3. Bugs and Drugs Flashcards
what are Gram positive, catalase positive cocci in clusters?
Staphylococcus aureus
drug of choice for Staph?
Keflex or Ancef
if keflex or ancef is not available,
what are alternative drug choices to treat Staph?
- clindamycin,
- Levaquin,
- Vancomycin,
- Azithromycin,
- dicloxacillin,
- nafcillin
Alternative drug for Staph if PCN allergy?
- clindamycin,
- Levaquin,
- Vancomycin,
- Azithromycin
(*CANNOT use dicloxacillin or nafcillin)
what if staph is resistant to methicillin?
MRSA (methacillin-resistant Staph aureus)
MRSA: drug of choice
- Vanco IV
- Bactrim PO (if sensitive)
what are alternatives for MRSA,
if vanco and bactrim are not available?
- synercid, or
- linezolid
MRSA: topical drug of choice
bactroban
Strep: drug of choice
- Keflex, or
- Ancef
what are Gram positive, catalase negative cocci that are in pairs or chains?
Streptococcus
what are alternative drugs to treat Strep,
if keflex or ancef is not available?
- clindamycin
- levaquin
- vancomycin
alternative tx for strep
in patients with penicillin allergy?
- clindamycin
- levaquin
- vancomycin
(same options with or without a penicillin allergy)
enterococcus: drug of choice
amoxicillin or vancomycin
alternative for enterococcus,
if amoxicillin or vancomycin is unavailable?
- Augmentin
- Linezolid
what if the enterococcus is resistant to vancomycin?
VRE
(vancomycin-resistant Enterococcus)
vancomycin-resistant enterococcus: drug of choice
- linezolid, or
- synercid
diptheroids: drug of choice
vancomycin
what is a short, Gram negative rod?
Escherichia coli
E. coli: drug of choice
Keflex or Ancef
Alternative for E. coli treatment if PCN allergy?
Cipro or Levaquin
Proteus: drug of choice
Keflex or Ampicillin
Alternatives for Proteus treatment if PCN allergy?
Cipro or Levaquin
E/C/S/M group: drug of choice
(ECSM: Enterobacter spp., Citrobacter spp., Serratia spp., and Morganella morganii)
Quinolone
(Cipro or Levaquin)
Alternative drugs for E/C/S/M group,
if quinolone is unavailable?
- 3rd generation cephalosporin
- Aztreonam
- Bactrim
what is a small Gram negative rod with pili and polar flagella?
pseudomonas aeruginosa
pseudomonas: drug of choice
Cipro
(ciprofloxacin)
Alternative drug for Pseudomonas treatment,
if ciprofloxacin is unavailable?
- 3rd gen cephalosporins
- Aztreonam
- Zosyn
- Timentin
how does Pseudomonas typically present?
blue-green purulence with grape-like odor
what Gram negative spirochete causes Lyme disease?
borrelia burgdorferi
lyme disease: drug of choice
doxycyline or Rocephin
alternative drug for Lyme disease,
if doxycycline or Rocephin is unavailable?
amoxicillin
bacteroides: drug of choice
- Augmentin
- Zosyn
- Unasyn
- Timentin
Alternatives for Bacteroides if PCN allergy,
(alternatives to augmentin, zosyn, unasyn, and timentin)
- clindamycin/Cipro
- Primaxin
- Flagyl
what is a large, Gram positive, anaerobic, “racquet-shape” rod that forms spores?
clostridium perfringens
clostridium: drug of choice
- penicillin
- imipenem
- clindamycin
- tetracycline
what are two soft tissue clinical manifestations caused by Clostridium?
Anaerobic cellulitis and gas gangrene
why is gas gangrene a surgical emergency?
It rapidly progresses to shock and renal failure and is fatal in 30% of cases
aeromonas: drug of choice
alternative?
Cipro PO/IV
alternative: Bactrim
pseudomonas cepacia: drug of choice
alternative?
doc: Bactrim
alternative: Ceftazidime
necrotizing fasciitis: drug of choice
primaxin
superficial thrombophlebitis: drug of choice
timentin
gonorrhea: drug of choice
Ceftriaxone or PCN if sensitive
cutaneous larva migrans: drug of choice
Promethia under occlusion
What organisms may form gas in soft tissue?
- Gram positive – Clostridium perfringens, Staphylococcus, Streptococcus, Peptostreptococcus
- Gram negative – Bacteroides, E. coli, Klebsiella, Serratia
what are some anaerobes?
- Gram positive – Actinomyces, Clostridium, Peptostreptococcus
- Gram negative – Bacteroides, Fusobacterium
patient with diabetes and a PCN allergy: drug of choice
clindamycin
severe limb-threatening infection: drug of choice
Primaxin
most common organisms of bite wounds?
- Human – Eikenella corrodens
- Cat and dog – Pasteurella multocida
what is Gram negative rod is associated with dog bites?
DF-2
[Capnocytophaga canimorsus sp. nov. (formerly CDC group DF-2)]
dog and cat bites: drug of choice
augmentin
most common organisms causing cellulitis
Staph and Strep
which type of Strep can cause impetigo, cellulitis, and erysipelas?
Group A Strep
What is the difference between cellulitis and erysipelas?
- Cellulitis – confined superficial infection
- Erysipelas – superficial infection that extends into the lymphatics
what is the most common organism that causes
acute hematogenous osteomyelitis?
- Staphylococcus aureus (adults)
- Gram negative rods (elderly)
what is the most common organism that causes
osteomyelitis following a puncture wound?
Pseudomonas aeruginosa
what is an anaerobic Gram positive filamentous bacteria?
Actinomyces
what organism may be found following a puncture wound in the ocean?
Vibrio vulnificus
what type of bacteria is gonorrhea?
Gram negative diplococci
what is gonorrhea cultured on?
Chocolate agar
what is the treatment for gonorrhea?
Ceftriaxone
if a patient is currently on an antibiotic,
how long should it be stopped before taking a wound culture?
At least 48 hours (if possible)
