Abx Flashcards
Otitis Media
Consider Ø Rx and f/u prn (if >6 mo)
Common Bugs: S. Pneumo, H. Flu
1st Line: Amox (80/mg/kg/day, three divided doses)
Acute Sinusitis
Common Bugs: S. Pneumo, H. Flu
1st Line: Amox (consider double dose), Levofloxacin if resistant
Pharyngitis
Common Bugs: Group A strep
1st Line: PCN 500 BID x 10D
Erythromycin x 10D if PCN allergy Amox in kids (liquid amox tastes better than liquid PCN)
Pneumonia
Common Bugs: S. Pneumo, Atypicals, H. Flu
1st Line: macrolide, doxycycline
Consider Levofloxacin if refractory,
Pt. is elderly, pt. has co-morbidities
Traveller’s Diarrhea
Common Bugs: E. Coli, Salmonella, Shigella, Campylobacter, Parasite
1st Line (Bacterial): Cipro 500 BID
x 3 days, initiate if Sx’s >24 hours, fever, bloody diarrhea;
Single-dose azithromycin for kids
1st Line (Giardia, Entamoeba): Metronidazole
Pseudomemb. Colitis/C. diff
PO Vanco 125 QID x 10D or
Fidaxomicin 200 BID x 10D
Metronidazole now 2nd line
UTI (Uncomplicated)
Common Bugs: E. Coli, other Gram negs, S. Saphrophyticus
1st Line: Macrobid 100 BID x 5D, Bactrim DS BID x 3D
Cipro 250 BIDx 3D (second line)
Chlamydia
1 gm Azithro po x 1
Partner(s) must be treated
Gonorrhea
Ceftriaxone 250 IM x 1
& Azithro 1 gram PO x 1
Partner(s) must be treated
Vaginitis (Candida)
OTC antifungals or Fluconazole 150mg PO x T
Vaginitis (Bacterial Vaginosis)
Flagyl (po/pv)
Vaginitis (Trichomonas)
Flagyl (treat partner)
Cellulitis/Impetigo/Abscess
Diclox/Keflex (QID), 2nd line: Clinda
Drain Abscess, Can use Bactroban for impetigo; MRSA: Bactrim, Doxy
Penicillins SE:
GI upset, allergic reaction (rash, anaphylaxis), yeast infection, ↓ seizure threshold, C. diff colitis
Penicillin
+++ Group A Strep, oral anaerobes, T. pallidum
++ Strep pneumoniae,
— S. aureus, Gonorrhea
Amoxicillin
+++ Group A Strep, Listeria, oral anaerobes
++ Strep Pneumo, Enterococcus
+ H. Flu, Moraxella, E. coli
— S. aureus, Gonorrhea
Dicloxacillin
+++ S. aureus, ++ Strep, + Oral anaerobes
— Gram Negs, MRSA
Amoxicillin/Clavulanic Acid (Augmentin)
+++ Group A Strep, oral anaerobes, H. flu, E. coli, Pasteurella multocida, S. aureus
++ Strep pneumo, Enterococcus
— resistant Pneumococcus
Cephalosporins SE:
GI upset, allergic reaction (5% cross-allergenicity with PCN), yeast infection C. diff colitis
1st Generation Cephalosporins: Cephalexin (Keflex)
+++ Group A Strep, Strep pneumo
++ S. aureus, + H. flu, Moraxella, E. coli
2nd Generation Cephalosporins: Cefuroxime, others
+++ H. flu, E. coli, Moraxella
++ Strep pneumo, other Gram (-), GC
Macrolides SE:
GI upset, allergic rxn (rare), yeast infxn, C. diff colitis.↑QT interval when combined w/ azoles (anti-fungals). Drug interxns: can increase levels of other drugs by inhibiting p450.
Erythromycin
+++ “Atypicals” (Mycoplasma, Chlamydia, Legionella), Group A Strep, Pertussis
++ Strep pneumo, C. trachomatis,
P. acnes
+ S. aureus, H. Flu, Moraxella
Azithromycin, Clarithromycin (Biaxin)
+++ “Atypicals,” Group A Strep, C. trachomatis, Pertussis
++ Strep pneumo, H. flu, Moraxella, S. aureus
Trimethoprim/Sulfamethoxizole SE:
Allergic reaction (rash, Steven’s Johnson Syndrome), GI upset, yeast infxn, C. diff colitis, E. multiforme, Anemia with G-6PD deficiency
Trimethoprim/Sulfamethoxizole coverage
+++ E. coli, PCP
++ Strep pneumo, H. Flu, Moraxella, MRSA
— Group A Strep, anaerobes
Tetracyclines SE:
GI upset, photosensitivity rash, allergic rxn, C. diff colitis, yeast infection, bone/teeth discoloration: avoid < 8 yo, pregnant
Doxycycline coverage
+++ C. trachomatis, Lyme, P.Acnes, MRSA, RMSF, “Atypicals” (Mycoplasma, Chlamydia,
Legionella)
++ Strep pneumo, H. Flu, Moraxella
Metronidazole (Flagyl) SE:
disulfiram-like rxn (severe GI upset w/ EtOH), GI upset, metallic taste, allergic rxn
Metronidazole (Flagyl) coverage
+++ Abdominal/Vaginal Anaerobes, C. difficile, Bact. vaginosis, Trich, Giardia, Ameobiasis
— Gram Negs, Gram Positives
Clindamycin SE:
GI upset, allergic rash, yeast infection,
C. diff colitis
Clindamycin coverage
+++ Oral/Vaginal Anaerobes,
S. aureus, Grp A Strep
++ Bacterial vaginosis, Strep pneumo, Trich
— Gram Negs
Fluoroquinolones SE:
GI upset, allergic rxn (1%), HA, yeast infection, C. diff colitis. Damages developing cartilage: avoid in pregnacy, kids
Cipro/Oflox/Norflox coverage
+++Gram Negs, Pseudomonas
++ Gonorrhea, Enterococcus
+ Strep
— Anaerobes, “Atypicals” (Mycoplasma, Chlamydia pneumoniae, Legionella)
Levofloxicin (Levaquin), Gatifloxacin (Tequin) coverage
+++ Gram Negs, Pseudomonas, “Atypicals” (Mycoplasma, Chlamydia pneumoniae, Legionella), Strep pneumo (including resistant strep)
++ Enterococcus
— Anaerobes, Staph
