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URTI Antibiotics Quiz

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URTI Antibiotics Quiz

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URTI antibiotics even though they are mostly viral so I don't understand the relevance of this at this point.

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Stephen
Stephen
United Kingdom

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URTI Antibiotics Quiz
 

URTI Antibiotics QuizOnline version

URTI antibiotics even though they are mostly viral so I don't understand the relevance of this at this point.

by Stephen
1

First-line antibiotic for suspected streptococcal tonsillitis in a non-allergic adult?

2

Phenoxymethylpenicillin’s primary mechanism of action?

3

Which drug correctly matches drug class?

4

For acute bacterial sinusitis that is severe/worsening, most appropriate first choice is:

5

Which antibiotic is contraindicated in pregnancy for typical URTI indications?

6

Key safety issue with macrolides (e.g., clarithromycin)?

7

Giving aminopenicillins in suspected EBV (glandular fever) is associated with:

8

What does clavulanic acid add when combined with amoxicillin?

9

Which child with acute otitis media (AOM) most warrants immediate antibiotics in primary care?

10

Which URTI antibiotic is most associated with photosensitivity and pill-oesophagitis (advise water + remain upright)?

Feedback

Most URTIs are viral; when bacterial pharygitis is presumed use narrow-spectrum penicillin V for ~5 days. Macrolides are for true penicillin allergy; co-amoxiclav isn’t first-line here.

β-lactams including penicillin V (Phenoxymethylpenicillin) bind PBPs and block cell-wall cross-linking → bactericidal.

Clarithromycin is a macrolide (50S inhibitor). Doxycycline is a tetracycline (30S). Co-amoxiclav is a β-lactam/β-lactamase inhibitor. Amoxicillin is a penicillin

According to NICE guidelines, the first step abx for bacterial sinusitis is Penicillin V but for worsening symptoms Co-amoxiclav is recommended. This is because worsening/prolonged sinusitis suggests β-lactamase–producing organisms so penicillin will be ineffective https://www.nice.org.uk/guidance/ng79/chapter/recommendations#choice-of-antibiotic

avoid tetracyclines (e.g., doxycycline) in pregnancy and in children younger than 12 due to effects on teeth/bone. Penicillins and erythromycin are generally acceptable.

Watch three things with clarithromycin: tummy upset, heart-rhythm risk from QT prolongation, and drug interactions because clarithromycin blocks CYP3A4, so drugs that rely on this enzyme (e.g., simvastatin, warfarin) build up in the blood and can cause toxicity.

Amoxicillin/ampicillin often trigger a benign widespread rash in EBV infections; avoid if mononucleosis suspected. (common exam question, I did a similar one on pastest)

Clavulanate inhibits many β-lactamases, protecting amoxicillin from enzymatic degradation; it doesn’t fix altered PBP

Most AOM improves in 2–3 days without antibiotics. Offer no or delayed antibiotics unless the child is systemically unwell, is less than 2 years old with bilateral AOM, or has otorrhoea. Provide analgesia and safety-netting. https://www.nice.org.uk/guidance/ng91/chapter/recommendations

Tetracyclines can cause photosensitivity and oesophageal irritation/ulceration so take with plenty of water and stay upright

 
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