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Flashcards in Clinical use of Antibiotics 3 Deck (19)

Give four micro-organisms that cause urethritis

Neisseria gonorrhoea, Chlamydia trachomatis, Ureaplasma urealyticum & Mycoplasma genitalium


Why is empirical treatment of urethritis often necessary?

Therapy is often started on the presence of gram negative cocci, which can include both N.gonorrhoea and C.trachomatis. Empirical treatment can cover both of these without further testing


What is empirical treatment?

Clinical therapy started on the basis of a well educated guess, in the absence of complete or perfect information


Why would you use culture to detect N.gonorrhoea instead of PCR?

Culture can give sensitivities of the strain, which is useful for determining treatment


What are some of the drugs N.gonorrhoea is exhibiting resistance to?

Amoxycillin & Penicillin
1st and 2nd generation cephalosporins


What are the antibiotics used to treat N.gonorrhoea in rural/remotes areas?

Amoxycillin & probenicid


What are the antibiotics used to treat N.gonorrhoea in metropolitan areas?

Empirical choice is a single dose of IMI ceftriaxone


What is the antibiotic used to treat Chlamydia?

A single dose of azithromycin (1gm)


What is the empirical treatment for Urethritis, without lab results?

Single dose of both azithromycin and IMI ceftriaxone, to cover both Chlamydia and gonorrhoea


How is atypical pneumonia different from normal pneumonia?

A patient will have both an upper and lower respiratory tract infection i.e. presents with both a cough and pharyngitis


What are some of the main causes of atypical pneumonia?

Mycoplasma pneumoniae, Chlamydophilia pneumoniae, legionella longbeachae, Legionella pneumophilia, Chlamydophilia psittaci. Haemophilus influenzae may also be a cause


What is empirical treatment of atypical pneumonia?

Doxycycline (tetracycline), clarithromycin or azithromycin, both of which are macrolides

Tetracyclines cover Chlamydophilia, Mycoplasma and Legionella species, while Macrolides cover Haemophillus, Chlamydophilia, Legionella pneumophilia and Mycoplasma species


What is a polymicrobial infection?

An infection caused by several species of micro-organisms


Why are diabetic foot ulcers polymicrobial?

The bare foot is exposed to a range of organisms, and in a immunocompromised host with an open wound, the resulting infection is usually caused by a number of tehse organisms


What are some of the species you would find in a diabetic foot ulcer?

Pseudomonas aeruginosa
Staph aureus
Alpha- and beta-haemolytic Streptococcus species


Which antibiotics are useful against anaerobic bacteria in early infection of DFU?

In early infection:
-Augmentin (amoxycillin + clavulanic acid)
-Clindamycin po (a lincosamide)
-Metronidazole, which is only active against anaerobes


What must you always consider with deep foot ulcers?

Underlying Osteomyelitis


Which antibiotics are useful against anaerobic bacteria in deep or bone infection in DFU?

-Timentin IV (ticarcillin + clavulanic acid) + Tazocin IV (piperacillin + tazobactam)
-Meropenem IV (a carbapenem)


What is a typical antibiotic regimen for early diabetic foot infection?

You would give:
Augmentin to cover gram positive species, enterobacteriaceae and anaerobes,
Cephalexin to cover gram positive and some enterobacteriaceae, and metronidazole to cover anaerobes

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