All Flashcards
What to avoid if pt is allergic to amoxicillin?
Ampicillin, Cephalexin
Penicillin allergy pairings
ceftriaxone + cefepime
ceftazidime + aztreonam
For cystitis in women, what is the recommended regimens?
Nitrofurantoin 50mg QDS x 5d
Fosfomycin 3g (One dose)
Bactrim 960mg BD x 3d
Amox-Clav 625mg BD x 5-7d
For uncomplicated cystitis in men, what is the recommended regimens?
Fosfomycin 3g x 3 doses (EOD)
What is safe for UTI in pregnant women?
Beta lactams
4-7d (cystitis) 14d (pyelo)
What are some non-pharmacological measures for UTI?
- hydrate well
- wipe from front to back
- urinate frequently
- keep area dry
When to expect resolution of s/s from UTI?
24-72h from initiation of abx
What is an adjunctive therapy for urinary symptoms?
Phenazopyridine 100-200mg TDS
(avoid in G6PD, SE: N/V, orange-red stool + urine)
What are some differential markers for pyelonephritis?
Flank pain, renal punch positive
What are some recommended regimens for pyelonephritis?
Cipro 500mg BD x 7d
Levo 750mg OD x 5d
Amox-Clav TDS x5-7d
Bactrim BD x 10-14d
What are the regimens to be given to severely ill patients w pyelonephritis?
IV/IM Gentamicin 5mg/kg + Amox-Clav 1.2g q8h
What are the regimens to be given to pyelo/suspected prostatitis in men?
Bactrim BD x10-14d
Cipro 500mg BD x10-14d
What are the regimens to be given to nosocomial/healthcare assoc UTI?
IV Cefepime 2g q12h +/- IV Amikacin 15mg/kg/d x7-14d
IV Meropenem 1g q8h x 7-14d
List the differential signs of SSTIs :)
Impetigo - honey colored crusts
Ecythema - ulcerative form of impetigo (deeper lesions)
Furuncle - boil reaches SC tissues
Carbuncle - furuncles extending into SC tissue
Skin abscess - more pus filled
Erysipelas - well-decarmecated raised edges
Cellulitis - acute, diffuse, poorly demarmecated erythema
Treatment for impetigo/ecythema
limited lesion - mupirocin ointment x 5d
several, ulcerative lesions - empiric PO Cephalexin / Clindamycin (Pen allergy) x7d
Treatment for purulent SSTI (Furuncle/Carbuncle)
5-10d
mild - I & D
moderate (systemic sx)- I & D + empiric PO Cephalexin / Clindamycin (Pen allergy)
severe - empiric IV Cephalexin / Clindamycin (Pen allergy)
Treatment for non-purulent SSTI (erysipelas, cellulitis)
5-10d
mild - empiric PO Cephalexin / Clindamycin (Pen allergy)
moderate (systemic sx)- include MSSA cover –> IV cloxacillin, clindamycin
severe - IV piptazo (if MRSA, add vancomycin)
When to expect resolution of s/s from SSTI?
24-72h from initiation of abx
DFI s/s
at least 2 signs of:
- erythema
- warmth
- tenderness
- pain
- induration
What classifies as mild treatment for DFI/PU?
DFI - skin/soft tissue infection + erythema surrounding area <2cm + no systemic sx
PU - S1/S2 (Epidermal abrasion / dermal ulcer)
What classifies as moderate treatment for DFI/PU?
DFI - bone/joint infection + erythema surrounding area >2cm + no systemic sx
PU - S3/S4 (SC ulcer, muscle/bone deep ulcer) + no systemic sx
What classifies as severe treatment for DFI/PU?
DFI - bone/joint infection + erythema surrounding area >2cm + systemic sx
PU - S3/S4 (SC ulcer, muscle/bone deep ulcer) + systemic sx
What is the treatment for mild DFI/PU?
Cover Staph + Strep
PO Cephalexin 500mg q6h
PO Bactrim BD
What is the treatment for moderate DFI/PU?
Cover gram -ve + anaerobes
IV Amox-Clav 1.2g q8h
IV Vancomycin 15mg/kg/d q8-12h
