Central Nervous System ................................................................................................

1
Cardiovascular System................................................................................................... 1
Genito-Urinary Sytem .................................................................................................... 1
Musculo-skeletal System ............................................................................................... 2
Respiratory System ........................................................................................................ 2
Skin ................................................................................................................................ 3
Surgical Prophylaxis ...................................................................................................... 3

Central Nervous System

Meningitis
Cefotaxime 2 g, 4 hourly for 2 doses, then QDS
IV for 10 days
Add benzylpenicillin if Listeria suspected
or
Rifampicin 600 mg BD
Oral for 2 days

Cardiovascular System
Endocarditis
Benzylpenicillin 1.2 g, 4 hourly
Gentamicin 80 mg BD
IV for 4 weeks

Septicaemia
Neisseria meningitides
Cefotaxime 2g, 6 hourly
IV for 10 days
Gram ve bacilli
Cefotaxime 2g, 6 hourly & Gentamicin
IV for 10 days
Staph aureus (not MRSA)
Flucloxacillin 1g QDS & Gentamicin
IV for 10 days

Genito-Urinary Sytem
Cystitis
Trimethoprim 200mg BD, oral for 3 days

or
Nitrofurantoin 100mg BD, oral for 3 days
use pivmecillinam if other Abx used recently

Pyelonephritis
Co-amoxiclav 625mg TDS, oral for 10 days
or
Co-amoxicalav 600mg 1.2g, IV for 10 days
(if severe, add gentamicin)

Prostatitis
Trimethoprim 200mg BD, oral for 3 weeks
(older men)
or
Ofloxacin 200mg BD, oral for 4 weeks
(younger men)

Pelvic Inflammatory Disease

Metronidazole 800 mg stat, then 400 mg
and Ofloxacin 200 mg BD
oral for 14 days
(if pregnant replace with erythromycin)

Musculo-skeletal System
Septic Arthritis
Flucloxacillin 1g QDS
and Fusidic Acid 500 mg TDS
oral or IV for 3 weeks +

Acute Osteomyelitis
Flucloxacillin 1g QDS
and Fusidic Acid 500 mg TDS
oral or IV for 6 weeks

Respiratory System
Exacerbation of COPD
Amoxicillin 500mg TDS
or
Erythromycin 500mg QDS
or
Cefaclor 375mg BD
or

Trimethoprim 200mg BD
or
Oxytetracycline 500mg QDS
(oral for 5 days)

Community Pneumonia
Amoxicillin 500mg to 1g TDS
and Erythromycin 500mg QDS
after flu, add Flucloxacillin 500mg QDS
IV or oral for 7 days
(if previous amoxicillin, replace with IV cefuroxime )

Nosocomial Pneumonia
Cefotaxime 1 2 g TDS
IV for 7 days
(if aspiration, add IV metronidazole 500mg TDS)

Skin
Animan or human bite
Co-amoxiclav 375mg TDS
Oral for 5 days
if allergic:
Erythromycin 500mg QDS
and Metronidazole 400mg TDS)

Cellulitis
Benzylpenicillin 1.2 g, 4 hourly
and Flucloxacillin 1g QDS
IV initially (e.g. 2 to 7 days), then switch to oral for up to 2 to 4 weeks
If allergic, replace both with IV/oral Clarythromicin 500mg BD

Surgical Prophylaxis
Upper GI tract
Cefuroxime 1.5 g IV at induction
Colorectal
Cefuroxime 1.5 g IV
and Metronidazole 500mg IV at induction
Caesarian Section

Co-amoxiclav 1.2 g IV on clamping umbilical cord

Hysterectomy
Co-amoxiclav 1.2 g IV at induction
Joint Replacements
Cefuroxime 1.5g IV at induction
+ 2 doses of 750mg IV 8 hourly
Above Knee Amputation
Benzylpenicillin 600mg QDS
IV for 5 days
if allergic, Metronidazole 500mg IV
Urological Surgery
Gentamicin 120 mg IV
up to 1 hour before surgery
Vascular Grafts
Co-amoxiclav 1.2 g IV
at induction, continue 8 hourly until drains removed.
If allergic, Gentamicin 120 mg IV