Bugs And Drugs Flashcards
Prostatitis
Septra DS BID 6 wks
Cipro BID 6 wks
H pylori
Bismuth
Metronidazole
Doxycycline
PPI
Gastric bleed
CTX (ppx)
Erythromycin (pro kinetic 30-90min before scope)
UTI Firstline
Nitrofurantoin in women/pregnant
Ciprofloxacin in male/complex/pyelo
Amoxicillin in peds (cefixime if complicated)
Cellulitis (uncomplicated, no MRSA coverage)
Cephalexin
AOM
amoxicillin
Otitis externa
Ciprodex otic suspension
Strep pharyngitis
Penicillin in adults
Amoxicillin in pediatrics
Second line: erythro/clarithro, keflex
CAP
Adults:
Amoxicillin or doxycycline first line
clarithromycin or azithromycin second line
Inpatient CTX/azithromycin or levofloxicin
Peds:
Amoxicillin Firstline
Clarithromycin <8 and doxycycline >8 second line
Acute rhinitis
Amoxicillin
If suspect resistant s pneumo do amoxicillin/clav
BV
Metronidazole
Gardenerlla vaginalis
HSV
Acyclovir
G+C
CTX IM or
Cefixime and azithromycin PO or
Doxycycline PO
Gastroenteritis (blood, fever, >3BM/d)
Ciprofloxacin
Azithromycin
C diffacile, colitis
Vancomycin PO
Peptic ulcer disease, not related to NSAID use
Bismuth, PPI, doxycycline, metronidazole or
Clarithromycin, amoxicillin, metronidazole, PPI
cystitis in women (uncomplicated, pregnant, pyelo)
Nitrofurantoin
TMP-SMX DS
Fosfomycin
If pregnant: Nitrofurantoin or amoxicillin (avoid TMP-SMX in first trimester and at term)
If pyelo: Ciprofloxacin or levofloxacin or IV CTX or IV gentamicin
Cystitis in men
Ciprofloxacin 7-14 days
Also 7-14 days if catheter (remove catheter if possible)
Coverage of atypical (2 antibiotics)
Macrolides and tetracyclines
Treatment for pinworms
Antihelminth (mebendazole, albendazole, pyrantel)
Most common bug causing traveler’s diarrhea
Enterotoxigenic e coli (ETEC)
Most common bugs causing CAP
S pneumo
H influenzae
S aureus
Mycoplasma
Moraxella
Treatment for traveler’s diarrhea
Macrolide and fluroquinolone
Can use loperamides and bismuth for symptoms
Penicillin G (IV) susceptible bugs
Strep pneumo
GAS
Nisseria meningitis
Syphilis
Listeria
Pasteurella
Penicillin V (PO)
GAS strep throat
Ampicillin/amoxicillin
Gram + and some gram - (enterococci)
Penicillinase resistant penicillins (cloxacillin)
Skin infection (not MRSA)
Antipseudomonal penicillins (piperacillin)
Anaerobic and pseudomonal coverage
First Gen cephalosporin (cephalexin, cefazolin)
Gram +, good for penicillin allergy
Third gen cephalosporin (CTX, cefixime)
Good CSF penetration (CTX) for meningitis
Carbapanem
Broad (no MRSA)
Ertapenem does not cover pseudomonas
Lincosamide (clindamycin)
Anaerobes, gram +, MRSA
Can cause C diff
GU infections
TSS
Aspiration PNA
Macrolide (azithromycin)
Gram +, atypical
Chlamydia
Legionella
Mycoplasma
CAP
Tetracycline
Chlamydia
Mycoplasma
Tick borne bruciella and rickettsia
Acne (can cause phototoxic dermatitis)
Aminoglycosides
Gram -, pseudomonas
Fluroquinolone (cipro levo moxi)
Gram -, pseudomonas
Legionella
Brucella
Mycobacterium
Lipocopeptide (vancomycin)
Gram + MRSA
Sulfonamide (TMP SMX)
Gram+, gram-
Protozoan (toxiplasma, pneumocystis)
TMPS- resp tree, mouth, pee, PCP ppx
Pseudomonal coverage
Piperacillin
Meropenem
Aminoglycoside
Ciprofloxacin
3rd gen cephalosporin
Anaerobic coverage
Clindamycin
Metronidazole
Penicillin with beta lactamase inhibitor (amoxclav piptazo)
Atypical
Macrolide
Tetracycline
FQ
MRSA
Vancomycin
Clindamycin
TMPSMX
Tetracycline
Linezoid
Most common bacterium for acne
Propionibacterium acnes
Virus causing croup
Parainfluenza 1 and 3
Pertussis organism
Borderella pertussis
Most common bug in AOM
S pneumo
M catarrhalis
H influenzae
AOM
Firstline: amoxicillin
If penicillin allergy: cefuroxime or clindamycin+cefixime
Second line: amoxclav or CTX
Treatment for AOM with prudent conjunctivitis
Amoxclav
Animal bites
Amox clav
Tdap (if >10yr or >5 yr +Ig if not complete series)
Consider post infectious ravines vaccine and Ig within 24h (public health notification)
HIV/Hep B/C if human bites
Most common bacteria in bites
Animal: pasteurella multiocida
Human: strep, hemophilus (anaerobe)
DM foot: pseudomonas, MRSA, gram neg, anaerobes
IVDU: staph, MRSA
HIV
Post exposure prophylaxis:
Truvada and raltegravir
HPV
Imiquimod or podofilox or cryotherapy
Chlamydia
Azithromycin or doxycycline
Co-treatment for gonorrhoea
Trace all contacts in last 60 days, test and treat
NAAT of cure, not recommended for most people, however if indicated, four weeks after treatment completion
Syphilis
Long acting benzathine penicillin, or doxycycline
Screen all patients for HIV concurrently
Scream pregnant women at first trimester and time of delivery
Contact tracing:
Primary syphilis three months
Secondary syphilis six months
Early late and syphilis one year
Follow up serial RPR at one, three, six, 12 months after treatments and infectious cases
Gonorrhoea
Cefixime plus azithromycin
Or ceftriaxone and azithromycin
Newborns of positive mothers should be given single dose of cetyl
Trace all contacts in last 60 days
Test of cure is recommended in all cases using NAAT typically around 3 to 4 weeks after completion of treatment
Re-screening a six months following treatment 
Genital herpes simplex
Valacyclovir, or acyclovir
Non-gonococcal urethritis
Cefixime plus azithromycin
All positive patients should be tested for GCNCT
All contacts in less 60 days should be traced
Mucopurulent cervicitis
Cefixime plus azithromycin
Or gentamycin plus azithromycin
Contact tracing up to 60 days
Epididymitis/orchitis
Levofloxacin if not sexually transmitted
Otherwise CTX and doxycycline
Pelvic inflammatory disease
Ceftriaxone plus doxycycline with or without metronidazole
Or levofloxacin with or without metronidazole
Bacterial vaginosis
Metronidazole or clindamycin, if symptomatic (unless pregnant then treat regardless)
Vulvovaginal candidiasis
Fluconazole
Trichomonas
Metronidazole
Scabies
Permethrin cream
Steroids for itch
Wash laundry and dry with high heat
Syphilis bacterium
Treponema pallidum
List of live vaccines
BCG
Zostavax
MMRV
Rotavirus
Smallpox, typhoid
Yellow fever
Common infections in asplenia
Pneumococcal most common
Meningococcal
HIB
Influenza
Hepatitis A/B
When to immunize for pneumococcal
H 65 or younger if specific risk factors
When you vaccinate for herpes zoster
Over 50 or immunosuppressed
Anyone who’s over 50 years old and VZV zero negative should be given varicella vaccine rather than herpes zoster
Special considerations for influenza immunization
Not recommended in children less than six months old as no effectiveness proven
And children less than nine years old recommend getting two doses, one month apart for their first vaccine
Mastitis treatment
Most common staph aureus
Cephalexin
Cloxacillin
Sulfamethimazole/trimethoprim
Bloody diarrhea bugs/ treatment
Avoid abx if suspect toxin (bloody, history of eating seed sprouts, rare beef, outbreak)
Otherwise fluoroquinolone or azithromycin
Bugs include shigella, campylobacter, c diff, travelers diarrhea, protozoal
Meningitis in <1mo bugs and drugs
Listeria monocytogenes
E. coli
GBS
Ampicillin and cefotaxime/gentamicin
Meningitis in >1mo bugs and drugs
S pneumo
HIB
Nisseria meningitidis
Vancomycin and CTX (add ampicillin if >50yr for listeria)
Dexamethasone if suspect s pneumo (decrease mortality) or HIB (decrease hearing loss)
Viral (aseptic) meningitis causative agents
Enterovirus
HSV
Lyme (borrelia burgdorferi - not a virus)
Acyclovir if suspect HSV encephalitis (personality/behaviour/cognition change)
Meningitis in immunocompromised bugs and drugs
Pseudomonas with meropenem
TB/cryptococcal coverage
Post exposure ppx for nisseria or HIB meningitis
NM - ciprofloxacin, rifampin, CTX
HIB - rifampin
Malaria organism
Plasmodium malriae
Malaria treatment/ppx
Malarone (avoid in children <5kg)
Mefloquine
Chloroquine
Doxycycline
Rule for pregnancy in Dengue/zika/chiungunya
Avoid pregnancy after return from endemic area 2 months for women and 6 months for men
Went to get typhoid vaccine
Travelling to south Asia
When to get meningitis vaccine?
Travelling to meningitis belt, Hajj
Went to get yellow fever vaccine
African is South African countries
Went to get Japanese and encephalitis vaccine
Travelling to rural Asia
Treatments for travelers, diarrhoea
Bismuth subsalicylate
-Can cause, black tongue, black stools, tinnitus, constipation
Imodium
Consider antibiotics if greater than four unformed, stool, daily, fever, blood or pus, high risk, including child, pregnant, elderly
- Ciprofloxacin, azithromycin (if pregnant)
- covers ETEC, Campylobacter, salmonella,
Spots of white on sea of red
Dengue fever
GBS bacteruria and intrapartum management
Bacteruria: amox or macrobid (not in labor) or septra (not in T1)
Labor: penicillin G or cefazolin or clindamycin
C diff treatment
Vancomycin
Flagyl
Fidaxomicin
Indication for vaccination against encapsulated organisms (and name the big 3 organisms)
Asplenia, sickle cell, thalassemia
Pneumococcal, HIB, meningococcal
Pertussis treatment
Erythromycin seven days or azithromycin in children under one month old
Most common bug in epiglottitis
Hemophilus influenza type B
Antibiotic recommended for peritonsillar and the retro pharyngeal abscess
Ampicillin or penicillin G
Live vaccines
BCG
Zostavax
MMRV
Rotavirus
Smallpox
Typhoid
Nasal influenza
Legionella
Levofloxicin
Dermatophyte infection (tinea)
Creams:
Ketaconazole
Terbinafine
Ciopirox
PO fluconazole/terbinafine if head or nails or refractory
Yeast (Malassezia)
Pityriasis vesicolor: antifungal oint, selenium, zinc
Seb dermatitis: antifungal shampoo (ketoconazole/selenium)
