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MK SR INDEX CASES CANCER CARE > Cancer Care Infections > Flashcards

Cancer Care Infections Flashcards

1
Q

Cancer Care: Choice of Antibiotics depends on

A
  • Site of infection
  • Potential organisms involved
  • Severity of infection and/or risk of rapid progression
  • Spectrum of different antibiotics
  • Known colonising flora - patient or environment
  • Any organ dysfunction- renal, hepatic
  • Any allergies
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2
Q

Cancer Care: How do we classify Organisms?

A 
• Gram positive – Staph/ Strep/ Pneumo
• Gram negative – Coliforms/ Pseudomonas
• Aerobic/ anaerobic
• Resistant organisms – MRSA/ ESBL/ VRE, Other resistant
gram negatives
• Atypical organisms
• C.difficile
• Fungal
• Mycobacteria
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3
Q

Cancer Care: Hospital superbugs

A
  • MRSA
  • Clostridium difficile
  • Multi-resistant gram-negatives
  • ESBL producers
  • Multi-resistant Acinetobacter
  • Multi-resistant Pseudomonas
  • Carbapenemase producing enterobacteriaceae(CPE)

• Other potential threats

  • MDR-TB
  • VHF
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4
Q

Cancer Care: Community superbugs

A
  • CA-MRSA
  • PVL Staphylococcus aureus
  • ESBL gram negatives
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5
Q

Cancer Care: Drug of choice for MSSA

A

DOC: Flucloxacillin

Alternative: Erythromycin, Cefuroxime, Teicoplanin/Vancomycin, Doxycycline

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6
Q

Cancer Care: Drug of choice for MRSA

A

DOC: Teicoplanin / Vancomycin

Alternatives: Daptomycin, Linezolid

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7
Q

Cancer Care: Drug of choice for Streptococci

A

DOC: Benpen, Amoxycillin

Alternatives: Erythromycin, Doxycycline, Cefuroxime, Teic/Vanc

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8
Q

Cancer Care: Drug of choice for Enterococci

A

DOC: Amoxycillin

Alternatives: Teic/Vanc, Linezolid

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9
Q

Cancer Care: Drug of choice for Coliforms

A

DOC: Amoxycillin, Co-amoxiclav, Gentamicin

Alternatives: Tazocin, Cephalosporin, Imipenem, Ciprofloxacin

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10
Q

Cancer Care: Drug of choice for ESBLs

A

DOC: Imipenem

Alternatives: based on sensitivities

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11
Q

Cancer Care: Drug of choice for Pseudomonas

A

DOC: Tazocin, Gentamicin

Alternatives: Imipenem, Ceftazidime, Ciproflxacin

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12
Q

Cancer Care: Drug of choice for C Difficile

A

DOC: Metronidazole / Vancomycin orally

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13
Q

Cancer Care: Drug of choice for Atypical pneumonia

A

DOC: Erythro/clarithromycin

Alternatives: Doxycycline, Ciprofloxacin

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14
Q

Cancer Care: coverage of amoxycillin

A

GP: Streptococci, Pneumo, Enterococci

GN: Coliforms

Other: Some anaerobes

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15
Q

Cancer Care: coverage of Co-amoxiclav

A

GP: Streptococci, Pneumo, Enterococci, Staphylococci

GN: Coliforms including BL producers

Other: Anaerobic

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16
Q

Cancer Care: coverage of Flucloxacillin

A

GP: Staphylococci

GN:

Other:

17
Q

Cancer Care: coverage of Tazocin

A

GP: Same as Co-amoxiclav (Streptococci, Pneumo, Enterococci, Staphylococci)

GN: Coliforms including BL producers, Pseudomonas

Other: Same as Co-amoxiclav (Anaerobic)

18
Q

Cancer Care: coverage of Erythromycin

A

GP: Streptococci, Pneumo, Staphylococci

GN:

Other:

19
Q

Cancer Care: coverage of Gentamicin

A

GP: Streptococci, Pneumo, Staphylococci
- Synergistic activity

GN: Coliforms including BL producers, Pseudomonas

Other:

20
Q

Cancer Care: coverage of Cefuroxime

A

GP: Streptococci, Pneumo, Staphylococci

GN: Coliforms

Other:

21
Q

Cancer Care: coverage of Ceftriaxone

A

GP: Streptococci, Pneumo, Staphylococci

GN: Coliforms

Other:

22
Q

Cancer Care: coverage of Ceftazidime

A

GP:

GN: Coliforms, Pseudomonas

Other:

23
Q

Cancer Care: coverage of Imipenem

A

GP: Streptococci, Pneumo, Enterococci, Staphylococci

GN: Coliforms including ESBL producers, Pseudomonas

Other: Some anaerobes

24
Q

Cancer Care: coverage of Ciprofloxacin

A

GP: May have activity against Staphylococci

GN: Coliforms, Pseudomonas

Other: Atypical

25
Q

Cancer Care: coverage of Doxycycline

oral only

A

GP: Streptococci, Pneumococci, Staphylococci

GN:

Other: Atypical

26
Q

Cancer Care: Which antimicrobials require monitoring for toxicity?

A
  • Aminoglycosides
  • Glycopeptides
  • Colistin
  • Others in special situations
27
Q

Immunocompromising conditions: Congenital conditions

A
  • B-cell and T-cell defects
  • Macrophage, cytokine, and miscellaneous defects
  • Phagocyte deficiency or dysfunction
  • Complement deficiencies
28
Q

Immunocompromising conditions: Acquired conditions

A
  • Malnutrition , Immunosenescence
  • HIV infection
  • Medical conditions : Cancer , Splenectomy, Pregnancy
  • Immunosuppressive drugs : Anti-cancer medication, Transplant
29
Q

neutropenic patients: Special risk sites

A

Ulcerated or damaged (by chemo/radio therapy) mucosal surfaces (mouth, whole GI tract)
Vascular lines, especially semipermanent (Hickman catheters, Port-a-Caths, central lines)
Empiric therapy must be started straight away (after collection of cultures)

30
Q

Most common organism associated with CVC infections

A

Staphylococcus epidermis, followed by Staphylococcus aureus. Gram- negative bacilli, fungi (Candida) and Mycobacteria are less common.

31
Q

Infection risks with monoclonal antibodies and ant-TNF

A
  • Prior to commencing anti-TNF, all patients should be screened for mycobacterial infection, hepatitis B/C/HIV
  • High index of suspicion for atypical and opportunistic infections
32
Q

Pneumonias in

Immunocompromised

A

Bacterial Infection - CAP pathogens include S. pneumoniae, H.influenzae, Mycoplasma, Legionella, Chlamydia, and others.
FungalInfection-Pneumocystisjirovecii,Aspergillus spp (especially A. fumigatus), and Cryptococcus neoformans.
Viral Infection - Cytomegalovirus , Influenza, Parainfluenza, and Respiratory Syncytial virus Parasites - Strongyloides stercoralis and Toxoplasma

MK SR INDEX CASES CANCER CARE (16 decks)

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