8 - Anti-Infectives

Question 1

Stages

Would Classification

Answer 1

Stage 1
Skin layers remail INTACT

• *Stage 2**
• *blister / partial** thickness

Stage 3
Full thickness skin loss
Stage 4
Further involved tissue and muscle/tendon/ bone

Question 2

Different types of Infections

that YOU CAN TREAT

no need to refer to MD

Answer 2

Impetigo
direct contact, preschool, small red spots -> vessicles
Topical OTC’s w/ neomycin / bacitracin / Polymixin B
Preferred = Mupirocin 2% (but RX only)

_Folliculitis_
Only if SUPERFICIAL infection
HAIR follicles -> 4+ days dirty yellow/gray erythema

RX only = Mupirocin 2%

Question 3

What type of INFECTION?

Superficial, bacterial inflammation of HAIR FOLLICLES

Lesions last for 4+ days
dirty yellow / gray w/ erythema

Susceptable areas are usually exposed to
water / grease / oils

Answer 3

FOLLICULITIS

can be treated with MUPIROCIN 2% (RX Only)

Systemic Antibiotic is usually indiated
REFER TO MD

Role of OTC is very limited
limited to SUPERFICIAL infections

Question 4

Treatment of ErythRASMA

bacterial infection of toes / groin + diabetes -> red SCALY eruptions

RASMA = SCALY ERUPTIONS

Answer 4

Minor cases may respond to
SHOWERS + POVIDONE-IODINE SOAP

Prefer SYSTEMIC/TOPICAL RX ANTIBIOTICS

REFER TO MD

Question 5

Neosporin + PAIN RELIEF Ointment
Ingredients

Answer 5

Polymixn B

Neomycin

PRAMOXINE

no bacitracin

Question 6

NEOSPORIN
ingredients

Answer 6

Polymixin B

Bacitracin

Neomycin

Question 7

Treatment of Faruncles / Carbuncles

nodules

Answer 7

RX Systemic Antibiotics

REFER TO MD

Resolved by I & D

Question 8

What type of Topical Antibiotic?

Polypeptide Antibiotic

Gram NEGATIVE coverage

minimally absorbed

1-3 times / day

Answer 8

POLYMIXIN - B SULFATE

Question 9

Treating IMPETIGO

Answer 9

Topical OTC

w/ Neomycin / Bacitracin / Polymixin B

CLEANSE AREA w/ mild soap + water

PREFERRED TREATMENT = MUPIROCIN RX ONLY

Question 10

Classification of

ACUTE Wounds

Answer 10

Result from Injury

Heal in ONE MONTH

Abrasions / punctures / lacerations / burns

chronic = Require INTENSE Medical treatment

Question 11

What type of INFECTION?

Acute / Tender / Inflammatory NODULE

Children / Adolescents / Elderly

Located around Hair follicles

MAY BECOME CHRONIC –> REFER TO MD

Answer 11

FURUNCLES

Carbuncles = conglomerate of furuncles

Question 12

What type of INFECTION?

Chronic bacterial infection of TOES & GROIN

Adults generally affected

Diabetes predisposes patients

Skin Lesions = SHARPLY marginated / Red / SCALY eruptions

May last for months to years

Answer 12

ErythRASMA

RASMA = SCALY ERUPTIONS

Minor cases may respond to
SHOWERS + POVIDONE-IODINE SOAP

Prefer SYSTEMIC/TOPICAL RX ANTIBIOTICS

REFER TO MD

Question 13

OTC Treatment of INFECTION

Answer 13

Only the MOST SUPERFICIAL CONDITIONS should be treated OTC

Products are adjuncts to PROPER CLEANSING / Bandaging / Hygiene

Topical antimicrobials are usually used in combination
in order to cover a broad spectrum

Question 14

What type of Topical Antibiotic?

Bactericidal

Gram POSITIVE coverage

• rare resistance development*
• minimal absorpton*

1-3 times / day

Answer 14

BACITRACIN

Question 15

What type of INFECTION?​

Ulcerative Bacterial Infection

Common in children / adolescents & elderly

Erthematous pustule

Common ankles / feet / thighs / buttocks

Lesions are pruritic / tender / last for WEEKS

Answer 15

ECTHYMA

Systemic Antibiotic is usually indiated
REFER TO MD

Role of OTC is very limited
limited to SUPERFICIAL infections

Question 16

What type of Topical Antibiotic?

AminoGlycoside + Bactericidal Activity

HYPERsensistivity is possible

Gram - NEGATIVES, anaerobes, gram positive (staph)

Can result in systemic toxicity

1-3 times / day

Answer 16

NEOMYCIN

N = NEGATIVE

Question 17

Treatment of Erysipeloid / Ecthyma / Folliculitis?

Answer 17

• *Systemic Antibiotic** is usually indiated
• *REFER TO MD**
• Role of OTC is very limited*
• *limited to SUPERFICIAL infections**

Folliculitis can be treated by Mupirocin 2% tho

Question 18

Polysporin Ointment

Answer 18

POLYMIXIN B

BACITRACIN

no neomycin

Question 19

Questions to Ask Patient with

INFECTION

Answer 19

What type of wound is present?
WHERE is the wound?

Any foreign objects present

Redness / warmth / pus + swelling?

Fever / immunocompromsised

What have you tried

Allergies

Question 20

What type of Topical Antibiotic?

Gram POSITIVE bacteria

Effective for STAPH + MRSA

IMPETIGO / FOLLICULITIS

AAA TID F7D

Answer 20

MUPIROCIN 2%

RX ONLY

BACTROBAN

Question 21

Different types of Infections

that you CAN NOT TREAT YOURSELF

SEE MD!

Answer 21

Furuncles & Carbuncles
NODULES around hair follicles -> may be chronic see MD
Ecthyma
ulcerative, erythematous pustule (blister) –> pruritic / tender

ErySIPEloid
evolving cellulitis from fish/meat/poultry -> sharply marginated lesions

ErythRASMA
chronic –> toes/groin -> prediabetes –> SCALY eruptions / marginated

_Folliculitis,_ sometimes treated w/ mupirocin 2% RX
HAIR follicles -> 4+ days dirty yellow/gray erythema

Question 22

What type of INFECTION?

Superficial Infection

Common in preschool children

Transmitted by direct contact

Lesions are small / red spots that develop into VESSICLES

Seen on Face / Arms / Legs / Buttocks

Answer 22

IMPETIGO

Can be treated with TOPICAL OTC
neomycin + bacitracin + polymixin B

Cleanse area with MILD SOAP + WATER

Preferred treatment = MUPIROCIN RX ONLY

Question 23

What type of ​WOUND?

Acute Evolving Cellulitis

Common source is FISH / MEAT / POULTRY

1-4 day inoculation period

Sharply marginated lesions

Skin ITCHES / BURNS / THROBS

resolves in 3 weeks

Answer 23

ErySIPELOID

Systemic Antibiotic is usually indiated
REFER TO MD

Role of OTC is very limited
limited to SUPERFICIAL infections