Antibiotics

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• Antibiotics are commonly prescribed medications in the acute setting
• It is useful to commit to memory the regimes for common infections e.g. pneumonia, urinary tract infections and cellulitis
• For more unusual infections, returned travellers and recent immigrants consult a microbiologist
• The relationship between site of infection, likely organism(s) and effective empirical antibiotic has some loose patterns but some regimes have to be memorised by rote
• A delay in administering antibiotics increases the mortality from sepsis
• Ongoing treatment may need to be modified after subsequent culture results and sensitivities are returned

ANTIBIOTIC REGIMES BY SITE OF INFECTION

• The following table is a simplified account for community acquired bacterial infections – outpatient and inpatient based on Australian Therapeutic Guidelines
• Hospital-in-the home regimes may have alternative or modified regimes to standard inpatient treatments.
• Post-op prophylaxis and post-surgical infections are not included.

The choice is based on first line empiric prescribing on known sensitivities in Metropolitan areas before culture results are available. (Do not follow this in indigenous populations or Far North Australia)

Unless specified the antibiotic chosen is appropriate also for pregnancy and children.

Use caution in amino-glycoside dosing in patients with renal failure

There may be cheaper or simpler options if the above considerations are not required.

An alternative is suggested for true beta lactam allergy (severe reactions are actually rare and cross-reactivity between penicillins and cephalosporins even less so particularly for the third generation variants).

Antibiotic spectra – simplified

Pencillin classification – simplified

Cephalosporin classification – simplified

* No cephalosporin is active against enterococcus

Adult Antibiotic doses (typical – consult Therapeutic guidelines)