Antibiotics Flashcards
Staph/Strep skin infection with low likelihood of MRSA
Cephalexin (Keflex, a first gen ceph) or amox-clav (Augmentin)
Staph/Strep skin infection with HIGH likelihood of MRSA
Clindamycin, TMP-SMX, or
Doxycycline (if child is older than 8y)
Mild inflammatory acne
Topical abx: Clindamycin, erythromycin (though perhaps not available), and benzoyl peroxide
Severe inflammatory acne
Oral abx: Tetracycline, doxycycline, minocycline
Tinea capitis
Oral griseofulvin x 6-12 weeks (no prior labs needed). Fluconazole or terbinafine are acceptable alternatives.
Tinea versicolor
Option 1. No sun + Astringent + topical antifungal cream.
Option 2: Oral ketoconazole, fluconazole, or itraconazole.
Option 3: Topical selenium sulfide or zinc (shampoo)
Septic arthritis in neonates
Cloxacillin/gentamicin
Bugs: Group B Strep, E coli, Staph aureus
Often concomitant osteomyelitis
Septic arthritis in infants
Cefuroxime (2nd gen ceph) or cefotaxime (3rd gen ceph)
Bugs: Strep pneumo, group A beta hemolytic Strep, H flu, Staph aureus
Septic arthritis in a child
Cefazolin (Ancef, IV, first gen ceph)
Bugs: Strep pneumo, group A beta hemolytic Strep, H flu, Staph aureus
Septic arthritis in an adolescent
Ceftriaxone/Cefixime + Azithromycin (to cover GC) N. gonorrhea, too.
Septic arthritis or osteomyelitis in patient with sickle cell
3rd gen cephalosporin such as Cefotaxime (to cover Salmonella)
Septic arthritis with HIGH likelihood of MRSA
Add vancomycin
H flu osteomyelitis
2nd or 3rd gen cephalosporin
In general, tx osteomyelitis with IV->PO abx x 4-6 weeks
Staph aureus or Group A Strep (pyogenes) osteomyelitis
oxacillin/nafcillin
1st/2nd gen cephalosporin
Clindamycin (if PCN allergic)
First generation cephalosporins
Cephalexin (Keflex, PO) and Cefazolin (Ancef, IV)
GramPos ++ (not MRSA)
GramNeg + (PEcK)
Second generation cephalosporins
Cefaclor, Cefuroxime, Cefotetan, Cefoxitin (no “T” except cefotetan, which has 2 T’s and is a 2nd gen ceph)
GramPos NO
GramNeg ++ (HEN PEcK)
Third generation cephalosporins
Ceftriaxone, Cefotaxime, Ceftazidime, Cefpodoxime (all have a T except CefPodoXime which is the X-cePtion)
GramPos Not really except good for Strep
GramNeg +++ (including Pseudomonas, esp Ceftaz - like TazMonian devil)
HEN PEcK
H flu, Enterobacter, Neisseria
Proteus, E coli, Klebsiella
Enterococcus
Vancomycin, linezolid, ampicillin (ampicillin is actually better than vanc!)
Rifampin, quinolones
DO NOT CHOOSE Clindamycin or Cephalosporin!!!
Quinolones (aka Fluoroquinolones)
Ciprofloxacin (2nd gen), levofloxacin, moxifloxacin
Avoid in under 18yo due to tendon rupture
Good broad spectrum drugs, ex. Hospital acquired PNA
Macrolides
Erythromycin, Azithromycin, Clarithromycin
Avoid erythro in under 1 mos due to pyloric stenosis
Bacteriostatic
SE: Increased GI motility
Fourth generation cephalosporins
Cefepime
GramPos ++ (as good as first gen ceph)
GramNeg ++ More resistant to beta-lactamases
Carbapenems
Imipenem
Extended-spectrum beta lactamase (ESBL) producing organisms, such as Enterobacter (a GramNeg org)
Metronidazole
Anaerobes and parasites
Especially intra-abdominal infections
Ex. Giardia, Entamoeba, Trichomonas, Bacterioides, C dif, and Gardnerella
Albendazole
Pyrantel pamoate
Worms
Ex. Enterobius (pin worms) = one time dose, can repeat in 2 weeks if recurs. But other bugs require multiple doses
Tetracyclines
Tetracycline, doxycycline, minocycline
Avoid in under 8yo due to teeth staining
Exception: Doxy is first line for Rocky Mountain Spotted Fever, regardless of patient’s age.
Meningitis prophylaxis
Who: Household contacts, people who ate/slept near index case within 7 days of symptom onset.
Tx: Oral Rifampin 4 doses over 3 days; IM Ceftriaxone x 1; or Ciprofloxacin x 1 dose if >18yo
