Antibiotics + Infections Flashcards
What abx cover mycoplasma and chlamydia?
Macrolides (clarithromycin, azithromycin, erythromycin)
Tetracyclines (tetracycline, doxycycline, minocycline)
Which abx prolong QT?
QT MF - QT Makes u Flutter
Macrolides (clarithromycin, azithromycin, erythromycin)
Fluoroquinolones (ciprofloxacin, norfloxacin, levofloxacin, moxifloxacin)
Rx pinworms
Mebendazole
Albendazole
Pyrantel
Folliculitis, Carbuncles, complicated carbuncles, impetigo Rx
Folliculitis = mupirocin 2%
Carbuncles or cellulitis = cephalexin 500mg BID x 7 days
Complicated = septra 1-2DS tabs
Impetigo = mupirocin 2%
Common pathogens UTI
E coli + enterobacteriaceae, Klebsiella, proteus mirabilis
UTI abx - simple
Nitrofurantoin 1st line
2nd line: septra, ciprofloxacin, cephalexin
rx of UTI in pregnancy
avoid quinolones (no cipro), repeat UC monthly during pregnancy
Out vs inpt rx for pyelonephritis
Outpatient: 1 dose ceftriaxone or gentamycin, 10 days amox-clav, Septra or cefixime, or 7 days cipro
Inpatient: 10 days ceftriaxone or gentamycin
cellulitis abx
cephalexin 5 days or cefazolin IV 5 days (can be done as outpatient with probenecid to increase half life and make it last 24 hrs)
difference between erysipelas + cellulitis + rx for erysipelas
difference is clear demarcation and raised edge - caused by group A strep, treat with penicillin V or amoxicillin
abscess management - when to give abx vs not
<2cm w/ no systemic sx + no surrounding cellulitis in otherwise healthy pt = drained, no need for abx
All other abscesses = antibiotics
>2cm or multiple
Immunocompromised
Systemic sx = fever
Surrounding cellulitis
Risk of endocarditis
Indwelling medical device
Risk of community transmission
Abx - cephalexin
Common pathogens for abscesses
group A strep, staph aureus, group B, C, G strep
types of impetigo + what bacteria causes them + what sx
Bullous impetigo - common in kids, vesicles enlarge to form flaccid bullae with clear yellow fluid that turns darker and turbid over time, commonly over thorax. Staph aureus
Non bullous impetigo - evolves over a week w/ lesions turning into papules into vesicles with surrounding erythema, form blisters that burst with honey crusted lesions, commonly face + extremities. Group A strep
Ecthyma - deeper punch lesions into dermis with surrounding erythema + yellow crust
rx impetigo
Tx - mupirocin 2% TID topically, if unresponsive to topical or if extensive involvement or if ecthyma = flucloxacillin 500mg PO QID treat until resolved (max 7 days). If MRSA suspected = Septra, clindamycin or doxycycline
What test to do if adult presents with impetigo?
HIV
When may CXR be falsely negative for PNA?
Immunocompromised pts
Need CT
common CAP pathogens
strep pneumonia, mycoplasma pneumonia, chlamydophyllia pneumonia, Hemophilus influenza
Rx for CAP
amoxicillin 1g PO TID x 5 days or doxycycline
If pt smokes, has comorbidities or recent abx use - amox-clav + azithromycin
Sx of bacterial sinusitis vs viral
nasal discharge, facial pain, fever, viral sx
Bacterial if fever >39, discharge/ facial pain for >3 days, or if URTI sx >10 days worsening around day 5. Unilateral facial pain, cacosmia, pain in teeth
common sinusitis pathogens
strep pneumonia, H influenza, moraxella catarrhalis
rx sinusitis (+ what is it if there is black necrotic discharge - who is more at risk and what should you do?)
Tx: amoxicillin 500-1g TID x5-7 days, nasal saline rinses
If black necrotic discharge, and diabetes or immunosuppression = mucormycosis (fungal infection). Needs ENT consult urgently
Sx UTI
dysuria, suprapubic discomfort, frequency
fever or flank pain = pyelo
cellulitis sx
redness, warmth, swelling, pain and unilateral involvement. Redness must not disappear with elevation of area
CAP sx
cough, fever, tachypnea, dyspnea, tachycardia