Antibiotics Use

History	Dx	Antibiotic Used	Comment (if any)
50 y/M/Chinese Stage 4 Lung Cancer with discharge 6 days prior p/w SOB for 2 days with crepitation over lungs and new pneumonic changes seen in X-ray	Hospital Acquired Pneumonia w/ u/l stage 4 lung carcinoma	IV Cefepime 2g BD	With the patient’s immnocompromised status and also the history of hospital admission the patient should be started on a broad spectrum antibiotic with the choices being piptazo, cefepime and meropenam with vancomycin added if the patient is suspected to have MRSA
30 y/M/Malay with u/l ESRF on dialysis was referred from the dialysis centre of culture was positive for E. coli sensitive to gentamicin and imipenem	UTI due to E. Coli infection with u/l ESRF	Imipenem 125mg BD	The although the organism was found to be sensitive to gentamicin the patient was not started due to the u/l ESRF and toxicity that aminoglycosides present in these cases. The patient also must have the dose adjusted to the patient’s bodyweight and also the Creatinine clearance
17 y/M/Malay with previous mastoidectomy and previous sub-occipital cranioectomy referred for continuation of care and antibiotics	Cerebellar abscess with mastoidectomy and previous sub-occipital cranioectomy	Ceftriaxone 1g BD	Ceftriaxone has good cover for anerobic gram negative and aerobic streptococci and is also the first choice treatment for patients who have mastoiditis
70 y/M/Male NKMI Fever for 3 days with productive cough and crepitation heard on the L lower zone with pneumonic changes on X-ray	Community acquire pneumonia	IV Augmentin 1.2g TDS T. EES 800mg BD	The common regime used in the hospital for community acquired pneumonia in HSNI
62 y/M/Chinese with u/l DM and COPD p/w SOB on the day of admission with cough 2 days prior to admission	AECOAD secondary to CAP	IV Augmentin 1.2g TDS T. Azithromycin 500mg OD	Another common regime used in HSNI for the treatment of CAP
19 year old M/Malay u/l Hodgkins Lymphoma p/w shortness of breath	CAP and UTI with u/l hodgkins lymphoma	Completed IV Cefepime 2g BD IV Ceftriaxone 2g BD	Again the patient in an immunecompromised state was started on cefepime for the lung infection and the ceftriaxone for the UTI
72y/M/Malay u/l COPD with SOB for the past 2 days with fever and cough for the same duration	AECOAD with CAP	IV Augmentin 1.2g TDS T. EES 800mg BD
45y/F/Chinese with u/l Down Syndrome p/w 2 episodes of generalized tonic-clonic seizures with one episode in the past 1 year with UFEME showing a UTI picture	UTI with u/l Down Syndrome	IV Cefuroxime 750 mg TDS.
52 y/M/Malay with u/l Bronchial Asthma presented with worsening SOB for 2 days not relieved by the inhaler associated with non-productive cough for the past 2 days.	AEBA with CAP	IV Augmentin 1.2g TDS T. Azithromycin 500mg OD

            In my opinion almost all of the cases where I have seen antibiotics used in the ward are warranted and the clinicians are sensitive to the indications and also the correct dosages that are to be used in each patient.