Infection Flashcards by Alice Sully

Example of an antiprotozoal used in amoebic infections

Mepacrine hydrochloride

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Safest antibiotic classes in pregnancy

Penicilins and Cephalosporins

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Signs and symptoms of infection

fever, inflammation, drowsiness in children, confusion in elderly, worsening of renal function

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Clinical markers of infection

Raised CRP, Low BP, High ESR, temperature, Resp rate, pulse

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what antibiotic classes must be avoided in children?

Tetracyclines (<12)

Quinolones cause arthropathy

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What antibiotic has the largest risk of C diffe

Clindamycin

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What type of antibiotics are related to adverse reactions e.g. fungal infections and antibiotic associated collitis/

Broad spectrum e.g. Cephalosporins

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Examples of notifiable diseases

Anthrax -Cholera
Botulism -Brucellosis
Diarrhoea (infectious/bloody)
Diptheria -Encephalitis(acute)
Food poisoning
haemolytic uraemic syndrome
viral hepatitis -Legionnaires
Leprosy -Malaria -measles
meningitis -meninigococcal septicaemia - mumps
paratyphiod fever -plague
polio -rabies -rubella -SARS
scarlet fever -Smallpox
Strep (group A) -tetanus -TB -typhoid fever -typhus -whooping cough -yellow fever

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What antibiotic is used in rheumatic fever to prevent recurrence?

Phenoxymethylpenicillin or sulfadiazine

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What antibiotic is used in invasive strep A infection to prevent recurrence?

Phenoxymethylpenicilin (if pen allergic -> erthyromycin or azithromycin

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What antibiotcs are used to prevent secondary menigococcal infection to exposed people?

Ciprofloxacin or Rifampicin

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What antibiotic is used in haemophilus influenza type B to prevent secondary cases?

Rifampicin - if therre are vunlerable occupants in household

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What antibiotic is used for diptheria in non immunocompromised patients to presvent secondary cases?

Erthyromycin - treat for further 10 days if swab +ve after 7 days of treatment

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Antibiotic therapy used for prophylaxis of pertussis

Clarithromycin

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Asplenia prophylaxis antibiotic of choice

Phenoxymethylpenicilin

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Antibiotic of choice following animla bites

co-amoxiclav (or doxy + metro)

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If a patient is having a GI procedure, what antibiotic should be given as a single STAT dose

Gent / cefuroxime / Co-amox up to 30 mins before procedure

If MRSA +ve - vanc/teic

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Examples of antipseudomonal antibiotics

Pip-Taz, ticarcillin with clavulanic acid

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What first line antibiotics should be given to suspected Meningococacal septicaemia patients

Benz pen OR cefotaxime OR chloramphenicol

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What antibiotics are used to eliminate nasipharyngeal carriage of meningitis?

Ciprofloxacin or rifampicin

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Antibiotics that can cause cholestatic jaundice

Co-amoxiclav + flucloxacillin

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Antbitocs contraindicated in pregnancy

tetracyclines, trimethoprim, nitrofurantion (causes nausea; avoid at term)

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Antibiotics to avoid in pregnancy

Metronidazole, Chloramphenicol, aminoglycosides and Tetracyclines, Quinolones and sulphonamides

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Generally, what antibiotic is used for staphylococci infection?

Flucloxacillin

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Generally, what antibiotic is used for MRSA infection?

Vancomycin

Generally, what antibiotic is used for Anaerobic infection?

Metronidazole

Generally, what antibiotic is used forpseudomonas taphylococci infection?

Gentamicin

Generally, what antibiotic is used for streptococci infection?

Phenoxymethylpenicilin or Benpen

If menigitis is caused by listeria, how should it be treated?

Amoxicilin + Gentamicin for 21 days

If a patient is over 50yrs and has meningitis, how do we treat them?

/Cefotaxime (or ceftriaxone) + AMOXICILLIN

Antibacterial of choice for otitis externa

flucloxacillin ( or clari if pen allergy. If pseudomonas suspected, give Cipro)

Signs of otitis media

Effusion, common in children, can be systemically unwell

When should antibiotics be offered to patients with OE

if systemically unwell e.g. fever or if there is otorrhoea or if pt <2 with bilateral OE Give amoxicilin or clari if pen allergic

Ear symptoms that would requrie referral

``` Dizziness or tinnitus Pain in the middle ear Fever and malaise in children (signs of systemic infection) Foreign body Deafness Inflammation of the pinea ```

What is the active ingredient in Sofradex

Framycetin 0.5%, Dex 0.05% and Gramicidin 0.005%

Active ingredient in locorten vioform

Flumetasone / ciloquinol 0/02%

What is the brand ofr neomycin + dexamethasone + acetic acid ear spray?

Otomize

antibiotic choice in Salmonella

Cipro or ceftotazidime

Antibiotic choice in campylobacter

clarithromycin

Treatment of C diffe

metronidazole PO for 10-14 days | OR Vanc PO OR Fidaxomicin

Antibioti choice for chlamydial infection

Doxycyline or Azithromycin for 7 days

Organisms that can cause sinusitis

Strep pneumoniae, Heam.influenzae, Moraxella catharrhalis

Should antibiotics be offered to all patients wiht ? sinusitis?

No - only those systemicall unwell with symptoms for 10 days or morer

First line antibiotics for Bronciesctasis or COPD acute exacerbations or

Doxy or Clari or amox

First line antibiotics for non severe CAP

Amoxicillin

First line antibiotic for moderate severity CAP

Amoxicilin + Clarithromycin or Doxy alone

High severity CAP treatment

Benzpen + clari

Atypical pneumonia first line antibiotic

Clari

HAP early onset natibiotic choice

co-amoxiclav

Treatmet for Impetigo if small areas of skin infected

Fusidic acid topical ( 7 days) or if MRSA mupirocin topical

Treatmet for Impetigo if widespread infection

PO flucloxacillin

Treatment for cellulitis

High dose flucloxacillin

Examples of aminoglycosides

Neomycin, amikacin, tobramycin, gentamicin, streptomycin

What type of bacteria is Gentamicin active against

many gram -ve (inc. P aeruginosa) and some gram +ve --> inactive against Anaerobes

Side effects of aminoglycosides

Nephrotoxic Otoxic Hypocalcaemia + hypokalaemia + hypomagnesaemia May impair neuromusculae transmission (CI in MG)

If a patient has renal impairment and is prescribed an aminoglycoside, what must be done to the dosage interval?

increase the interval so there is more time for the drug to be excreted

What condition is AG contraindicated in?

Myasthenia Gravis

Why is IBW used to calculate Gentamicin doses>

AG are hydrophilic - to avoid excessive dosing in obese patinets

When should Gentamicin levels be taken and what is the aim?

For OD dose regimes: pre dose <1mg/mL | For multi dose regimes: take 1 hour after dose (5-10mg/mL) and trough levels (<2mg/mL)

If a gentamicin pre-dose conc is high, what should be done

increae the dosing interval

If an aminglycoside post dose level is high what should be done?

Reduce the dose of AG

MHRA alert for histamine related reaction was associated with which aminoglycoside?

Gentamicin

What antibiotics are broad spec and beta lactams?

Carbapenems

Are carbapenems active against methicillin resistant staph aureus?

Examples of Carbapenems

Meropenum and Imipenem

What antibiotics are cautioned in penicilin allergy?

Carbapenems

Which carbapenem is not active against P.aeruginosa?

Ertapenem (used for CAP, abdominal and gynae infection)

Why is imipenem given with Cilastatin?

Cilastatin is an enzyme inhibtor that blocks imipenems renal metabolism as kidneys partially inactive imipenem

Which carbapenem has the least seizure inducing potential?

Meropenem

What is the interaction between carbapenem and sodium valporate?

Carbapenems decrease the concentration of sodium valp as low as 10% - increasing sodium valp dose does nto counteract the interaction

What spectrum are cephalosporins?

Broad spec

Example of 1st gen cephalosporin

Cephalexin (often used in UTI, safe in pregnancy)

Example of 2nd gen cephalosporin

Cefuroxime (more activity against gram -ve bacteria)

Example of 3rd gen cephalosporin

Ceftriaxone and Ceftazidime (ceftazidime is active against pseudomonas)

Which cephlasporin can cause gall bldder stones?

Cetriaxone - caution in history of hypercalciuria

Examples of glycopeptides

vanc + Teic

What spectrum are glycopepetides active against

Gramm +ve only

Side effects of glycopeptides

Red man syndrome ( if infused too fast), nephrotxocitiy and otoxicity

What is the aim for Vancomycin trough levels?

10-20mg/L

Which antibiotic is well concentrated into bone and exreted in bile and urine?

clindamycin

Which antibiotic is most liley ot cause antibiotic associated colitiis?

Clindamycin

What is a caution associated wiht Macrolides?

Can prolong QT

Which macrolide is QDS dosing and which is BD?

``` QDS = erythromycin (more GI s/e) BD = clarithromycin ```

Macrolides can cause drug interactions. Why?

They are enzyme inhibitors so can increase levels of warfarin, statins, CCBs, Apixaban, digoxin etc

What condition can Azithromycin be sold as a max 1g dose for OTC?

Asymptomatic chlamydia trachomatis gential infection

Counselling points with metronidazole

Take with food, avoid alcohol and for48 hours after treatment, may darken urine

Which antibiotics are penicillinase resistant?

Flucloxacillin and Temocillin

what antibiotics are antipseudomal penicilins?

Pip-taz (4.5g TDS)

Amoxicilin peadiatric doses

Age 1-11months: 125mg TDS Age 1-4 years: 250mg TDS Age 5-17 years: 500mg TDS

What is the only oral antibiotic agaisndt P..aeruginosa

Ciprofloxacin

What drug in conjunction to a quininole can increae the risk of convulsions

NSAIDS

What is the MHRA alert regarding quinolones

Tendon ruptue and damage - CI if history of tendon disorders following quinolone use

Concomittant therapy with what drug increases the risk of quinolone induced tendon rupture?

Corticosteroids

what antibiotic class is associated with an MHRA alert regarding increased risk of Aortic anerusym and dissection?

Quinolones

What conditions are quinolones cautioned in

QT prolongation, arthropathy in children, epilepsy, G6DP deficiency, excessive exposure to sunlight

What medication interacts with Trimethoprim / co-trimz>

Methotrexate

Dose of trimethoprim for UTIS

200mg BD (occassionally 100mg ON for UTI prophylaxis)

What is the name for trimethoprim + sulfamethoxazole

Co-trimoxazole

What antibiotic is used ofr PCP infection

Co-trimox 120mg/kg/day for treatment and 960mg for propylaxis dose (noramally M/W/Fri)

What must you monitor for with trimethoprim/co-trimox?

Blood disorders (leucopenia, thrombocytopenia, aneamia)

How should tetracyclines be taken?

Swallow whole, avoid exposure to sunlight, indigestion remedies/zin iron 2 hours before or after

Which tetracycline holds the greatest risk of SLE?

Minocycline

Why should chloramphenicol be avoided in babies?

Grey baby syndrome risk

What needs to be monitored during daptomycin therapy

Creatine phosphokinase - before and then at least weekly during treatment + renal function

What are the mhra warnings associated wiht Linezolid?

1. Optic neuropathy | 2. Blood disorders

What is the risk of using linezolid in combination wiht SSRIS

Serotonin syndrome

What is Rifaximin used for?

Travellers diarhorrea and recurrence of hepatic encepthalopathy

Nitrofurantoin has the risk of what neuropathy?

Peripheral neuropathy

When is antiviral treatment needed for children with chickenpox?

If <1 month i.e. neonate

What is herpes Zooster more commonly known as

Shingles

What drug is used for herpes zooster (systemically) and herpes simplex (topically)

Aciclovir

Valaciclovir can be used for what form of herpes?

Genital herpes

What is Ganciclovir used to treat?

CMV

What is Oseltamivir licensed for use for?

flu - start within 48 hours

Infection Flashcards

(114 cards)