nice algorithm treatment

Question 1

what are the 1st line and 2nd line treatment for sinusitis?

what is the alternative for someone with a penicillin allergy?

what can a pregnant woman take if she has a penicillin allergy?

Answer 1

1st line: phenoxymethylpenicillin

2nd line: co-amoxiclav if very unwell or life threatening

penicillin allergy: doxycyline/clarithromycin

pregnant with pen allergy: erythromycin

Question 2

what kind of antibiotics are used for oral infections? [4]

Answer 2

broad spec [eg amox, co amox, phenoxy] cephalosporins
metronidazole
macrolides
doxycyline

Question 3

what is the 1st line treatment for acute sore throat?
what is the option for penicillin allergy?
what is the option for pregnant woman with pen allergy?

Answer 3

1st line: phenoxymethylpenicillin

pen allergy: clarithromycin

pregnant with pen allergy: erythromycin

Question 4

what is the 1st line and 2nd line treatment for conjunctivitis [eye infections]

Answer 4

1st line: bathe/clean eyelids with cotton wool dipped in saline/clean water

2nd line: chloramphenicol drops/ointment

Question 5

what is otitis media?

what is otitis externa?

Answer 5

otitis media: inflammation of the middle ear

otitis externa: inflammation of the external ear [the outer ear]

Question 6

what is the 1st line and 2nd line treatment of otitis externa?
what is the alternative for pen allergy?

Answer 6

1st line: simple analgesia

2nd line: flucloxacillin

pen allergy: clarithromycin, azithromycin, erythromycin

Question 7

what is the 1st line, 2nd line treatment for otitis MEDIA?

what is the alternative for pen allergy?

Answer 7

1st line: amoxicillin
2nd line: co-amoxiclav

pen allergy: erythromycin/clarithromycin

Question 8

what is the 1st line treatment for endocarditis infection for INITIAL BLIND THERAPY?

what must be used if patient has suspected MHRA as well or if they have severe sepsis or a penicillin allergy?

Answer 8

1st line: amoxicillin/ampicillin

suspected MHRA/pen allergy/sepsis: low dose gentamicin + vancomycin

Question 9

what is the 1st line treatment for endocarditis caused by STAPHYLOCOCCI?

what do you give if the patient is allergic to penicillin or if they have suspected MHRA as well?

Answer 9

1st line: flucloxacillin

pen allergy/MHRA: vancomycin + rifampicin

Question 10

what is the 1st line treatment for endocarditis caused by STREPTOCOCCI?

what is the alternative for penicillin allergy?

Answer 10

1st line: benzylpenicillin sodium

pen allergy: low dose gentamicin and vancomycin

Question 11

what is the 1st line options for septicaemia [community/hospital acquired]? [3 options]

Answer 11

• piperacillin with tazobactam
• ticarcillin with clavulanic acid
• cephalosporin broad spec eg cefuroxime

Question 12

what is the treatment for a person suffering with septicaemia who also has suspected MRSA?

Answer 12

add on [from 1st line options] vancomycin or teicoplanin

Question 13

what is the treatment for a person suffering with septicaemia and an anaerobic infection?

Answer 13

cephalosporin and metronidazole

Question 14

what is the treatment of a person suffering with septicaemia and another infection? [not MRSA or anaerobic]

Answer 14

use a broad spec antibiotic eg meropenem

Question 15

what is campylobacter enteritis?

what is the 1st line and 2nd line treatment?

Answer 15

a bacteria which causes food poisoning

1st line: clarithromycin/azithromycin/erythromycin

2nd line: ciprofloxacin

Question 16

what is the 1st line and 2nd line treatment for salmonella and shigellosis [GI infections]?

Answer 16

ciprofloxacin

2nd line: azithromycin/cefotaxime

Question 17

what is 1st line and 2nd line treatment for typhoid fever?

Answer 17

1st line: cefotaxime/ceftriaxone

2nd line: azithromycin

Question 18

what is the 1st line and 2nd line treatment of c.diff infection?

Answer 18

1st line: vancomycin

2nd line: fidaxomicin

Question 19

what is the 1st line treatment for biliary infection? [a gi infection]

Answer 19

Ciprofloxacin or gentamicin or a cephalosporin

Question 20

what is the 1st line treatment for diverticulitis?

Answer 20

co-amoxiclav

Question 21

what is the 1st line for bacterial vaginosis?

what is the 2nd line treatment for bacterial vaginosis?

Answer 21

1st line: oral or topical metronidazole

2nd line: topical clindamycin

Question 22

what is the 1st line and 2nd line treatment for chlamydia?

Answer 22

1st line: doxycycline

2nd line: azithromycin [for pregnant women as well]

Question 23

what is the first line options of gonorrhoea?

what must you use if susceptibility not known prior to treatment?

Answer 23

ceftriaxone or ciprofloxacin

IM ceftriaxone

Question 24

what is the 1st line and 2nd line treatment of syphillis?

Answer 24

1st line: benzylpenicillin

2nd line: doxycyline/erythromycin

Question 25

what is the 1st line and 2nd line treatment of a lower urinary tract infection for NON pregnant women?

Answer 25

1st line: nitrofurantoin OR trimethoprim 2nd line: Nitrofurantoin (if not used first line), fosfomycin, pivmecillinam, or amoxicillin

Question 26

what is the 1st and 2nd line treatment for lower UTI in pregnant women?

Answer 26

1st line: nitrofurantoin [avoid at term] 2nd line: amoxicillin or cefalexin

Question 27

what is the 1st line treatment of lower UTI in men?

Answer 27

trimethoprim or nitrofurantoin

Question 28

what is the treatment choice for lower UTI in pregnant women with catheter?

Answer 28

cefalexin

Question 29

what is the 1st line treatment for mild infection of diabetic foot? what is the alternative for pt with pen allergies or pregnant women?

Answer 29

1st line: flucloxacillin pen allergy: clarithromycin/doxycyline or erythromycin [pregnant women]

Question 30

what is the 1st line treatment for osteomyelitis [an MSK infection]? what is the alternative for a patient with penicillin allergy?

Answer 30

1st line: flucloxacillin pen allergy: clindamycin

Question 31

what is the 1st line treatment for meningitis caused by meningococci? what is the alternative for someone with pen allergy?

Answer 31

1st line: benzylpenicillin or cefotaxime alternative/2nd line: chloramphenicol

Question 32

what is the 1st line and 2nd line treatment for meningitis caused by pneumococci? what is the alternative for penicillin allergy?

Answer 32

1st line: cefotaxime [can add dexamethasone] 2nd line: benzylpenicillin pen allergy: cephalosporin and vancomycin

Question 33

what is the 1st for meningitis caused by listeria? what is the alternative for pen allergy?

Answer 33

1st line: amoxicillin/ampicillin and gentamicin pen allergy: co trimoxazole

Question 34

what is the 1st line treatment for meningitis caused by H.influenzae?

Answer 34

cefotaxime or ceftriaxone

Question 35

what is the 1st line treatment options for epiglottitis? [resp infection] what is the alternative for pen allergy?

Answer 35

1st line: cefotaxime or ceftriaxone pen allergy: chloramphenicol

Question 36

what is the 1st line treatment options for copd? [3 options] what are the 2nd line treatment options?

Answer 36

1st line options: amoxicillin/clarithromycin/doxycyline 2nd line: co-amoxiclav, levofloxacin, co-trimoxazole

Question 37

what is the 1st line treatment for acute cough? what are the alternatives for pregnant women?

Answer 37

1st line: doxycyline, amoxicillin, clarithromycin, erythromycin pregnant women: amox or erythromycin

Question 38

what is the 1st line treatment for community acquired pneumonia? what are the options for pen allergy?

Answer 38

1st line: amoxicillin pen allergy: erythromycin/doxycyline/clarithromycin

Question 39

what is the topical first line and 2nd line treatment for impetigo?

Answer 39

topical 1st line: hydrogen peroxide 1% cream topical 2nd line: fusidic acid cream

Question 40

what is the 1st line ORAL treatment for impetigo? what is the 2nd line ORAL treatment for impetigo?

Answer 40

1st line: flucloxaillin 2nd line: clarithromycin/erythromycin

Question 41

what is the 1st line treament for cellulitis? | what is the alternative for pen allergy?

Answer 41

flucloxacillin | pen allergy: clarithromycin/erythromycin/doxycyline

Question 42

what is the 2nd line treatment for cellulitis?

Answer 42

co-amoxiclav , clindamycin

Question 43

what is the 1st line treatment for leg ulcers? what is the alternative for pen allergy?

Answer 43

1st line: flucloxacillin pen allergy: clarithromycin, erythromycin, doxycyline

Question 44

what is the 2nd line treatment for leg ulcers? what is the alternative for pen allergy?

Answer 44

2nd line: co amoxiclav pen allergy: co- trimoxazole

Question 45

what is the 1st line treatment for animal and human bites? what is the alternative for pen allergy?

Answer 45

1st line: co-amoxiclav pen allergy: doxycyline with metronidazole

Question 46

what is mastitis?

Answer 46

inflammation of breast tissue that can turn into an infection

Question 47

what is the 1st line for mastitis during breastfeeding? | what is the alternative for a patient who is allergic to penicillin?

Answer 47

1- flucloxacillin pen allergy: erythromycin