Bacterial Infections Flashcards by Brianna Spahn

Tx for neonatal profylaxis of gonorrhea and chlamydia

Erythromycin ointment

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Tx for bacterial conjunctivitis

Gentamycin, Tobramycin (Aminoglycosides)

Azithromycin (Macrolide)

Bactrim (sulfa)
ADR, corneal ulcer Interacts w SILVER

Ofloxacin, Ciprofloxacin, etc (Fluoro)
ADR, photophobia

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Tx for acute otitis externa

Acetic Acid (mild)

2. Polymyxin B / Neomycin Drops

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Tx chronic otitis externa

Polymyxin B / Neomycin drops

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Tx for “malignant “ otitis externa - usually caused by pseudomonas, DM patients more prone - infection has spread to surrounding tissue / bone

Medical emergency, IV antibiotics and debridement

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1st line Tx for Acute Otitis Media

Amoxacillin

Augmentin with resistance

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PCN allergic Tx for acute otitis media

Cefdinir or Ceftriaxone

If anaphylaxis Rx&raquo_space; Macrolide (Clarithro, Azithro)

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Gonorrhea and Chlamydia, treating togehter

Ceftriaxone IM + Azithromycin

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Nasal decolonization of MRSA

Mupirocin

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Tx for bacterial sinusitis, 1st line and PCN allergic

Augmentin (after 2 weeks of sinusitis)

PCN allergic: Cephalsporin (Cefdinir, Ceftriaxone)
if Analphylactic allergic: Macrolide (Clarithro, Azithro)

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1st line Tx Strep Pharyngitis

Augmentin
or
Amoxiicllin / Ampicillin 
or
Pen VK **black hairy tongue**

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Tx for PCN allergic, Strep Pharyngitis

Cephalosporins

1st gen: Ceph-alexin, Ceph-adroxil, Cef-azolin

2nd gen: Cef-prozil, Cef-otetan, Cef-uroxime

3rd gen: Ceftriaxone?

4th gen: Cefepime

5th gen: Ceftaroline (MRSA)

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1st line Tx for CAP, outpatient, no use of abx in the past 3 months

(Most like S. pneumonia)

Azithromycin, Clarithromycin, Erythromycin (Macrolides)

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1st line Tx for CAP, outpatient, WITH CHRONIC DZ or use of and in past 3 months

Respiratory Fluoroquinolone

Moxifloxacin, Gemifloxacin, Levofloxacin

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2nd line Tx for CAP, outpatient, WITH CHRONIC DZ or use of abx in past 3 months

Amoxicillin / Augmentin + Azithro or Clarithro

PCN allergic:

Ceftriaxone + Azithro or Clarithro

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1st line Tx for CAP INPATIENT, non-ICU

also good for PCN allergic

Moxi, Levo, Gemi (resp fluoroquinolone)

also good for PCN allergic

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2nd Line Tx for CAP INPATIENT, non-ICU

(same as 2nd line CAP outpatient w chronic dz)

Amoxicillin / Augmentin + Azithro or Clarithro

PCN allergic:

Cetriaxone + Azithro or Clarithro

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1st line Tx for CAP, INPATIENT ICU

Cefotaxime, Ceftriaxone, Ampicillin + Levo, Moxi, Gemi

PCN allergic: AZTREONAM + Levo, Moxi, gemi

Notable ADR of Fluoroquinolones

Joint cartilage injury in kids <16 yrs

Tx for known pseudomonas infection

Levofloxacin + B Lactam + Gentamycin (Aminoglycoside)

Fluoroquinalones interact with what common OTC medication

Antacids! (Mg, Ca)

Separate dose by 2 hours

Fluoroquinolone MOA

Inhibit DNA gyrase and Topoisomerase IV (X DNA)

1st line HAP Tx, no MDR risks, not recent abc use

Levofloxacin

1st line HAP Tx, MRSA or mortality risks

Levofloxacin + LINEZOLID or VANCOMYCIN

Pertussis Tx, 1st line

Clarithromycin

Pertussis Tx, 2nd line

Sulfa Trimethoprime

Sulfonamide MOAs

Inhibits biosynthesis of bacterial nucleic acids and proteins (X DNA) Bacteriocidal

Macrolide MOAs

Inhibit protein synthesis by binding 50 S ribosome (X DNA) Bacteriostatic

Macrolides and P450

Azithromycin is NOT a P450 Erithro and Clarithro P450!! - show up in Breast Milk and Cross Placenta

1st line for sepsis caused by Community Acquired Pneumonia, Skin and Soft Tissue Disease and Meningitis

Vancomycin 1. with Levo for CAP 2. with Ceftriaxone, Ampicillin, and Dexamethasone for Meningitis 3. Piperacillin or tazobactam for STD

1st line for sepsis caused by Intra-abdominal infections, Pelvic or UTI

Piperacillin or Tazobactam with Gentamycin

Gonorrhea Tx

1st line: Ceftriaxone with Azithromycin (presumptive tx of chlamydia too)

Ceftriaxone IM - the shot MUST be given with what??

LIDOCAINE - very painful IM shot

1st line Lyme Disease Tx

Doxycycline or Amoxicillin / Ampicillin

Notable Doxycycline ADRs and warnings

Teeth discoloration Black tongue Preg D DON'T TAKE W DAIRY

Perioperative Prophylaxis

CEFAZOLIN (1st gen cef)

1st line Tx Uncomplicated UTI (Absence of fever, flank pain, or other suspicion for pyelonephritis Able to take oral medication)

``` Sulfa Trimethoprime (avoid if used recently for UTI or if known resistance) ``` or Nitrofurantoin or Fosfomycin

Pyelonephritis or Complicated UTI

Ciprofloxacin | Levofloxacin unless there is known community resistance

Black Box warning for Fluoroquinalones

Tendon issues, esp in adolescents

1st line Tx ,Bacterial Vaginitis

Metronidazole

Metronidazole ADRs and warnings

Metallic taste Alcohol toxicity, into with Disulfiram NO USE IN 1ST TRIMESTER PREGNANCY

2nd line Tx, Bacterial vaginitis (if early preg or alcoholic)

Clindamycin

1st line Tx Oncomycosis

Efinaconazole

C diff Tx

Metronidazole Vancomycin PO Fidaxomycin