Antibiotics in ED.
Approximately what percentage of people say they are allergic to Penicillin compared to what percentage who actually are ?
I think it is probably because people use the word allergy for a side effect like nausea or diarrhoea.
Which cephalosporin is considered safe to use in patients who are allergic to Penicillin?
Cefazolin is generally considered safe in patients with Penicillin allergy because it lacks a similar side chain structure to Penicillins.
Which of the following is UNTRUE about Doxycycline?
It surprised me that it is now allowed to be used in patients < 8yrs and does not cause tooth problems if used for a short time. This is from the just updated "Therapeutic Guidelines".
It can cause Stevens Johnson Syndrome.
Which of the following is TRUE about antibiotic use in children with acute otitis media?
Amoxycillin 15mg/kg orally q8hrs or Amoxycillin 30mg/kg q12hr orally for 5 days is recommended in the subgroup of children where antibiotics are indicated.
Children with acute otitis media and a cochlear implant is such a subgroup. There are other subgroups such as those who are immunosuppressed.
Which of the following is INCORRECT about Howard Florey?
Bit of a trick question. He used to be on the "paper" $50 note but is not on the new polymer banknote.
Which of the following antibiotics is the recommended treatment for acute cystitis in adult women?
Nitrofurantoin 100mg orally q6hr for 5 days is recommended for both pregnant and non pregnant women.
Drinking plenty or fluids, using urine alkalinisers and taking simple analgesics also assist.
What antibiotic is recommended for an adult with recurrent impetigo and more than 2 sores?
Mupericin ointment (Bactroban) is for simple non recurrent cases where there are 2 or less sores.
You can use use Dicloxacillin instead of Flucloxacillin at the same dose. If the lesions have cleared by 3 days of antibiotic therapy guidelines say you can stop the antibiotic course at that point. (Image thanks to Melanie Palm MD, MBA)
Which of the following is TRUE about cat bites?
Both cats and dogs oral flora contain Pasteurella species. Without antibiotic prphylaxis between 30 to 50% of cat bites seen in the Emergency Department will get infected. Cat bites tend to go deep because of their sharp teeth.
What antibiotic if rapidly infused can cause a non immune mediated pruritic erthematous rash to the face, neck and upper torso?
It is an anaphylactoid reaction (not like immune mediated anaphyaxis) . It occurs from Histamine release from the degranulation of mast cells. The patient can get chest tightness and become hypotensive.
It can be difficult to tell from anaphylaxis but here there is no angioedema, stridor or wheeze.
Stop the infusion. Give antihistamines and fluids IV. Usually settles in 20mins.
Used to be called "red man syndrome" now called "Vancomycin infusion reaction".
Which one of these prices is CORRECT according to "Chemist Warehouse"?
Amoxycillin and Keflex is about half my quoted price. Nitrofurantoin is just over double. These prices are PBS (you get if you have a Medicare card) but not concession rates (eg Pensioner).