Conditions

Question 1

What is your treatment of choice for moderate pneumonia (no pen. allergy)

Answer 1

Amoxicillin and clarithromycin

Question 2

What is your treatment of choice for severe pneumonia (no pen. allergy)

Answer 2

Co-amoxiclav and clarithromycin

Question 3

What is your treatment of choice for severe pneumonia in a patient who is penicillin allergic?

Answer 3

Clarithromycin and teicoplanin

Question 4

What is your treatment of choice for infective exacerbation of COPD with non-pneumonic symptoms?

Answer 4

Amoxicillin or doxycycline

Question 5

What is your treatment of choice for aspiration pneumonia and why?

Answer 5

Co-amoxiclav - it has good anaerobe cover

Question 6

What is your treatment of choice for infective exacerbation of COPD with pneumonic symptoms?

Answer 6

Amoxicillin

Question 7

What is your treatment of choice for recurrent infections in a patient with COPD?

Answer 7

Co-amoxiclav

Question 8

What is your treatment of choice for mild - moderate cellulitis (no penicillin allergy)?

Answer 8

Flucloxacillin

Question 9

What is your treatment of choice for severe cellulitis (no penicillin allergy)?

Answer 9

Benzylpenicillin and flucloxacillin

Question 10

What is your treatment of choice for cellulitis in a patient with penicillin allergy?

Answer 10

Clindamycin

Question 11

Which bacteria are you trying to target in necrotising fasciitis?

Answer 11

Group A streps.
Clostridium perfringens
Anaerobes

Question 12

What is your treatment of choice for necrotising fasciitis?

Answer 12

Benzylpenicillin + ciprofloxacin + clindamycin

Question 13

What is your treatment of choice for MRSA tissue infections?

Answer 13

Teicoplanin

Question 14

What is your treatment of choice for bites?

Answer 14

Co-amoxiclav

Question 15

What is your treatment of choice for septic arthritis / osteomyelitis (no penicillin allergy)?

Answer 15

Flucloxacillin + Sodium fusidate

Question 16

What is your treatment of choice for septic arthritis / osteomyelitis in a penicillin allergic patient?

Answer 16

Clindamycin

Question 17

Which organism causes osteomyelitis in sickle cell patients?

Answer 17

Salmonella

Question 18

What is your treatment of choice for native valve endocarditis (no penicillin allergy)?

Answer 18

Amoxicillin + gentamicin
If viridens group strep. is confirmed, use benzylpenicillin and gentamicin

2 weeks combination IV treatment, then switch to oral regime of amoxicillin for further 4 weeks

Question 19

What is your treatment of choice for infective endocarditis in an IVDU?

Answer 19

Flucloxacillin

Question 20

What is your treatment of choice for infective endocarditis in a new prosthetic valve?

Answer 20

Teicoplanin + gentamicin + rifampicin

Question 21

What is your treatment of choice for native valve endocarditis in a patient with penicillin allergy?

Answer 21

Teicoplanin + gentamicin

Question 22

What is your treatment of choice for gastroenteritis caused by E. coli, salmonella, or shigella?

Answer 22

Ciprofloxacin

Question 23

What is your treatment of choice for gastroenteritis caused by campylobacter?

Answer 23

Clarithromycin (or another macrolide)

Question 24

What is your treatment of choice for gastroenteritis caused by C. difficile?

Answer 24

1st line = Metronidazole (oral) 10-14 days
2nd line = Vancomycin (oral)
3rd line = Metronidazole and vancomycin in combination
4th line = Fidaxomicin

Question 25

What is the treatment of choice for a patient with gastroenteritis who has recently been to Africa or the Middle East?

Answer 25

Ciprofloxacin

Question 26

What is the treatment of choice for a patient with gastroenteritis who has recently been to Asia?

Answer 26

Azyithromycin

Question 27

What is the treatment of choice for a giardia infection?

Answer 27

Tinidazole OR metronidazole

Question 28

What is your treatment of choice for peritonitis (no penicillin allergy)?

Answer 28

Cefuroxime and metronidazole

Question 29

What is your treatment of choice for peritonitis in a patient who is penicillin allergic?

Answer 29

Ciprofloxacin and metronidazole

Question 30

What is your treatment of choice for mild-moderate diverticulitis, cholangitis or cholecystitis (no penicillin allergy)?

Answer 30

Co-amoxiclav

Question 31

What is your treatment of choice for severe diverticulitis, cholangitis or cholecystitis (no penicillin allergy)?

Answer 31

Cefuroxime and metronidazole

Question 32

What is your treatment of choice for diverticulitis, cholangitis or cholecystitis in a patient who is penicillin allergic?

Answer 32

Ciprofloxacin and metronidazole

Question 33

List 5 drugs which may be used in an uncomplicated UTI

Answer 33

``` Trimethoprim Nitrofurantoin Amoxicillin Ciprofloxacin Cefadroxil ```

Question 34

Which 2 drugs are safe in pregnancy for UTI?

Answer 34

Amoxicillin | Cefadroxil

Question 35

What is the drug of choice for pyelonephritis (no penicillin allergy)?

Answer 35

Cefuroxime

Question 36

What is the drug of choice for pyelonephritis in a patient who is penicillin allergic?

Answer 36

Ciprofloxacin

Question 37

Which drug would you add for pyelonephritis in a patient with septic shock?

Answer 37

Gentamicin

Question 38

What is the first line drug in the community for a patient with suspected bacterial meningitis?

Answer 38

IM benzylpenicillin

Question 39

What is the first line drug in hospital for a patient with suspected bacterial meningitis?

Answer 39

IV ceftriaxone

Question 40

What would you add to the treatment for bacterial meningitis if you suspected encephalopathy was possible?

Answer 40

Aciclovir - herpesvirus is a likely cause

Question 41

What would you add to the treatment for bacterial meningitis if you suspected pneumococcus was likely?

Answer 41

Dexamethasone Beware - this can worsen meningococcal meningitis so it's important to differentiate the two!

Question 42

What would you add to the treatment for bacterial meningitis if you suspected Listeria was possible e.g. in immunocompromised?

Answer 42

Ampicillin

Question 43

What is the first line drug for a patient with bacterial meningitis who is penicillin allergic?

Answer 43

Chloramphenicol

Question 44

What is the treatment of choice for neutropaenic sepsis?

Answer 44

Piperocillin-tazobactam and gentamicin

Question 45

What would you do if a patient with neutropenic sepsis has not responded to treatment within 48 hours?

Answer 45

- Consider escalating regime to meropenem - Add teicoplanin for good staphylococcus cover - Add anti-fungal agent