Condition Common pathogens Drug (1st line) Alternatives Other
UTI E.coli Trimethoprim 200mg BD for 3 – 5 days Long term therapy in the
Or elderly, monitor hepatic
Nitrofurantoin 100mg m/r BD for 3-7 days function and pulmonary
Nitrofurantoin 50mg QDS for 3-7 days function
C.diff Clostridium difficile PO metronidazole 400mg TDS 10-14 days Fidaxomicin if s.e’s metronidazole (GI, taste
Or if not responding or intolerant unresponsive to disturbances, furred tongue,
Oral vancomycin 125mg to 500mg QDS 10-14 days vancomycin oral mucositis, optic neuropathy
s.e’s vancomycin (blood
disorders, nephrotoxicity,
ototoxicity, red man syndrome)
Impetigo Staphylococcus aureus Topical fusidic acid TDS-QDS for 7 days Erythromycin Use oral if topical fails
Or If wide spread use oral
PO flucloxacillin 500mg QDS flucloxacillin or oral
clarithromycin if allergic for 7
days
Bacterial Gardnerella vaginalis Metronidazole 2g stat or 400-500mg BD for 5- Topical metronidazole
vaginosis 7days for 5 days or topical
clindamycin for 7 days
Meningitis Benzylpenicillin adult 1.2g IV Cefotaxime injection 1g Non blanching rash
or If caused by pneumonococci,
Chloramphenicol cefotaxime 1st choice
injection
Sinusitis Strep pneumonia Amoxicillin for 7 days Doxycycline,
Haemophilis influenzae Co-amoxiclav if no improvement in 48 hours Clarithromycin (7 days)
Otitis S.aureus If topical, clioquil with flumetasone pivalate or If penicillin allergic, If pseudomonas suspected
externa sofradex clarithromycin or ciprofloxacin or gentamicin
Or if very unwell, Flucloxacillin azithromycin or
erythromycin.
Otitis media Strep pneumonia Usually caused by viruses, should resolve itself, if If penicillin allergic,
Haemophilis influenzae no improvement after 72 hours: clarithromycin,
Amoxicillin or, Co-amoxiclav if no improvement azithromycin or
after 48 hours (5 days) erythromycin (5 days)
UTI E.coli Trimethoprim 200mg BD for 3 – 5 days Long term therapy in the
Or elderly, monitor hepatic
Nitrofurantoin 100mg m/r BD for 3-7 days function and pulmonary
Nitrofurantoin 50mg QDS for 3-7 days function
C.diff Clostridium difficile PO metronidazole 400mg TDS 10-14 days Fidaxomicin if s.e’s metronidazole (GI, taste
Or if not responding or intolerant unresponsive to disturbances, furred tongue,
Oral vancomycin 125mg to 500mg QDS 10-14 days vancomycin oral mucositis, optic neuropathy
s.e’s vancomycin (blood
disorders, nephrotoxicity,
ototoxicity, red man syndrome)
Impetigo Staphylococcus aureus Topical fusidic acid TDS-QDS for 7 days Erythromycin Use oral if topical fails
Or If wide spread use oral
PO flucloxacillin 500mg QDS flucloxacillin or oral
clarithromycin if allergic for 7
days
Bacterial Gardnerella vaginalis Metronidazole 2g stat or 400-500mg BD for 5- Topical metronidazole
vaginosis 7days for 5 days or topical
clindamycin for 7 days
Meningitis Benzylpenicillin adult 1.2g IV Cefotaxime injection 1g Non blanching rash
or If caused by pneumonococci,
Chloramphenicol cefotaxime 1st choice
injection
Sinusitis Strep pneumonia Amoxicillin for 7 days Doxycycline,
Haemophilis influenzae Co-amoxiclav if no improvement in 48 hours Clarithromycin (7 days)
Otitis S.aureus If topical, clioquil with flumetasone pivalate or If penicillin allergic, If pseudomonas suspected
externa sofradex clarithromycin or ciprofloxacin or gentamicin
Or if very unwell, Flucloxacillin azithromycin or
erythromycin.
Otitis media Strep pneumonia Usually caused by viruses, should resolve itself, if If penicillin allergic,
Haemophilis influenzae no improvement after 72 hours: clarithromycin,
Amoxicillin or, Co-amoxiclav if no improvement azithromycin or
after 48 hours (5 days) erythromycin (5 days)
