Respiratory Hospital Adult Empirical Treatment Flashcards Preview

Year 1: Respiratory > Respiratory Hospital Adult Empirical Treatment > Flashcards

Flashcards in Respiratory Hospital Adult Empirical Treatment Deck (26):
1

If NEWS is >/ = 5, think _____

Sepsis

2

possible vital signs in sepsis

temperature = >38 degrees or <36 degrees
pulse = > or = 90
respiratory rate = >20
altered mental state
known or suspected neutropenia
WCC <4 or > 12

3

how often should antibiotic therapy be reviewed?

daily
(Think if antibiotics can be stopped/ switched/ simplified)

4

indications for IV use

-2 or more criteria out of range (temperature, rr, pulse, WCC)
-febrile with neutropenia or immunosuppression
-specific infections e.g. endocarditis, septic arthritis, abscess, meningitis, osteomyelitis
-oral route compromised
-post-surgery: unable to tolerate 1 litre of oral fluids
-no oral formulation available

5

for CAP, CURB65 should be assessed. Which antibiotics should be given if score = 0-2 (mild/ moderate) and dose?

amoxicillin (5 days)
Dose: 1g tds (three times a day) IV/ PO

6

for CAP, CURB65 should be assessed. If patient is PENICILLIN ALLERGIC, which antibiotics should be given if score = 0-2 (mild/ moderate) and dose?

doxycycline PO 200mg on day 1, then 100mg od (once a day)
(or IV clarithromycin if NBM - nil by mouth)

7

For CAP, CURB65 should be assessed. Which antibiotics should be given if score = 3-5 (severe) and dose?

co-amoxiclav IV 1.2g tds (three times a day) + doxycycline PO 100mg bd (twice a day)

8

For CAP, CURB65 should be assessed. If penicillin allergic, which antibiotics should be given if score = 3-5 (severe) and dose?

IV levofloxacin 500mg bd (twice a day)

9

For CAP, CURB65 should be assessed. Which antibiotics should be given if score = 3-5 (severe), and the patient is in ICU/ HDU or NBM? dose?

co-amoxiclav IV tds (three times a day) and clarithromycin IV 500mg bd

10

For CAP, CURB65 should be assessed. If patient is PENICILLIN ALLERGIC, which antibiotics should be given if score = 3-5 (severe), and the patient is in ICU/ HDU or NBM? dose?

IV levofloxacin 500mg bd

11

How many days should a total IV/ PO last?

7 days

12

ALL patients with severe CAP should be stepped down to 100mg bd of which antibiotic?

doxycycline

13

For severe HAP and aspiration pneumonia, which antibiotics should be given?

IV amoxicillin and metronidazole and gentamicin

14

For severe HAP and aspiration pneumonia, which antibiotics should be given to a PENICILLIN ALLERGIC patient?

IV co-trimoxazole and metronidazole (and possible also gentamicin)

15

For patients with severe HAP or aspiration pneumonia, their treatment should be stepped down to which antibiotics (and which route)?

PO co-trimoxazole and metronidazole

16

How many days should the total antibiotic treatment for severe HAP or aspiration pneumonia be?

7 days (IV/ PO)

17

For non-severe HAP or aspiration pneumonia, which antibiotics should be given?

PO amoxicillin and metronidazole (5 days)

18

For non-severe HAP or aspiration pneumonia, which antibiotics should be given if the patient is PENICILLIN ALLERGIC?

PO co-trimoxazole and metronidazole

19

If HAP or aspiration pneumonia patient has previous ICU admission or history of MRSA, you should ____ _____

seek advice

20

For an acute exacerbation of COPD, antibiotics should be given if there is increased sputum purulence. True/ False?

True.

21

For an acute exacerbation of COPD, where there is NO increase in sputum purulence, should antibiotics be given?

Antibiotics should not be given UNLESS there is consolidation on CXR or signs of pneumonia

22

For acute exacerbation of COPD, what is the 1st line antibiotic (and dose)?

amoxicillin 500mg tds (three times a day) for 5 days

23

For acute exacerbation of COPD, what is the 2nd line antibiotic (and dose)?

doxycycline 200mg on day 1 then 100mg daily
(5 days)

24

For acute cough/ acute bronchitis, should antibiotics be given?

For acute cough/ acute bronchitis, antibiotics give no significant benefit in clinical improvement, but may be considered in the elderly.

25

When it has been decided that antibiotics are to be prescribed to patient with acute cough/ acute bronchitis, which antibiotics (and dose) are 1st line?

amoxicillin 500mg tds
(5 days)

26

When it has been decided that antibiotics are to be prescribed to patient with acute cough/ acute bronchitis, which antibiotics (and dose) are 2nd line?

doxycycline 200mg on day 1 then 100mg daily
(5 days)