Presentation is loading. Please wait.

Presentation is loading. Please wait.

Common infections Dr Arlo Upton Microbiologist Medical Director Labtests Professor Bruce Arroll Department of General Practice and Primary Health Care.

Similar presentations


Presentation on theme: "Common infections Dr Arlo Upton Microbiologist Medical Director Labtests Professor Bruce Arroll Department of General Practice and Primary Health Care."— Presentation transcript:

1 common infections Dr Arlo Upton Microbiologist Medical Director Labtests Professor Bruce Arroll Department of General Practice and Primary Health Care

2 goodfellowunit.org

3

4

5 UTI need for MSU resistance issues antibiotics when to avoid specific abs pyelonephritis

6 vaginal discharge self swab± internal exam which swabs high vaginal vs cervix Rx for candida, trichomonas Rx gonorrhoea, bacterial vaginosis

7 PID gonorrhea + chlamydia + anaerobes how easy is diagnosis swabs then empirical Rx Rx options partner?

8 epididymitis Enterobacteriaciaes older men STIs younger men gonorrhea suspected or cultured Rx options repeat sexual health screen 3/12

9 urethitis men painful micturition women sterile pyuria organisms Rx

10 common cold Abs no use secondary bacterial infection myth nasal or oral decongestants ipratropium nasal spray NSAID paracetamol ? vicks in children

11 acute bronchitis

12 acute bronchitis 4 weeks of cough sputum value pertussis ?? check if patients want abs –passive voice

13 acute sinus symptoms facial pain, nasal discharge, dental pain, nasal congestion mainly viral decongestant analgesic intranasal steroids 80% USA get abs most unnecessary

14 acute sinus symptoms second sickening > 10 days or if very toxic antibiotics if symptoms last >10 d severe symptoms last for >3 days consecutive days, or worsening symptoms last after 3 consecutive days

15 acute sinus symptoms which Abs duration- unclear ? 10 days if no improvement after 5 days change ab

16 overview of respiratory antibiotics discretionary other than strep pharyngitis, pneumonia, severe symptoms most abs given for symptoms not bacterial diagnoses if give then short duration except if clear bacterial sinusitis

17 acute otitis media antibiotics if < 6 months if 6 to 24 months severe pain or temp>39 o unilateral OM & not severe, watch –Pediatrics 2013;131:e964–e999

18 acute otitis media amoxil 90mg/kg/day duration?? < 2yrs ? 10 days 2 to 6yrs 7 days > 6yr 5 to 7 days if recent amox then augmentin clavulanate 6.4 mg/kg per day

19 antibiotic stewardship 50% kiwis get abs each year rising resistance delayed abs offer reassessment public campaign C difficile gut bacteria probiotics

20 ear canal pus otitis externa Abs + steroids steroids alone ?? acetic acid < Abs + steroids

21 ear canal pus with perforation swabs? quinolones other Abs + steroids ear toxicity?? role of oral antibiotics

22 ear canal pus - complications necrotizing otitis externa –immune status? cholesteatoma mastoiditis

23 COPD exacerbations 2 symptoms out of 3: increasing dyspnoea increase in sputum volume decrease in lung function

24 COPD exacerbations which abs when to use augmentin role of steroids

25 pneumonia –curb 65 Confusion of new onset Blood Urea nitrogen greater than 7 mmol/l Respiratory rate > 30/min Blood pressure <90 mmHg systolic DBP < 60 mmHg Age 65 or older

26 pneumonia –curb 65 0 to 1 ok at home (2%) 2 admit of watch closely (7%) >2 admit (death 14 to 28%)

27 boils staph drainage vs abs which abs MRSA – which abs topical abs recurrent boils

28 impetigo ? swab topical hydrogen peroxide topical vs oral abs which abs recurrent impetigo

29 cellulitis

30 questions write in text box >>


Download ppt "Common infections Dr Arlo Upton Microbiologist Medical Director Labtests Professor Bruce Arroll Department of General Practice and Primary Health Care."

Similar presentations


Ads by Google