Bacterial Infections Flashcards
Timing of surgical antibiotics
60 mins before (cefazolin) or 120 mins before (vanco)
Re-dose if surgery is longer than 4 hours
Discontinue immediately after or withion 24 hours
First-line and option for beta-lactam allergy in cardiac/vascular, orthopedic, and GI surgeries
Cardio: cefazolin (or cefuroxime); clindamycin or vanco
Ortho: cefazolin; clindamycin or vanco
GI: cefazoling + metronidazole; clinamycin + quinolone
Meningitis - what bacteria, coverage for each age group, duration for each infection?
N. gonorrhea, H. flu, strep pneumo, listeria (age > 50, neonaters, immunocompromised)
Neonates: ampicillin + cefotaxime
Age 1 month - 50 years: ceftriaxone + vancomycin
Age > 50: ceftriaxone + vancomycin + ampicillin
N. meningitidis or H. flu: 7 days
Strep pneumo: 10-14 days
Listeria: at least 21 days
Use dexamethasone x4d in all (only helpful for pneumo infections) - NO BENEFIT AFTER FIRST DOSE OF ABX
Otitis Media - first-line (and dose), alternatives, duration, treatment failure
First-line: amoxicillin 90 mg/kg/day (BID) or Augmentin 90/6.4 mg/kg/day (BID)
Alternatives: second or third generation cephalosporins
Under 2: 10 days, 2-5: 7 days, 6 and up: 5-7 days
Failure: Augmentin (if not used prior) or ceftriaxone
Strep throat treatment
Penicillin or amoxicillin
Sinus Infection treatment (and when to give)
Augmentin (long duration or severe symptoms)
Pertussis
Azithromycin or clarithromycin
COPD exacerbation (treatment and duration)
Azithromycin, doxycycline, Augmentin, quinolone x5-7 days
CAP treatment and duration
Outpatient/no comorbidities: amoxicillin or doxy or azithro
Outpatient/comorbidities: (augmentin or cephalosporine) + (axithro or doxy) or quinolone
Inpatient/non-severe: (Unasyn or cephalosporin) + (azithro or doxy) or quinolone
Inpatient/severe: (Unasyn or cephalosporin) + (azithromycin or fluoroquinolone)
Always 5-7 days
HAP/VAP
Always give pseudomonas: zosyn, cefepime, levo
Add MRSA PRN: vancomycin, linezolid (IV abx in last 90 days, prevalence > 20%)
Add x2 pseudomonas PRN (IV abx in last 90 days, prevalenece of resistance >10%)
Duration 7 days
Tuberculosis drugs - key points about all 4
Rifampin - red/orange secretions, inducer of CYP3A4 and others, causes flu-like symptoms
Isoniazid - hepatotoxicity, neuropathy (add vitamin B6)
Pyrazinamide - contraindicated in gout
Ethembutol - visiual damage, confusion, hallucinations
Tuberculosis regimens
Latent: isoniazid + rifampin x12 weeks
Active: all 4 x2 months, then isoniazid + rifampin x4 months)
Endocarditis
Strep: penicillin or ceftriaxone
Staph: nafcillin, cefazolin or vanco (MRSA)
Enterococci: (penicillin or ampicillin) + gentamicin
VRE: daptomycin or linezolid
ADD gentamicin and rifampin if prosthetic valve
USE vanco in beta-lactam allergies
SSTI (superficial, purulent, non-purulent and severe cellulitis, necrotizing, diabtetic foot)
Superficial: mupirocin topical or Keflex (impetigo), Bactrim or doxycycline (furnucle)
Non-purulent cellulitis: Keflex
Purulent cellulitis: Bactrim or doxycycline
Severe cellulitis: vancomycin, daptomycin, linezolid
Necrotizing: vanco + Zosyn (or meropenem) + clindamycin
Diabetic foot: unasyn, zosyn, meropenem, ertapenem, (cephalosporin + metronidazole) (add vanoc or linezolid if MRSA)
Duration of cystitis meds
Bactrim (3 days)
Nitrofurantoin (5 days)
Fosfomycin (1 dose)
