ANTIBIOTICS

Question 1

Q: What is the 1st-line antibiotic for mild to moderate CAP in adults?

Answer 1

A: Amoxicillin 500 mg TDS for 5 days

Question 2

Q: What is the treatment for severe CAP or hospitalized patients?

Answer 2

A:
IV benzylpenicillin + gentamicin
OR ceftriaxone 1–2 g IV daily

Question 3

Q: What if the patient has a penicillin allergy but has CAP?

Answer 3

A: Use azithromycin or doxycycline

Question 4

Q: First-line treatment for acute sinusitis?

Answer 4

A: Amoxicillin 500 mg TDS for 7–10 days

Question 5

Q: What is the 2nd-line agent for treatment failure or resistance for acute sinusitis?

Answer 5

A: Amoxicillin/clavulanic acid (Augmentin)

Question 6

Q: First-line treatment for otitis media in children?

Answer 6

A: Amoxicillin 90 mg/kg/day divided into 2 doses for 5 days

Question 7

Q: Alternative for recurrent otitis media or beta-lactamase producers?

Answer 7

A: Amoxicillin-clavulanate

Question 8

Q: Treatment for suspected Group A Strep pharyngitis?

Answer 8

A:
Benzathine penicillin G IM once OR
Phenoxymethylpenicillin PO for 10 days

Question 9

Q: Alternative in penicillin-allergic patients for Group A strep pharyngitis?

Answer 9

A: Azithromycin or Erythromycin

Question 10

Q: When are antibiotics indicated for diarrhea?

Answer 10

A:
Dysentery (bloody diarrhea)
Suspected cholera
Severe dehydration with bacterial cause

Question 11

Q: First-line antibiotic for bloody diarrhea (shigella)?

Answer 11

A: Ciprofloxacin 500 mg BD for 3 days

Question 12

Q: Antibiotic for cholera?

Answer 12

A:
Doxycycline 300 mg single dose OR
Azithromycin 1g single dose

Question 13

Q: What does antimicrobial stewardship recommend regarding empiric therapy?

Answer 13

A:
Start empirically if needed
Review at 48–72 hrs with culture results
De-escalate or stop if not bacterial

Question 14

Q: When should you switch from IV to oral antibiotics?

Answer 14

A:
When clinically stable, able to tolerate oral intake, and improving

Question 15

Q: What is the preferred duration for most antibiotic treatments?

Answer 15

A: 5–7 days, unless specified otherwise

Question 16

Q: What if TB meningitis is suspected?

Answer 16

A: Start RIPE therapy (Rifampin, Isoniazid, Pyrazinamide, Ethambutol) + steroids

Question 17

Q: Empirical treatment for bacterial meningitis in adults?

Answer 17

A:
Ceftriaxone 2 g IV BD + Vancomycin if pneumococcal resistance is a concern

Question 18

Q: Empiric treatment for neonatal sepsis?
A:

Answer 18

Ampicillin + Gentamicin IV

Adjust based on culture results

Question 19

Q: Why is azithromycin added in gonorrhoea treatment?

Answer 19

A: To cover chlamydia co-infection and prevent resistance.

Question 20

Q: Recommended treatment for uncomplicated gonorrhoea?

Answer 20

A:

Ceftriaxone 500 mg IM single dose + Azithromycin 1 g PO once

Question 21

Q: Management of complicated UTI or pyelonephritis?

Answer 21

A:
Ceftriaxone IV or
Ciprofloxacin (PO or IV) depending on severity

Question 22

Q: Treatment for UTI in pregnancy?

Answer 22

Amoxicillin or Cefalexin

Avoid nitrofurantoin in 1st trimester & near term

Question 23

Q: Treatment of uncomplicated UTI in women?

Answer 23

A:
Nitrofurantoin 100 mg BD for 5 days
Trimethoprim-sulfamethoxazole (Bactrim): 160/800 mg (1 double-strength tablet) twice daily for 3 days

Fosfomycin trometamol: 3 g single dose

Trimethoprim: 100 mg twice daily for 3 days (depends on resistance patterns)

Question 24

Q: What is the first-line treatment for uncomplicated skin infections (e.g., cellulitis)?

Answer 24

A:
Cloxacillin 500 mg PO QID for 5 days
OR Flucloxacillin
If allergic: Erythromycin or Clindamycin

Question 25

Q: What is the empiric treatment for complicated SSTIs or abscesses with systemic symptoms?

Answer 25

A: Ceftriaxone + Metronidazole (if anaerobes suspected) Add Vancomycin if MRSA suspected

Question 26

⚠️ 12. Sepsis and Septic Shock Q: Empiric antibiotic therapy for suspected sepsis in adults?

Answer 26

A: Ceftriaxone 2g IV daily + Metronidazole 500 mg TDS IV Add Gentamicin if urinary source suspected Modify based on suspected source and culture

Question 27

Q: Key principle in sepsis management (besides antibiotics)?

Answer 27

A: Early fluid resuscitation Identify and control the source Start antibiotics within 1 hour

Question 28

Q: What’s used to prevent TB in HIV+ patients with latent infection?

Answer 28

A: Isoniazid Preventive Therapy (IPT) for 6 months Add Pyridoxine 25 mg daily to prevent neuropathy

Question 29

🧫 13. TB Management (with Antimicrobials) Q: What is the standard TB treatment regimen?

Answer 29

A: Intensive phase (2 months): Rifampicin + Isoniazid + Pyrazinamide + Ethambutol (RHZE) Continuation phase (4 months): Rifampicin + Isoniazid (RH)

Question 30

Q: What is the preferred antibiotic for surgical prophylaxis?

Answer 30

A: Cefazolin 2g IV 30–60 min before incision If allergic: Clindamycin or Vancomycin

Question 31

Q: Should antibiotics be continued post-surgery in clean surgeries?

Answer 31

A: No — a single pre-op dose is sufficient for most clean procedures.

Question 32

Q: What antibiotic can be used in non-severe penicillin allergy (e.g., rash)?

Answer 32

A: Cephalosporins (e.g., cefuroxime, ceftriaxone) – with caution

Question 33

Q: What to use in severe penicillin allergy (e.g., anaphylaxis)?

Answer 33

A: Macrolides (azithromycin, erythromycin) Tetracyclines (doxycycline) Clindamycin for anaerobic or gram-positive infections

Question 34

Q: General rule for duration of most antibiotic courses?

Answer 34

A: 5–7 days for most uncomplicated infections Always review within 48–72 hours

Question 35

Q: What is the “Start Smart – Then Focus” principle?

Answer 35

A: Start empirical antibiotics if needed Then review cultures and clinical signs within 48–72 hours Either stop, change, or de-escalate therapy