Antibiotics (NICE)

Question 1

Acute sore throat?

Answer 1

1. Phenoxymethylpenicillin (5-10 days)
   If pen allergy then Clari/erythromycin(5 days)

Question 2

Acute otitis media

Answer 2

1. Amoxicllin
2. Co-amoxiclav
   (Clari/erythro if pen allergic)

Question 3

Sinusitis

Answer 3

1. Phenoxymethylpenicillin (5 days)
2. Co-amoxiclav

Doxy/clari/erythro if pen allergic

Question 4

Scarlet Fever

Answer 4

1. Phenoxymethylpenicillin
2. Azithromycin

Question 5

Acute COPD exacerbation

Answer 5

1. Amoxicillin/Doxy/Clari
2. One of the others

If HIGH RISK,
- Co-amox, co-trimoxazole, levofloxacin

Question 6

Acute bronchiectasis exacerbation

Answer 6

1. Amox/Doxy/Clari

If high risk,
- Co-amox
- Levoflox
- Ciprofloxacin

Question 7

Epididymo-orchitis
1. STI
2. Gonorrhoea/enteric org
3. Enteric org

Answer 7

Due to STI
- IM Ceftriaxone + Doxy

Due to chlamydia/gon + enteric org
- IM Ceftriaxone + Ofloxacin

**Due to enteric organisms **
- Ofloxacin + Levofloxacin

Question 8

Acute diverticulitis

Answer 8

1. Co-amox
   If pen allergy then metro + one of cefalexin, trimethoprim, ciprofloxain

Question 9

HAP
Adults + children

Answer 9

Adults
1. Co-amoxiclav
Alt choices doxy, cef, co-trimox, levoflox

Children
1. Clarithromycin

Question 10

Acute cough
(Adults + children)

Answer 10

Adults
1. Doxycycline
Alt choices = amox, clari, erythro

**Children **
1. Amoxicillin
Alt choices = clari, erythro, doxy (if 12 or over)

Question 11

Lyme disease

Answer 11

1. Doxycyline
   (Amoxicillin if above contraindicated)

**Ceftrixone if disseminated disease **

Question 12

Scabies

Answer 12

1. Permethrin/malathion
2. Ivermectin

Question 13

Mastitis

Answer 13

Lactating women
1. Flucloxacillin
2. Co-amox
(If pen allergy, clari/erythromycin)

Non-lactating women
1. Co-amoxiclav
If pen allergy, metro + clari/erythro

Question 14

Cellulitis/erysipelas

Answer 14

1. Flucloxacillin
   (If pen allergy, doxy/clari/erythro)

If infection near face/nose
1. Co-amox
(Clari + metronidazole if pen allergy)

Question 15

Leg ulcer

Answer 15

1. Flucloxacillin
   If pen allergy then Doxy/Clari/erythro
2. Co-amox
   Co-trimoxazole if pen allergy

Question 16

Bacterial vaginosis

Answer 16

Metronidazole 5-7 days

2nd line = Topical clindamycin

Question 17

Genital herpes

Answer 17

1. Aciclovir

Only give if within 5 days of symptom onset
Prophylaxis if at least 6 occurences per year

Question 18

Gonorrhoea

Answer 18

1. IM ceftriaxone
   OR
   Oral ciprofloxacin single dose

Question 19

Trichomoniasis

Answer 19

Metronidazole

Question 20

Chlamydia

Answer 20

1. Doxycycline OR
   Azithromycin

If contraindicated erythro OR ofloxacin

Azithro/erythro/amox if pregnant/breastfeeding

Question 21

Vaginal candidiasis

Answer 21

Local
1. Clotrimazole pessary 500mg single dose intravaginally

Oral
Fluconazole or itraconazole
**
LOCAL TREATMENTS ONLY IF PREGNANT **

Question 22

Lower UTI (Non-pregnant women)

Answer 22

1. Nitrofurantoin or Trimethoprim
2. Pivmecillinam/fosfomycin

Question 23

Lower UTI (Pregnant women)

Answer 23

1. Nitrofurantoin
2. Amoxicillin OR Cefalexin

Question 24

CAP
(Non severe, moderate severity, high severity)

Answer 24

Non-severe
1. Amoxiclllin
Alt choices = Doxy/clari/erythro

Moderate severe
1. Amoxicillin + clarithromycin
Alt choices = Doxy/clari

High severity
1. Co-amox + Clari/erythro

Question 25

Acute pyelonephritis (Non-pregnant, pregnant + children)

Answer 25

Non-pregnant 1. Cefalexin/co-amox/trimethoprim/ciprofloxacin Pregnant 1. Cefalexin Children 1. Cefalexin OR Co-amox

Question 26

Lower UTI (Men)

Answer 26

1. Trimethoprim OR Nitrofurantoin (7 days) 2. Base on culture

Question 27

CAUTI (Non-pregnant, pregnant + children)

Answer 27

**Non pregnant** 1. Nitro/trimeth/amox 2. Pivmecillinam **Pregnant** 1. Cefalexin **Children** 1. Trimetho/amox/cefalexin/co-amox

Question 28

Acute prostatitis

Answer 28

1. Ciprofloxacin/ofloxacin/trimethoprim 14 days 2. Levofloxacin OR co-trimoxazole

Question 29

Oral candidiasis (Children + Adults)

Answer 29

**Children** 1. Miconazole gel 2. Nystatin 3. Refer if no improvement after 2 weeks **Adults** 1. Miconazole gel 2. Nystatin 3. Oral fluconazole 50mg OD for 14 days **HIV positive ** Oral fluconazole 200mg stat, then 100-200mg OD for 14 days

Question 30

Threadworms

Answer 30

1. Single dose of mebendazole If pregnant, breastfeeding or child < 6 months, hygiene measures only for 6 weeks

Question 31

C.Diff

Answer 31

1. Vancomycin 2. Fidaxomicin **Further episode within 12 weeks/3months** - Fidaxomicin **Further episode after 12 weeks** - Vancomycin or Fidaxomicin

Question 32

H.pylori

Answer 32

1. PPI + Amox + Clari/metro Other options = Levofloxacin, tetracycline or tripotassium

Question 33

PID

Answer 33

1. IM ceftriaxone + metronidazole + doxycycline OR Ofloxacin + metronidazole

Question 34

Eczema (Bacterial)

Answer 34

1. Fusidic acid 2% 2. Flucloxacillin (if pen allergy then clari/erythro)

Question 35

Impetigo

Answer 35

1. Hydrogen peroxide 1% 2. Fusidic acid/mupirocin 2% 3. Flucloxacillin (Clari/erythro if pen allergy)

Question 36

Human bite

Answer 36

1. Co-amox Doxy + metro if pen allergy

Question 37

Diabetic foot infection

Answer 37

1. Flucloxacillin 2. Doxy/clari/erythro