Antibiotic in meningococcal sepsis — DipIMC MCQ

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ModeratePharmacologyAntibiotic in meningococcal sepsisDipIMC

A 14-year-old has fever, hypotension and a non-blanching rash in a rural village. Transfer time is 35 minutes and parenteral antibiotics are available. What is the most appropriate drug/dose?

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Correct answer: C — Give parenteral benzylpenicillin according to protocol before transfer

Give parenteral benzylpenicillin according to protocol before transfer is the best answer because suspected meningococcal septicaemia is an indication for pre-hospital parenteral antibiotic therapy when available. Give nebulised salbutamol as sole treatment is less appropriate because bronchodilator therapy may help wheeze but does not treat systemic shock; Delay medication until hospital review is less appropriate because time-critical emergency drugs should not wait for hospital arrival. Give intravenous adrenaline 1 mg as a rapid bolus and Give intramuscular adrenaline 1 mg are also suboptimal because they move attention away from the key pre-hospital priority.. The key DipIMC principle is to treat immediate reversible threats, communicate clearly and move the patient toward the right definitive care.

Reference: JRCALC Guidelines; NICE Meningitis guidance