Antibiotics Therapy
ONLY GIVE ABX IF CLINICAL EVIDENCE PRESENT
Guidelines:
Management
Acute sinusitis
Acute sore throat (pharyngitis/ tonsillitis/ laryngitis)
Acute otitis media
COPD exacerbation
UTI
Bites/ Clenched fist injuries
If infection not established:
If infection established:
Source
Ms Danielle Truscott 2014
Guidelines:
- Narrow --> broad spectrum
- Monotherapy preferred
- Ensure shortest duration
- Ensure compliance
Management
Acute sinusitis
- 1st line: Amoxicillin --> cefuroxime/ if allergic
Acute sore throat (pharyngitis/ tonsillitis/ laryngitis)
- No need for abx unless complication
Acute otitis media
- 70% bacterial
- 1st line: amoxicillin bd/ tds
- Cefuroxime/ Cefaclor
- Augmentin if >7d
COPD exacerbation
- Use if ++ SOB, and ++sputum, and ++ sputum purulence
- 50% bacterial
- 1st line: Amoxicillin 500mg tds/ doxycycline 100mg bd 5 days
- 2nd line: Augmentin
UTI
- 1st line: Trimethoprim 300mg OD 5 days
- Pregnant: Cephalexin bd
- Alt: Cephalexin, Augmentin bd, nitrofurantoin QID
Bites/ Clenched fist injuries
- Wound swab/ debridment
- Tetanus:
- If at least 3 tetanus toxoid in <5y: do nothing
- If at least 3 in 5-10y: tetanus toxoid in unclean wounds, do nothing for clean minor wounds
- If at least 3 in 10+y: tetanus toxoid in all wounds
- If uncertain + not clean minor wound: add Tetanus Ig
If infection not established:
- 1st line: Augmentin 5 days
- Alt: metronidazole+doxycycline/ bactrim/ cirpofloxacin 5 days
If infection established:
- 1st line: metronidazole+ceftriaxone/ cefotaxime IV
- Alt: Tazocin (Piperacillin/ tazobactam)
Source
Ms Danielle Truscott 2014