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Infections Flashcards

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1
Q

Human and animal bites

A

Co-amoxiclav

pen allergy - doxycycline AND metronidazole

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2
Q

Human and Animal bites
prophylaxis duration

A

3 days

  • bitten no signs of infection
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3
Q

Human and Animal bites
treatment duration

A

5 days

bitten and signs of infection

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4
Q

Human and Animal scratches

A

Flucloxacillin

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5
Q

Tick bites (Lyme disease)

A
  1. Doxycycline 100mg BD
  2. Amoxicillin 1000mg TDS
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6
Q

Tick bites (Lyme disease)- duration of treatment

A

21 days

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7
Q

Mild diabetic foot infection

A

mild= less than 2 cm
- flucloxacillin
- pen allergic= clarithro/erithro/doxy

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8
Q

Mod-severe diabetic foot infection

A

Flucloxacillin or co-amoxiclav +/- gentamicin

Penicillin allergy: co-trimoxazole +/- gentamicin

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9
Q

Cellulitis

A

flucloxacillin

Penicillin allergy or if flucloxacillin unsuitable

  • Clarithromycin or erythromycin (eryth in pregnancy)
  • Doxycycline
  • Co-amoxiclav
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10
Q

Cellulitis- near eyes or nose

A

Co-amoxiclav

Penicillin allergy: clarithromycin AND metronidazole

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11
Q

CAP- low severity

A

amoxicillin
doxy/clarithro/erythro (pregnant)

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12
Q

CAP- moderate severity

A

First line: amoxicillin AND clarithromycin (erythromycin in pregnancy)

Doxycycline or clarithromycin

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13
Q

CAP- high severity

A

First line: co-amoxiclav AND clarithromycin (erythromycin in pregnancy)

Second line: levofloxacin

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14
Q

C.diff

A

vancomycin
fidaxomicin

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15
Q

C.diff life threatening

A

Vancomycin and IV metronidazole

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16
Q

Travellers diarrhoea

A

Standby: azithromycin

prophylaxis/treatment: Bismuth Subsalicylate

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17
Q

Otitis media

A

amoxicillin

worsening despite 2-3 days treatment= co-amoxiclav

pen allergy= clarithro/erythro (pregnancy)

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18
Q

Otitis externa

A

topical acetic acid
Second line: topical neomycin sulphate with corticosteroid
If systemic treatment needed: flucloxacillin

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19
Q

H.pylori
diagnostic tests

A

The urea (13C) breath test, Stool Helicobacter Antigen Test (SAT), or laboratory-based serology

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20
Q

What can adversely effect the results of a h.pylori diagnostic test? and which tests are effected?

A

The urea (13C) breath test, Stool Helicobacter Antigen Test (SAT)

PPI- 2 weeks before test
ABX- 4 weeks before

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21
Q

H.pylori- triple therapy

A

PPI+ 2 abx

Amoxicillin/Metronidazole/Clarithromycin
any PPI

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22
Q

H.pylori- triple therapy

doses of abx

A

amox- 1g BD
met- 400mg BD
Clarithro - 500mg BD

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23
Q

H.pylori- triple therapy

duration of treatment

A

7 days

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24
Q

HAP- non-severe

A

First line: co-amoxiclav

Second line (adults): doxycycline, or cefalexin, or co-trimoxazole, or levofloxacin

Second line (children): clarithromycin
-no doxy under 12

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25
Impetigo - localised non bollous
First line: hydrogen peroxide 1% Second line: fusidic acid (mupirocin 2% and resistance suspected)
26
Impetigo - widespread non bollous
First line: fusidic acid (mupirocin 2% if fusidic acid is suspected to be resistant)
27
Impetigo- Bullous or patients who are systemically unwell
First line: flucloxacillin Second line: clarithromycin (erythromycin in pregnancy)
28
UTI - ABx and duration men
First line: nitrofurantoin or trimethoprim Treatment duration: 7 days
29
UTI - ABx and duration non-pregnant women
First line: nitrofurantoin or trimethoprim Second line: pivmecillinam or Fosfomycin Treatment duration: 3 days if uncomplicated
30
UTI - ABx and duration pregnant women
First line: nitrofurantoin Second line: cefalexin or amoxicillin ***Trimethoprim is avoided as it is anti-folate *** Treatment duration: 7 days treatment
31
UTI -duration Catheter associated
7 days
32
at what eGFR should Nitro be avoided
45mL/Min
33
Strep/scarlett fever
pen V - normally 5 days treatment for strep - adults= 500mg QDS for 5 days
34
Acne Vulgaris
Adapalene, clindamycin, benzoyl peroxide, lymecycline
35
Acne Vulgaris- what should be co-prescribed with an abx
topical retinoid *** NOT topical ABX***
36
Acne Vulgaris- when should patients abx (topical and oral) be reviewed?
3 monthly intervals treatment no more than 6 months
37
Bacterial vaginosis and trichomoniasis
Usually anaerobic infections = Metronidazole
38
Chlamydia
Doxycycline
39
Conjunctivitis and blepharitis
Chloramphenicol OTC not to <2 years old or pregnant women
40
Dental abscess
Amoxicillin or metronidazole
41
Gonorrhoea
Ceftriaxone or ciprofloxacin
42
Meningitis- meningococci
Benzylpenicillin cefotaxime 7 days
43
Meningitis- pneumococci
Cefotaxime (or ceftriaxone) If micro-organism highly penicillin- and cephalosporin-resistant, add vancomycin and if necessary rifampicin. 14 days
44
Meningitis- Haemophilus influenzae
Cefotaxime (or ceftriaxone) Pen allergy cefotaxime, chloramphenicol 10 days
45
Meningitis- Listeria
Amoxicillin (or ampicillin) + gentamicin Suggested duration of treatment 21 days. Consider stopping gentamicin after 7 days. penicillin allergy co-trimoxazole Suggested duration of treatment 21 days.
46
Scabies
permethrin * whole body * another application 7 days after * creams- leave on for 8-12 hours * all close contacts need to be treated
47
Sinusitis
Pen v Doxy
48
Threadworm
mebendazole Do not give to <2 years old pregnant women/BF *** hygiene measures only for Pregnancy and under 2, for at least 6 weeks ***
49
Common pathogen CAP
Streptococcus Pneumoniae
50
Common pathogen UTI
E.coli
51
Common pathogen Cellulitis/skin
Staphylococcus Aures
52
Common pathogen Meningitis
Streptococcus Pneumoniae 
53
Gentamicin- active against
Gram-negative bacteria including Pseudomonas, Proteus, Escherichia coli, Klebsiella pneumoniae, Enterobacter aerogenes, Serratia Gram-positive Staphylococcus.
54
Gentamicin- Peak and trough serum conc (not endocarditis)
Peak serum concentration 5-10mg/L Trough serum concentration: <2mg/L
55
Gentamicin- Peak and trough serum conc (endocarditis)
peak- 3-5mg/L Trough- <1mg/L
56
Gentamicin- action if: High trough
Increase interval
57
Gentamicin- action if: high peak
reduce dose
58
Gentamicin- action if: renal impairment
increase interval severe= increase dose interval and reduce dose as well
59
Gentamicin- MHRA warnings
ototoxicity
60
Gentamicin- interaction with ototoxic drugs
Cisplatin Loop diuretics (furosemide, bumetanide, torasemide) Vancomycin Vinka Alkaloids
61
Gentamicin dose calculation- Obese patient - what weight is used?
Use ideal body weight based on height to calculate parenteral dose Use actual: toxicity Aminoglycosides: hydrophilic
62
Examples of glycopeptides
Dalbavancin, teicoplanin, telavancin, vancomycin
63
Glycopeptides-
Initial doses based on body weight, then dose adjustments based on serum-vancomycin concentrations
64
Glycopeptides- what weight is used to calculate dose
Initial doses based on body weight, then dose adjustments based on serum-vancomycin concentrations
65
Vancomycin- trough concentration
15-20mg/L around hour before next dose
66
Vancomycin S/E
Red man syndrome Severe cutaneous adverse reactions – Steven Johnson’s Syndrome Blood dyscrasias: agranulocytosis, eosinophilia, neutropenia

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