Clinical Uses of Antimicrobials

Question 1

G+ Drugs

Answer 1

PCN G+V
Anti-staph PCNs
1st gen Cephalosporins
Vanco, Dapto
Bacitracin
Streptogramins

Question 2

G- Drugs

Answer 2

Anti-pseudomonal PCNs
Aztreonam
2nd gen Cephalosporins

Question 3

Aerobic only

Answer 3

Aztreonam

Aminoglycosides

Question 4

Anaerobic only

Answer 4

Metronidazole

Question 5

Bactericidal

Answer 5

Aminoglycosides
Beta-lactams
Fluoroquinolones
Metro
Vanco
Streptogramins

Question 6

Bacteriostatic

Answer 6

Clindamycin
Macrolides
Sulfonamides
Tetracyclins
TMP

Question 7

Surgical Prophylaxis (>50% infection in untreated)

Answer 7

GI
Hysterectomy
C-section
Joint replacement
Open fracture surgery

Question 8

Renal Elimination

Answer 8

Aminoglycosides
Most cephalosporins
Fluoroquinolones
PCN
Sulfonamides
Tetracyclines (except Doxy)
TMP-SMX
Vanco

Question 9

Hepatic Elimination

Answer 9

Chloramphenicol
Clindamycin
Clarithromycin
Erythromycin
Nafcillin

Question 10

Aminoglycoside effect on Fetus/Neonate

Answer 10

Damage to CN VIII

Question 11

Tetracycline, Glycylcycline effect on Fetus/Neonate

Answer 11

Tooth enamel dysplasia

Inhibition of bone growth

Question 12

Sulfonamide effect on Fetus/Neonate

Answer 12

Kernicterus

Question 13

Chloramphenicol effect on Fetus/Neonate

Answer 13

Gray baby syndrome

Aplastic anemia

Question 14

Fluoroquinolone effect on Fetus/Neonate

Answer 14

Cartilage damage

Question 15

Nitrofurantoin effect on Fetus/Neonate

Answer 15

Hemolytic anemia

Question 16

TMP effect on Fetus/Neonate

Answer 16

Folate deficiency

Question 17

Clarithromycin effect on Fetus/Neonate

Answer 17

Embryotoxic

Question 18

Goals of Non-surgical prophylaxis

Answer 18

Prevent CMV, HIV, Influenza, Meningococcemia, TB, bites, chronic bronchitis

Question 19

Cardiothoracic surgery prophylaxis

Answer 19

Cefazolin

MRSA - Cefazolin + Vanco

Question 20

Colorectal surgery prophylaxis

Answer 20

Ampicillin

Sulbactam

Question 21

Vascular surgery prophylaxis

Answer 21

Cefazolin or Cefuroxime

Question 22

General/Neuro/Ortho surgery prophylaxis

Answer 22

Cefazolin

Question 23

Cardiothoracic surgery prophylaxis PCN allergy

Answer 23

Vanco

Aztreonam

Question 24

Colorectal surgery prophylaxis PCN allergy

Answer 24

Ciprofloxacin + Metro or Clindamycin

Question 25

General/Ortho/Vascular surgery prophylaxis PCN allergy

Answer 25

Vanco | Clindamycin

Question 26

Neuro surgery prophylaxis PCN allergy

Answer 26

Vanco

Question 27

Beta-Lactamase G+ MDR

Answer 27

Anti-staph PCN

Question 28

Beta-Lactamase G+, G- MDR

Answer 28

Carbapenems

Question 29

Beta-Lactamse G- MDR

Answer 29

Aztreonam

Question 30

MRSA and enterococci MDR

Answer 30

Vanco

Question 31

MRSA, enterococci and VRE

Answer 31

Daptomycin

Question 32

Backup for MDR G+, G-

Answer 32

Tigecycline

Question 33

MRSA and VRE

Answer 33

Streptogramins | Linezolid

Question 34

TB, MRSA, Meningitis prophylaxis

Answer 34

Rifampin

Question 35

Most common cause of C. Diff

Answer 35

Clindamycin

Question 36

Common causes of C. Diff

Answer 36

Ampicillin/Amoxicillin Cephalosporins Fluoroquinolones

Question 37

Occasionally cause C. Diff

Answer 37

PCN Erythromycin TMP

Question 38

Rarely cause C. Diff

Answer 38

``` Tetrocycline Metro Vanco Fidaxomicin Aminoglycosides ```

Question 39

DOC C. Diff

Answer 39

Metro

Question 40

C. Diff Tx

Answer 40

Metro Vanco Fidaxomicin Stool infusion

Question 41

Any empirical Adult Meningitis Tx

Answer 41

Vanco and Ceftriazone (3rd)

Question 42

Meningitis Prophylaxis

Answer 42

Rifampin Cipro Ceftriaxone (IMPORTANT)

Question 43

Community S. pneumoniae

Answer 43

PCN G | Ceftriaxone

Question 44

Community N. meningitidis

Answer 44

PCN G | Ceftriaxone

Question 45

Community H. influenza

Answer 45

Ceftriaxone

Question 46

Post-traumatic/Surgical S. epidermidis

Answer 46

Vanco

Question 47

Post-traumatic/Surgical S. aureus

Answer 47

Oxacillin

Question 48

Post-traumatic/Surgical P. aeruginosa

Answer 48

Ceftazidime + Gentamicin

Question 49

Post-traumatic/Surgical S. pneumoniae

Answer 49

PCN G | Centriaxone

Question 50

Immunocompromised Listeria

Answer 50

Ampicillin + Gentamicin

Question 51

Immunocompromised P. aeruginosa

Answer 51

Ceftazidime + Gentamicin

Question 52

Immunocompromised S. pneumoniae

Answer 52

Vanco + 3rd gen Cephalosporin

Question 53

Community PNA healthy

Answer 53

Macrolide | Doxycycline

Question 54

Community PNA with comorbidities

Answer 54

Resp fluoroquinolones | Beta-lactam + Macrolide

Question 55

Community PNA inpt non-ICU

Answer 55

Resp fluoroquinolones | Beta-lactam + Macrolide

Question 56

Community PNA inpt ICU

Answer 56

Beta-lactam with | Azithromycin or Resp Fluoroquinolone

Question 57

Community PNA inpt ICU PCN allergy

Answer 57

Resp Fluoroquinolone + Aztreonam

Question 58

Most common cause of Infective Endocarditis

Answer 58

Staph/Strep (viridans)

Question 59

Infective Endocarditis Native valve (viridans/bovis)

Answer 59

PCN G or Ceftriaxone + Gentamicin

Question 60

Infective Endocarditis Native valve (viridans/bovis) PCN allergy/MRSA

Answer 60

Vanc or Ceftriaxone + Gentamicin

Question 61

Infective Endocarditis Native valve (viridans/bovis) with high MIC

Answer 61

Ampicillin/Vanco + Gentamicin

Question 62

Infective Endocarditis Native valve (staph)

Answer 62

Nafcillin | Oxacillin

Question 63

Infective Endocarditis Native valve (staph) PCN allergy

Answer 63

Cefazolin

Question 64

Infective Endocarditis Native valve (staph) resistant

Answer 64

Vanco

Question 65

Infective Endocarditis Prosthetic valve

Answer 65

Vanco + Gentamicin +/- Rifampin

Question 66

Infective Endocarditis resistant to Vanco

Answer 66

Linezolid/Dapto

Question 67

Endocarditis prophylaxis

Answer 67

Oral amoxicillin

Question 68

Endocarditis prophylaxis PCN allergy

Answer 68

Clindamycin Cephazolin Macrolide

Question 69

Endocarditis prophylaxis IV

Answer 69

Ampicillin

Question 70

Endocarditis prophylaxis IV PCN allergy

Answer 70

Clindamycin | Cefazolin

Question 71

DOC Syphilis

Answer 71

PCN G

Question 72

Syphilis, pregnant, PCN allergy

Answer 72

Desensitization

Question 73

Jarisch-Herxheimer Reaction

Answer 73

Fever, chills, myalgia, tachy | Pretreat with prednisolone and continue PCN

Question 74

UTI Tx (E. coli)

Answer 74

Cotrimoxazole Cipro Nitrofurantoin Amoxicillin + Clavulanic acid

Question 75

Pregnant + UTI

Answer 75

PCN Cephalosporins Nitrofurantoin