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Infection
Common Areas Tested in the GPHC Exam
Sepsis
BNF updates
Doses
Side effect
Causative Organisms
Interactions
Rashes (paediatric big topic)
Cautionary Labels
Narrow therapeutic drugs
Before Choosing Abx
What are the 3 factors to consider before prescribing?
Patient
Causative organism
Risk of resistance with repeated courses
What are the patient factors?
Allergy
Renal & hepatic function
Susceptibility to infection
Ability to tolerate drug by mouth
Severity of illness
Ethnic origin
Infection 1
, Age, other medication? female? pregnant? bf?
Oral contraceptives?
What is a superinfection?
Infection on top of another infection
Broad spectrum = more likely to be associated with ADR = antibiotic-
associated colitis (AAC)
Broad vs Narrow Spectrum Abx
Examples of Broad spectrum ABX?
Aminoglycosides
Ampicillin
Amoxicillin
Carbapenems
Cephalosporins
Chloramphenicol
Macrolides
Quinolones
Tetracyclines
Examples of narrow spectrum Abx? & memory trick?
Mnemonic = narrow TV & PC
Teicoplanin (G+ve bactericidal activity vs aerobic & anaerobic bacteria)
Vancomycin (G+ve bactericidal activity vs aerobic & anaerobic bacteria)
Penicillin G (benzylpenicillin) - G+ve)
Clindamycin (G+ve anaerobic)
Sepsis & Septicaemia
Difference between sepsis & septicaemia?
Infection 2
, Sepsis = life threatening emergency - body’s reaction to severe infection -
affects the whole body (multi-organ infection)
Septicaemia = infection of the blood (causes = bacteria, fungi, virus)
Septicaemia can lead to = sepsis
What are the symptoms of sepsis ADULTS? memory trick?
SEPSIS = mnemonic
Shivering - fever or cold
Extreme pain or disomfort
Pale - discoloured skin
Sleepy - lethargic
“I - feel like I might die”
Shortness of breath
What are the signs of SEPSIS CHILDREN & BABIES?
Very high or low temp (feels hot or cold to touch)
No urine = last 12 hours
Breathing fast (breathlessness - SOB)
Non blanching rash - like meningitis (doesn’t disappear when glass
applied)
Vomiting
Blue/pale skin or lips
Babies (high pitch cry & lethargic)
Community acquired Sepsis - what is the treatment ?
Either:
Broad-spectrum antipseduomonal penicillin - TAZOCIN (peperacillin with
tazobactam)
Broad-spectrum cephalosporin - Cefuroxime
Hospital acquired Sepsis - what is the treatment ?
Any of the following broad spectrum antipseudomonal beta-lactam antibacterials:
Infection 3
, TAZOCIN (peperacillin with tazobactam)
Cefatazidime
Imipenem with cilastatin
Meropenem
What can be added if MRSA is suspected?
Either:
Vancomycin
Teicoplanin
What can be added with an anaerobic infection is suspected?
Metronidazole - to the broad spectrum cephalosporin
What is the treatment in community/hospital setting if meningococcal disease
is suspected?
Broad spectrum Abx - MAX dose (ideally within 1 hour) = reduce risk of
severe illness or death
IV Benzylpenicillin = community setting
IV Ceftriaxone = hospital
Monitor high risk pts = regularly, no less than every 30 minutes
What are some notifiable disease? give examples?
All in the BNF
Disease where there could = public health risk - tell local authority or health
protection
Anthrax
Botulism
Cholera
COVID-19
Infectious blood diarrhoea
Diphtheria
Infection 4
, Encephalitis
Food poisoning
Haemolytic uraemia syndrome (HUS)
Haemorrhagic fever
Hepatitis
Leprosy
Malaria
Measles
Meningitis, Meningococcal septicaemia
Mumps
Parathyroid fever
Plague
Rabies
Rubella
SARS
Small pox
Scarlet fever
Tetanus
Tuberculosis
Whooping cough
Yellow fever
Food interactions & Important Labels
Which Abx need to be taken before food/empty stomach? (what label?)
(MEMORY T)
MEMORY TRICK = DROP FAT (label = 22/23)
Demeclocycline
Rifampicin
Infection 5
, Oxtetracyline
Phenoxymethylpenicllin
Flucloxacillin/Fosfomycin
Ampicillin
Tetracycline
Which Abx need to be taken with food? label?
Marvins Nice Pizza - Label 21 (take with or just after food/meal)
Metronidazole
Nitrofurantoin
Pivmecillinam
Which Abx can be taken with Milk? (memory trick)
Dox Like Milk (label 6)
Doxycycline
Lymecycline
Minocycline
Which Abx need to avoid milk? (memory trick)
C.D(e)OT (label 7)
Ciprofloxacin
Demeclocycline
Oxytetracycline
Tetracycline
What do the labels mean? (5,6,7,22,23)
5
do not take indigestion remedies 2 hours before or after you take this
medicine
Enteric coated tablets & gabapentin
6
Infection 6
Infection
Common Areas Tested in the GPHC Exam
Sepsis
BNF updates
Doses
Side effect
Causative Organisms
Interactions
Rashes (paediatric big topic)
Cautionary Labels
Narrow therapeutic drugs
Before Choosing Abx
What are the 3 factors to consider before prescribing?
Patient
Causative organism
Risk of resistance with repeated courses
What are the patient factors?
Allergy
Renal & hepatic function
Susceptibility to infection
Ability to tolerate drug by mouth
Severity of illness
Ethnic origin
Infection 1
, Age, other medication? female? pregnant? bf?
Oral contraceptives?
What is a superinfection?
Infection on top of another infection
Broad spectrum = more likely to be associated with ADR = antibiotic-
associated colitis (AAC)
Broad vs Narrow Spectrum Abx
Examples of Broad spectrum ABX?
Aminoglycosides
Ampicillin
Amoxicillin
Carbapenems
Cephalosporins
Chloramphenicol
Macrolides
Quinolones
Tetracyclines
Examples of narrow spectrum Abx? & memory trick?
Mnemonic = narrow TV & PC
Teicoplanin (G+ve bactericidal activity vs aerobic & anaerobic bacteria)
Vancomycin (G+ve bactericidal activity vs aerobic & anaerobic bacteria)
Penicillin G (benzylpenicillin) - G+ve)
Clindamycin (G+ve anaerobic)
Sepsis & Septicaemia
Difference between sepsis & septicaemia?
Infection 2
, Sepsis = life threatening emergency - body’s reaction to severe infection -
affects the whole body (multi-organ infection)
Septicaemia = infection of the blood (causes = bacteria, fungi, virus)
Septicaemia can lead to = sepsis
What are the symptoms of sepsis ADULTS? memory trick?
SEPSIS = mnemonic
Shivering - fever or cold
Extreme pain or disomfort
Pale - discoloured skin
Sleepy - lethargic
“I - feel like I might die”
Shortness of breath
What are the signs of SEPSIS CHILDREN & BABIES?
Very high or low temp (feels hot or cold to touch)
No urine = last 12 hours
Breathing fast (breathlessness - SOB)
Non blanching rash - like meningitis (doesn’t disappear when glass
applied)
Vomiting
Blue/pale skin or lips
Babies (high pitch cry & lethargic)
Community acquired Sepsis - what is the treatment ?
Either:
Broad-spectrum antipseduomonal penicillin - TAZOCIN (peperacillin with
tazobactam)
Broad-spectrum cephalosporin - Cefuroxime
Hospital acquired Sepsis - what is the treatment ?
Any of the following broad spectrum antipseudomonal beta-lactam antibacterials:
Infection 3
, TAZOCIN (peperacillin with tazobactam)
Cefatazidime
Imipenem with cilastatin
Meropenem
What can be added if MRSA is suspected?
Either:
Vancomycin
Teicoplanin
What can be added with an anaerobic infection is suspected?
Metronidazole - to the broad spectrum cephalosporin
What is the treatment in community/hospital setting if meningococcal disease
is suspected?
Broad spectrum Abx - MAX dose (ideally within 1 hour) = reduce risk of
severe illness or death
IV Benzylpenicillin = community setting
IV Ceftriaxone = hospital
Monitor high risk pts = regularly, no less than every 30 minutes
What are some notifiable disease? give examples?
All in the BNF
Disease where there could = public health risk - tell local authority or health
protection
Anthrax
Botulism
Cholera
COVID-19
Infectious blood diarrhoea
Diphtheria
Infection 4
, Encephalitis
Food poisoning
Haemolytic uraemia syndrome (HUS)
Haemorrhagic fever
Hepatitis
Leprosy
Malaria
Measles
Meningitis, Meningococcal septicaemia
Mumps
Parathyroid fever
Plague
Rabies
Rubella
SARS
Small pox
Scarlet fever
Tetanus
Tuberculosis
Whooping cough
Yellow fever
Food interactions & Important Labels
Which Abx need to be taken before food/empty stomach? (what label?)
(MEMORY T)
MEMORY TRICK = DROP FAT (label = 22/23)
Demeclocycline
Rifampicin
Infection 5
, Oxtetracyline
Phenoxymethylpenicllin
Flucloxacillin/Fosfomycin
Ampicillin
Tetracycline
Which Abx need to be taken with food? label?
Marvins Nice Pizza - Label 21 (take with or just after food/meal)
Metronidazole
Nitrofurantoin
Pivmecillinam
Which Abx can be taken with Milk? (memory trick)
Dox Like Milk (label 6)
Doxycycline
Lymecycline
Minocycline
Which Abx need to avoid milk? (memory trick)
C.D(e)OT (label 7)
Ciprofloxacin
Demeclocycline
Oxytetracycline
Tetracycline
What do the labels mean? (5,6,7,22,23)
5
do not take indigestion remedies 2 hours before or after you take this
medicine
Enteric coated tablets & gabapentin
6
Infection 6
