Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

SDCEP guidance > bacterial infections > Flashcards

bacterial infections Flashcards

(70 cards)

Start Studying
1
Q

what is the use of broad spectrum ABs associated with?

A

increased c difficile associated disease

so care if prescribing to elderly, GIT disease inc PPIs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

dental abscess local measures

A

achieve drainage of pus - ext/through RCs, drain any ST pus by incision (don’t drain a cellulitis-type swelling)
remove cause where possible

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

NUG local measures

A

remove supra and subgingival deposits, OH advice

due to pain may only be able to tolerate limited debridement in acute phase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

local measures for pericoronitis

A

irrigation and debridement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

sinusitis local measures

A

advise steam inhalation (not children)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

indications for ABs

A

evidence of spreading infection: cellulitis, LN involvement, swelling
evidence of systemic involvement: fever, malaise
local measures have failed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

indications for ABs - NUG/pericoronitis

A

systemic involvement or persistent swelling despite local tx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

indications for ABs - sinusitis

A

persistent symptoms and/or purulent discharge lasting at least 7 days or where symptoms are severe

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what should ABs be used in conjunction with?

A

local measures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

pts who have taken AB course in prev 6 weeks

A

increased risk of harbouring bacteria resistant to that drug and should therefore be prescribed an alternative

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

emergency transfer to hospital

A

significant trismus
FOM swelling
difficulty breathing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

don’t prescribe antibiotics to:

A

treat pulpitis
prevent dry socket in non-surgical ext

= these are inflammatory causes of pain

prophylaxis to prevent infections after a routine dental surgical procedure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

before prescribing ABs what should you do?

A

refer to BNF and BNFC for drug interactions
advise pts to space out doses as much as possible throughout the day
review within 2-7days (whether or not ABs were prescribed)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

contraception - recent change to guidelines

A

additional precautions no longer required when antibacterials that do not induce liver enzymes are taken with

  • combined oral contraceptives (unless diarrhoea/vomiting)
  • contraceptive patches or vaginal rings

ABs in this document don’t induce liver enzymes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

IE 2008 NICE

A

ABP against IE not recommended for people undergoing dental tx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

IE 2015 review

A

no evidence it is of benefit (inc in prosthetic joints)

unacceptable to expose pts to the potential adverse effects of ABs in these circumstances

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what MOs are usually responsible for dental abscesses?

A

viridians streptococcus spp or gram - organisms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

dental abscess - why are ABs not indicated where infection localised to PR tissues?

A

indicates infection being adequately managed by immune system
abscess mostly isolated from circulation - v little AB penetration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

dental abscess - when are ABs required?

A 
immediate drainage not achieved using local measures
spreading infection (swelling, cellulitis, LN involvement)
systemic involvement (fever, malaise)

suggest immune response alone not able to adequately manage infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

what is it good practice to measure in a dental abscess pt?

A

temp - <36 or >38 degrees indicative of systemic involvement

but absence of pyrexia does not preclude ABs if other S+S of spreading infection or systemic involvement are present

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

dental abscess - compare amoxicillin and phenoxymethylpenicillin (penicillin V)

A

amoxicillin usually as effective as phenoxymethylpenicillin but better absorbed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

dental abscess - what does the amoxicillin/phenoxymethylpenicillin duration depend on?

A

severity and clinical response, usually 5 days

don’t prolong courses unduly - can encourage development of resistance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

dental abscess - if severe infection how should the AB dose be adjusted?

A

double dose

e.g. EO swelling, eye closing, trismus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

dental abscess - what should you do if pt doesn’t respond to the prescribed AB?

A

check diagnosis and consider referral to a specialist

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
dental abscess - first line ABs
amoxicillin phenoxymethylpenicillin (metronidazole)
26
dental abscess - amoxicillin
500mg capsules 15 capsules x3 daily double in severe infection in adults and children aged 12-17 years
27
dental abscess - amoxicillin cautions/contraindications
can cause hypersensitivity reactions, inc rashes and anaphylaxis, can cause diarrhoea - don't prescribe to pts with history of anaphylaxis, urticaria or rash immediately after penicillin administration - at risk of immediate hypersensitivity
28
dental abscess - phenoxymethylpenicillin
250mg tablets 40 tablets 2 tablets x4 daily severe infection in adults - double dose
29
dental abscess - phenoxymethylpenicillin cautions/contraindications
can cause hypersensitivity reactions, inc rashes and anaphylaxis, can cause diarrhoea - don't prescribe to pts with history of anaphylaxis, urticaria or rash immediately after penicillin administration - at risk of immediate hypersensitivity
30
dental abscess - when is metronidazole indicated?
pts allergic to penicillin | can be used as an adjunct to amoxicillin in pts with spreading infection or pyrexia
31
dental abscess - what is metronidazole effective against?
anaerobic bacteria
32
dental abscess - metronidazole
tablets 200mg 15 tablets x3 daily for severe infection double dose in adults and children 12-17yrs
33
dental abscess - metronidazole cautions/contraindications
``` avoid alcohol (disulfiram-like reaction with alcohol) don't prescribe to pts on warfarin ```
34
dental abscess - why shouldn't 2nd line ABs be prescribed first?
no advantage over 1st line drugs for most pts, could contribute to antimicrobial resistance use of broad-spectrum ABs associated with increase in clostridium difficile infection
35
dental abscess - if pt hasn't responded to 1st line AB prescribed, what should you do?
check diagnosis | either refer pt or consider speaking to a specialist before prescribing clindamycin, co-amoxiclav or clarithromycin
36
dental abscess - what is clindamycin active against?
gram + cocci, inc streptococci and penicillin-resistant staphylococci
37
dental abscess - when can clindamycin be used?
if pt has not responded to amoxicillin/metronidazole
38
dental abscess - risk of clindamycin
can cause the serious adverse effect of antibiotic-associated colitis more frequently than other ABs
39
dental abscess - what is co-amoxiclav active against?
B-lactamase producing bacteria that are resistant to amoxicillin
40
dental abscess - when can co-amoxiclav be used?
to tx severe dental infection with spreading cellulitis or dental infection that has not responded to 1st line antibacterial tx
41
dental abscess - what is clarithromycin active against
B-lactamase producing bacteria
42
dental abscess - which broad-spectrum ABs are especially high risk of resultant c difficile infection?
coamoxiclav and clindamycin
43
dental abscess - what should the use of broad-spectrum ABs be restricted to and why?
2nd line tx of severe infections or in cases of severe infection with spreading cellulitis risk of c difficile infection
44
dental abscess - clindamycin
150mg capsules 20 capsules x4 daily, swallowed with water same for 12-17 yr olds
45
dental abscess - clindamycin cautions
don't prescribe to pts with diarrhoea states advise pt to discontinue use immediately if diarrhoea or colitis develops as clindamycin can cause the SE of antibiotic-associated colitis
46
dental abscess - coamoxiclav
``` 250/125 tablets 15 tablets x3 daily same for 12-17 yr olds amoxicillin 250mg as trihydrate and clavulanic acid 125mg as potassium salt ```
47
dental abscess - coamoxiclav cautions
cholestatic jaundice can occur either during or shortly after use, more common in >65s and in men - don't prescribe to pts who have a history of co-amoxiclav-associated or penicillin-associated jaundice or hepatic dysfct can result in hypersensitivity reactions inc rashes and anaphylaxis, can cause diarrhoea - don't prescribe to pts with history of anaphylaxis, urticaria or rash immediately after penicillin administration as these pts are at risk of immediate hypersensitivity
48
dental abscess - clarithromycin
tablets 250mg 14 tablets x2 daily same for 12-17 yr olds
49
dental abscess - clarithromycin cautions/contraindications
use with caution in pts who are predisposed to QT interval prolongation inc electrolyte disturbances, and those with hepatic/renal impairment don't prescribe: - pregnant/breastfeeding - taking warfarin/statins
50
NUG
painful, superficial infection of the gingival margins associated with anaerobic fuse-spirochaetal bacteria
51
what groups is NUG more common in?
smokers immunosuppressed poor OH
52
pericoronitis
superficial infection of operculum, with occasional local spread, that is often associated with anaerobic bacteria
53
NUG and pericoronitis first line tx
local measures
54
when should ABs be used for NUG and pericoronitis?
severe/systemic involvement/persistent swelling despite local measures
55
ABs for NUG/pericoronitis
metronidazole first choice | alternative - amoxicillin
56
NUG and pericoronitis - metronidazole
400mg tablets 9 tablets x3 daily
57
NUG and pericoronitis - metronidazole cautions/contraindications
``` avoid alcohol (disulfiram-type reaction) don't prescribe to pts taking warfarin ```
58
NUG and pericoronitis - amoxicillin
capsules 500mg 9 capsules x3 daily double in severe infection in adults and children aged 12-17yrs
59
NUG and pericoronitis - amoxicillin cautions
can cause hypersensitivity reactions inc rashes and anaphylaxis, can cause diarrhoea - do not prescribe to pts with history of anaphylaxis, urticaria or rash immediately after penicillin administration - at risk of immediate hypersensitivity
60
sinusitis course of illness
generally self-limiting, av duration 2 and a half weeks
61
sinusitis local measures
advise pt to use steam inhalation (not recommended for children)
62
sinusitis - indications for ABs
persistent symptoms and/or purulent discharge lasting at least 7 days or if symptoms are severe
63
sinusitis - ephedrine
nasal drops 0.5% 10 ml 1 drop into each nostril up to 3 times daily when required same for 12-17 yr olds advise pt to use for max 7 days dose can be increased to 2 drops 3 or 4 times daily if required
64
sinusitis - ephedrine contraindication
don't use in pts with high bp
65
sinusitis - AB choices
Phenoxymethylpenicillin | doxycycline
66
sinusitis - amoxicillin
capsules 500mg 21 capsules x3 daily double in severe infection in adults and children aged 12-17 years
67
sinusitis - amoxicillin cautions/contraindications
can result in hypersensitivity reactions, inc rashes and anaphylaxis, can cause diarrhoea. Don't prescribe to pts with history of anaphylaxis, urticaria or rash immediately after penicillin administration as these pts are at risk of immediate hypersensitivity
68
sinusitis - doxycycline
capsules 100mg (/dispersible tablets) 8 capsules 2 capsules on 1st day, followed by 1 capsule daily swallow whole with plenty of fluid during meals, while sitting or standing severe infection in adults and >12yrs - 2 capsules daily
69
sinusitis - doxycycline cautions/contraindications
use with caution in pts with hepatic impairment or those receiving potentially hepatotoxic drugs do not prescribe - pregnant/breastfeeding/<12yrs - can deposit on growing bone and teeth (by binding to calcium) and cause staining and occasional dental hypoplasia - pts taking warfarin
70
sinusitis - doxycycline SEs
``` nausea vomiting diarrhoea dysphagia oesophageal irritation and photosensitivity ```

SDCEP guidance (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions