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Need to know > Bugs & Antibiotics > Flashcards

Bugs & Antibiotics Flashcards

1
Q

Causes of osteomyelitis

A 
Staph aureus 
Other staph spp
Strep 
Enterococci 
E coli 
Klebsiella 
Pseudomonas

Paed: kingella, HiB

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2
Q

Treatment of osteomyelitis

A

Flucloxacillin 50mg/kg IV to 2g Q6H

Add vancomycin 15-20 mg/kg IV IBW or paed 25-30 mg/kg IV

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3
Q

Causes of septic arthritis

A

Staphlococcus aureus
Streptococcus
Neisseria meningiditis (sexually active adults)

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4
Q

Treatment of septic arthritis

A

Flucloxacillin 50mg/kg IV Q6H

Add vancomycin 15-20 mg/kg (or 25-30mg/kg paeds) IV

If gram positive chain or gram negative - add ceftriaxonw 50mg/kg to 2g IV Daily

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5
Q

Treatment of diabetic foot infection

A

Moderate: Amoxycillin/clavulanic acid 1g/200mg IV Q8H
Severe: Piperacillin/Tazobactam 4.5g IV Q6H
- alt ciprofloxacin plus clindamycin

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6
Q

Causes of infective endocarditis

A

Native valve:

  • staph aureus
  • strep viridans
  • enterococci
  • HACEK: haemophilus, aggregatibacterium, cardiobacterium, eikenella, kingella

Prosthetic valve:

  • staph aureus
  • Corynebacterium
  • Strep
  • Enterococci
  • E coli
  • Pseudomonas
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7
Q

Treatment of infective endocarditis

A

Benzylpenicillin 50mg/kg to 1.8g Q4H
Flucloxacillin 50mg/kg to 2g IV Q4H
Gentamicin 5-7 mg/kg IV

If suspected MRSA, prosthetic valve or ICD or septic shock, replace benpen with Vancomycin 25-30 mg/kg

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8
Q

Causes of meningitis

A

> 2 months:

  • Strep penumonia
  • Neisseria meningiditis
  • > 50, immunocomp, alcoholic: listeria
  • Unvacc paed: HIB

< 2 months:

  • GBS (agalactiae)
  • E coli
  • Listeria
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9
Q

Treatment of meningitis

A

> 2 months: Ceftriaxone 50mg/kg to 2g IV BD plus dexamethasone 0.15mg/kg IV to 10 mg Q6H
- listeria: add benzylpenicillin 2.4g IV Q4H

< 2 months:

  • Benzylpenicillin 60mg/kg IV to 2.4g
  • Cefotaxime 50mg/kg IV
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10
Q

Treatment of encephalitis

A

Acyclovir 20mg/kg IV to 12 yrs, then 10mg/kg IV Q8H

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11
Q

Causes of encephalitis

A

Adult:

  • HSV
  • VZV
  • Enteroviruses
  • Listeria, toxoplasmosis

Paed:

  • Enteroviruses
  • HSV
  • Herpes viruses - EBV, CMV, VZV
  • Aboroviruses
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12
Q

Brain Abscess causes

A 
Polymicrobial 
- Streptococcus 
- anaerobes 
Surgical - staph aureus 
Ear - gram neg 
Immunocomp - Nocardia, toxo, cryptococcus, candida, aspergillosis
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13
Q

Treatment of brain abscesses

A

Ceftriaxone 2g IV BD

Metronidazole 12.5mg/kg to 500mg IV Q8H

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14
Q

Treatment of clamydia trachmatis

A

Doxycycline 100mg PO BD for 7 days

OR azithromycin 1g PO once

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15
Q

Treatment of neisseria gonorrhoea

A

Ceftriaxone 500mg IM/IV
PLUS
Azithromycin 1g PO

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16
Q

Sexually transmitted epididymoorchitis treatment

A

Ceftriaxone 500mg IM/IV

Doxycycline 100mg PO BD for 7 days (or azithromycin 1g PO and rpt 1 week)

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17
Q

Primary gential herpes infection treatment

A

Acyclovir 400mg PO Q8H for 10 days

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18
Q

Non-severe PID treatment

A 
Ceftriaxone 500mg IV/IM 
PLUS 
Metronidazole 400mg PO BD for 14 days 
PLUS 
Doxycycline 100mg PO BD for 7 days (or azithromycin 1g PO rpt in 1 week)
19
Q

Severe PID treatment

A

Ceftriaxone 2g IV daily
Azithromycin 500mg IV daily
Metronidazole 500mg IV BD

20
Q

Post-procedural Pelvic infection treatment

A

Mild-Mod: Amoxycillin claviculanic acid 875/125 PO BD for 14 days

Severe:

  • Gentamicin 5-7 mg/kg IV TBW
  • Amoxycillin 2g IV Q6H
  • Metronidazole 500mg IV BD
21
Q

Treatment of prostatitis

A

Trimethoprim 300mg PO daily for 2 weeks

If severe

  • Gentamicin 5-7 mg/kg IV
  • Ampicillin 2g IV Q6H
22
Q

Treatment of endopthalmitis or penetrating eye injury

A

Intravitreal: ceftazidime and vancomycin

Exogenous - moxifloxacin 400mg or ciprofloxaacin 750 mg PO

If IV needed: IV ceftazidime and vancomycin

23
Q

Febrile neutropaenia treatment

A

Piperacillin tazobactam 4.5g IV Q6H

If risk MRSA - add vancomycin
If septic shock - add gentamicin 5-7 mg/kg IV (to Pip taz)

24
Q

Initial antiretroviral treatment in adults

A

Dolutegravir, abacavir and lamivudine

25
Q

Treatment of acute cholangitis

A

Ampicillin 2 g
Gentamicin 5-7 mg/kg IV

metronidazole if chronic biliary obstruction

26
Q

Treatment of acute appendicitis

A

Gentamicin 5-7 mg/kg IV
Metronidazole 500mg IV BD
Amoxycillin 2g IV Q6H

Delayed hyersensitivity: cef & metro
If immediate hypersensitivity to penicillin: gent and clinda

27
Q

Treatment of spontaneous bacterial peritonitis

A

Ceftriaxone 2g IV Daily

28
Q

Organisms involved with suspected peritonitis in peritoneal dialysis patient

A 
Staph epidermidis
Staph aureus 
Etnerobacteriae
Streptococcus 
Enterococcus
29
Q

Empirical therapy of peritonitis in peritoneal dialysis patient

A

Intermittent administration, intraperitoneal
Gentamicin 0.6 mg/kg to 50mg in 1 bag of dialyis fluid per day
Cefazolin 15 mg/kg in 1 bag of dialysis fluid per day

If known to have MRSA, replace cefazolin with vancomycin
If suspected bowel perf: add metronidazole 400mg PO BD

30
Q

Contraindications to aminoglycosides

A

History of aminoglycoside vestibular / auditory toxicity
History of severe hypersensitivity reaction to aminoglycoside
Myasthenia Gravis

Precaution / generally avoid if:

  • pre-existing significant hearing impairment
  • pre-existing vestibular condition
  • first degree relative with aminoglycoside induced auditory toxicity
31
Q

Treatment of melioidosis

A

Meropenem 1g IV Q8H

32
Q

Initial treatment of uncomplicated malaria

A

Quinine sulfate 600 mg PO Q8H
PLUS
Doxycycline 100mg PO BD (adult) or clindamycin

PLUS single dose primaquine 15mg PO

33
Q

Treatment of helmithic infection

A

Mebendazole 100 mg PO BD for 3 days (single dose for threadworm)

Albendazole 400mg PO BD for 3 days (strongyloidiasis,

34
Q

Post-exposure prophylaxis Hep B

A

Exposed person immune - nil further
Exposed non-immune
- source negative - HBV vaccination course ASAP < 24 hrs
- Source positive / unknown
– test exposed at baseline and 6 months for HBsAg
–start vaccination course < 24 hrs
–HBV IgG within 72 hrs

35
Q

HIV PEP required if

A

Source HIV positive / detectable viral load

  • Intercourse (anal/vaginal)
  • Non-occupational MM/not intact skin exposure
  • Occupational MM / broken skin / needle stick
  • Shared injecting equipment

If HIV status unknown, PEP for sexual or injecting equipment not required, unless source MSM/high prevalence group (>1% country)

If source is high risk & occupational exposure, consider 2 drug regimen

36
Q

HIV PEP regimen

A

Lamivudine 300 mg PO daily for 4 weeks
Tenofovir 300 mg PO daily for 4 weeks

If 3 drug:
Dolutegravir 50mg PO daily for 4 weeks

37
Q

Standard short course therapy for TB

A

Isoniazid 300 mg PO Daily for 6 months
Rifampicine 600 mg PO daily for 6 months
Ethambutol 1200 mg PO daily for 2 months
Pyrazinamide 2g daily for 2 months

38
Q

Treatment of acute rheumatic fever

A

Benzathine benzylpenicillin IM 1.2 million units

39
Q

Treatment of sepsis/septic shock, source not apparent in an adult

A

Flucloxacillin 2g IV Q4H
Gentamicin 5-7mg/kg IV

Meningitis suspected - ceftriaxone 2g IV
MRSA suspected - vancomycin 25-30 mg/kg

40
Q

Treatment of sepsis/septic shock in children

A

< 2 months:
Benzylpenicillin 60mg/kg IV and cefotaxime 50mg/kg IV

> 2 months:
Ceftriaxone 100mg/kg (to 4g) IV Daily
Flucloxacillin 50mg/kg (to 2g) IV Q6H

41
Q

Causes of necrotising skin and soft tissue infections

A 
Streptococci (pyogenes)
Clostridium perfringes 
Staph aureus 
Vibrio spp 
E Coli 
Bacteroides fragilis
42
Q

Empirical therapy for necrotising skin and soft tissue infections

A

Meropenem 20 mg/kg to 1g IV Q8H
Vancomycin 25-30 mg/kg IV
Clindamycin 15 mg/kg IV to 600 mg IV Q8H

If water associated - add ciprofloxacin 400mg IV Q8H

43
Q

When is tetanus vaccine indicated

A

If < 3 doses of vaccine recieved
If > 3 doses of vaccine, but > 5 yrs (other wound) or > 10 yrs since last dose
** 9-13 year olds

44
Q

When is tetanus immunoglobulin indicated

A

If < 3 doses of tetanus toxoid, and not clean minor wound

If humoral immune deficiency or HIV if not clean minor wound

Need to know (5 decks)

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