Common infections Flashcards
(31 cards)
How should mild-to-moderate C. difficile infection be treated ?
oral metronidazole 400 mg three times a day for 10–14 days.
How should severe C.difficile be treated ?
Vancomycin oral 125 mg QDS 10-14 days
What is the treatment for recurrent or second line antibiotic for C.difficile ?
Fidaxomicin 200mg BD
What is initial blind therapy for endocarditis ?( Native valve endocarditis)
Amoxicillin (or amipicilin) + low dose gentamicin
If patient is penicillin allergic, what antibiotics can be offered for initial blind therapy of endocarditis ?
penicillin-allergic, or if meticillin-resistant Staphylococcus aureus suspected, or if severe sepsis, use vancomycin + low-dose gentamicin
If prosthetic valve endocarditis, how should patients be treated ?
, vancomycin + rifampicin + low-dose gentamicin
Which antibiotics should be given for endocardatitis caused by staphylococci or streptococci?
Flucloxacillin: staphylococci
Benzylpenicillin: streptococci
What is first line treatment for mild severity CAP ? 5 days treatment
Amoxicillin 1st line
Alternative: doxycycline, clarithromycin, erythromycin ( pregnancy)
What is first line treatment for moderate severity CAP ?
Amoxicillin + clarithromycin or erythromycin or if penicillin allergic doxycycline alone or calrithormycin
What is first line treatment for severe CAP ?
Co-amoxiclav and clarithromycin or erythromycin. Alternative: levofloxacin
What is first choice antibiotic in non-severe HAP?
co-amoxiclav
Alternatives: doxycycline, cefalexin, co-trimoxazole, levofloxacin
children alternative 1st choice: clarithormycin
5 days then review
What is first line treatment in severe or at higher risk of resistance HAP ?
Intravenous first line:
Piperacillin with tazobactam, ceftazidime, ceftazidime with avibactam, ceftriaxone, cefuroxime, levofloxacin [unlicensed], or meropenem.
If meticillin-resistant Staphylococcus aureus confirmed or suspected add vancomycin, or teicoplanin, or linezolid (under specialist advice only if vancomycin cannot be used).
If meningococcal disease (meningitis with non-blanching rash or meningococcal septicaemia) suspected, which antibiotic should be given before transfer to hospital ?
benzylpenicillin sodium
cefotaxime alternative
chloramphenicol if penicillin allergy
In hospital which drug should be considered as adjuvant to antibiotic, but should be given no longer than 12 hours after starting antibiotic in meningitis ?
dexamethasone
avoid dexamethasone in septic shock, meningococcal septicaemia, or if immunocompromised, or in meningitis following surgery.
What is empirical treatment of meningitis in hospital if aetiology not known for Adult and child 3 months–50 years and Adult over 50 years ?
Adult and child 3 months–50 years,cefotaxime (or ceftriaxone)
Adult over 50 yearscefotaxime (or ceftriaxone) + amoxicillin (or ampicillin)
Suggested duration of treatment at least 10 days
How should osteomyelitis be treated ?
Flucloxacillin
Consider adding fusidic acid or rifampicin for initial 2 weeks.
Suggested duration of treatment 6 weeks for acute infection
If penicillin-allergic, clindamycin
Consider adding fusidic acid or rifampicin for initial 2 weeks.
Suggested duration of treatment 6 weeks for acute infection
If meticillin-resistantStaphylococcus aureussuspected, vancomycin (or teicoplanin)
Consider adding fusidic acid or rifampicin for initial 2 weeks.
Suggested duration of treatment 6 weeks for acute infection
Outline antibiotic treatment for impetigo ?
Topical first line if hydrogen peroxide unsuitable or ineffective: fusidic acid.
Alternative if fusidic acid resistance suspected or confirmed: mupirocin.
Oral first line:Flucloxacillin.
Alternative if penicillin allergy or flucloxacillin unsuitable: clarithromycin or erythromycin (in pregnancy).
What are the first choice antibacterials for cellulitis ?
Oral or Intravenous first line: Flucloxacillin.
Alternative in penicillin allergy or flucloxacillin unsuitable: clarithromycin, oral erythromycin (in pregnancy), or oral doxycycline.
Oral or Intravenous first line if infection near the eyes or nose: Co-amoxiclav.
Alternative in penicillin allergy or co-amoxiclav unsuitable: clarithromycin with metronidazole.
Which antibiotics are used in animal and human bites ?
Co-amoxiclav
If penicillin-allergic, doxycycline + metronidazole
Which antibiotics can be used for skin and soft-tissue infections caused by MRSA?
- A tetracycline alone or a combination of rifampicin and fusidic acid can be used
- Clindamycin alone is alternative
- vancomycin can be used for severe skin and soft-tissue infections associated with MRSA; if a glycopeptide is unsuitable, linezolid
What is the treatment for pericoronitis, gingivitis ?
metronidazole or amoxicillin alternative
3 day treatment
What is the treatment for periodontitis ?
Metronidazole or alternative if over 12 doxycycline
What is the treatment for sore throat ( acute ) ?
Phenoxymethylpenicillin
Suggested duration of treatment 5 to 10 days.
If penicillin-allergic, clarithromycin (or erythromycin)
Suggested duration of treatment 5 days.
What is the treatment for sinusitis ?
1st line:Non-life threatening symptoms:phenoxymethylpenicillin.
Systemically very unwell, signs and symptoms of a more serious illness, or at high-risk of complications: co-amoxiclav.
2nd line: co-amoxiclav
Penicillin allergy or intolerance: First line: doxycycline or clarithromycin (erythromycin in pregnancy).
