QuestionSBA
QuestionChoice
Flucloxacillin would be the first-line agent to treat cellulitis, but should not be used in view of the patient’s previous adverse reaction to penicillin
33961
b
Flucloxacillin 500mg PO QDS
QuestionChoice
Vancomycin is an aminoglycoside antibiotic with anti-MRSA activity and is used to treat severe skin and soft tissue infections. Due to its narrow therapeutic range and side effects it is not a first-line agent to treat cellulitis
33964
e
Vancomycin 15mg/kg IV BD
QuestionChoice
Linezolid is a very broad spectrum oxazolidinone antibiotic with powerful anti Gram-positive activity and is used to treat severe skin and soft tissue infections. It should not be initiated without specialist microbiology input
33962
c
Linezolid 600mg PO BD
QuestionChoice
Phenoxymethylpenicillin is sometimes used as prophylaxis against skin and soft tissue infections in some patients, but should not be used to treat cellulitis as it likely has limited activity against Staphylococcus species
33963
d
Phenoxymethylpenicillin 500mg PO QDS
QuestionChoice
Clarithromycin is a second-line agent to treat cellulitis in patients who are penicillin-allergic
33960
a
Clarithromycin 500mg PO BD
QuestionComment
The reaction to tazocin should be listed under allergies to make this question clear and fair that it is in fact an allergy.
6552
User
subscriber
Giggy G
QuestionComment
 clarithromycin is second line if allergy not clindamycin
6816
QuestionComment
clindamyin is first line for severe infection which i think it what they're trying to get at (although could be much clearer)
6897
User
subscriber
Dermis Cystic
User
subscriber
Syndrome Kinin
Concept
Chapter
#### Monitoring

The BNF advises to monitor lung function (in patients with a history of obstructive airway disease).

#### Overdoses

Overdosages with beta-blockers may cause cardiac effects such as bradycardia, hypotension, syncope, conduction abnormalities, and heart failure. Bradycardia is the most common arrhythmia, but some beta-blockers may induce ventricular tachyarrhythmias secondary to prolongation of QT interval (e.g. sotalol) or QRS duration (e.g. propranolol).
Non-cardiovascular effects include central nervous system effects (including drowsiness, confusion, convulsions, hallucinations, and in severe cases coma), respiratory depression, and bronchospasm.

Management
 - Airway protection 
 - Activated charcoal within 1 hour
 - IV Fluids
 
IV glucagon is the first-line management.
 
For symptomatic bradycardia, IV atropine may be used.

2618
2736
Cellulitis in penicillin allergic patients
Topic
9
Internal Medicine
6803
Case Presentation: A 45 year old man attends A&E with a painful swollen left calf. **PH** type 2 diabetes, previous myocardial infarction. **DH** metformin hydrochloride 500mg PO TDS, glimepiride 4mg PO OD, aspirin 75mg PO OD, bisoprolol fumarate 5mg PO OD, ramipril 5mg PO OD. Previous adverse drug reaction to Tazocin – urticarial rash.


**O/E**

Large erythematous patch on left calf, very tender to touch. Temperature 38.0°C. All other observations stable.

**Investigations**

WCC 15.9, CRP 89. Blood cultures pending.

Question: Select the most appropriate management at this stage.
a