Tayside Antibiotic man

Question 1

How do you treat meningitis

Answer 1

Ceftriaxone IV 2g bd + Dexamethasone IV 10mg qds (started with or just before giving the abx)

Question 2

How do you treat epiglottitis

Answer 2

Treated with Ceftriaxone IV 2g od

Question 3

Prescribing in mild/ moderate CAP

Answer 3

Mild/ Mod (CURB65 =0 - 2) - Amoxicillin (Doxycycline if allergic)

Question 4

Prescribing in Non severe HAP

Answer 4

Amoxicillin, doxy if allergic

Question 5

What is the first and second line treatment for a COPD exacerbation - acute

Answer 5

Amoxicillin then doxycycline

Question 6

What is the treatment for subacute native valve endocarditis?

Answer 6

Subacute - Amoxicillin and gentamicin IV

Question 7

What is the treatment for prosthetic valve endocarditis?

Answer 7

Vancomycin, Rifampicin and gentamicin

Question 8

What is the treatment for a C dif infection?

Answer 8

Non severe - Metronidazole PO

Severe - Vancomycin +/- metronidazole

Question 9

What is the treatment for Peritonitis/ Biliary tract/ Intra abdominal

Answer 9

IV amox, metronidazole and gentamicin - step down to Co -trimoxazole and metronidazole
Vancomycin if allergic

Question 10

Treatment for spontaneous bacterial peritonitis

Answer 10

Severe - Piperacillin step down to Co-trimoxazole

Mild - Co-trimoxazole

Question 11

What do you give a IV drug user for endocarditis?

Answer 11

Flucloxacillin

Question 12

How long are antibiotics normally given for for endocarditis?

Answer 12

4 -6 weeks

Question 13

Prescribing in H pylori infection

Answer 13

Triple therapy
Either
PPI + amoxicillin + clarithromycin or
PPI + metronidazole + clarithromycin

Question 14

How long is it okay to wait to give the steroids with meningitis treatment?

Answer 14

12 hrs

Question 15

How do you treat Severe CAP

Answer 15

Severe (CURB65 = 3-5) - Co-amoxiclav + either clarithromycin or doxycycline - if penicillin allergic, levofloxacin

Question 16

How do you assess CAP severity?

Answer 16

CURB65 - Confusion, Urea, Resp rate, Blood pressure, age

Question 17

How do you treat severe HAP

Answer 17

IV amox and Gent, if allergic IV co-amox and gent

Question 18

How do you treat non severe aspiration pneumonia?

Answer 18

Amox and met PO

Question 19

How do you treat severe aspiration pneumonia?

Answer 19

IV amox, met, gent

Question 20

How do you treat acute native valve endocarditis?

Answer 20

IV fluclox

Question 21

How do you treat prosthetic valve endocarditis?

Answer 21

IV vanc and Gent

Question 22

How do you treat an uncomplicated UTI

Answer 22

1st line - Nitrofurantonin

2nd line - Trimethoprim

Question 23

How do you treat a complicated UTI

Answer 23

IV amox and gent, if allergic IV co-amox and gent

Question 24

How do you treat cellulitis

Answer 24

Flucloxacillin

Question 25

How do you treat MRSA cellulitis

Answer 25

Vanc IV

Question 26

How do you treat severe systemic infection of unknown source

Answer 26

IV amox, met, gent

Question 27

How do you treat conjunctivitis (bacterial)

Answer 27

Usually self limiting. Chloramphenicol eye drops every 2 hours for 2 days

Question 28

How do you treat ophthalmic shingles?

Answer 28

Aciclovir 800mg 5 times daily

Question 29

How do you manage tonsillitis?

Answer 29

Assess on the feverPAIN score and if more than 4 consider abx - Penicillin V 1g bd or 500mg qds or clarithromycin 500mg bd

Question 30

How do you manage sinusitis?

Answer 30

If symptoms <10 days there is no evidence abx will help, if >10 days or worsening symptoms, Penicillin V 500mg qds or doxycycline 200mg

Question 31

How to treat otitis media?

Answer 31

Most cases will resolve without abx, consider abx if otorrhoea present. 1st line - amoxicillin 500mg, 2nd line clarithromycin 500mg

Question 32

How to treat otitis externa?

Answer 32

Acetic acid 2%, aural care

Question 33

How to treat oral candida?

Answer 33

Miconazole gel qds, fluconazole 50mg daily (7days)

Question 34

How to treat prostatitis?

Answer 34

ofloxacin 200mg bd or ciprofloxacin 500mg bd | Assess if STI is likely

Question 35

How to treat uncomplicated chlamydia?

Answer 35

Doxycycline 100mg bd for 7 days, if intolerant azithromycin 1g od

Question 36

How to treat pelvic inflammatory disease?

Answer 36

metronidazole 400mg bd + ofloxacin 400mg bd

Question 37

How do you treat a facial cellulitis - sinus, dental, mandibular

Answer 37

co-amoxiclav 625mg tds (7days)

Question 38

How do you treat dog/cat bites?

Answer 38

co-amoxiclav 625mg tds, 2nd line metronidazole 400mg tds + doxycycline 100mg bd For a human bite change the doxycycline to clarithromycin 500mg bd