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Infectous Disease > Dr. Cluck Treatment > Flashcards

Dr. Cluck Treatment Flashcards

1
Q

S. aureus

A

-most virulent Gram (+)
-Staph. -> produces β-lactamase

-Only coagulase-positive Staphylococci -> Abscess
-causes bacteremia, skin soft tissue infections, endocarditis, pneumonia, abscesses, osteomyelitis, food-borne illness, toxic shock syndrome

NEVER a contaminant

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2
Q

Treat S. aureus (MSSA)

A

If severe (in the blood) > IV

MSSA: Antistaph. bc they are ß-lactamase resistant
-> C D M N O OR 1st Gen Cephalosporin

IV: Nafcillin, Cefazolin
PO: Dicloxacillin, Cephalexin

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3
Q

Treat S. aureus (MRSA)

A

MRSA:
IV: Vancomycin OR Linezolid, Tigecycline Daptomycin, Ceftaroline

PO: Doxycycline, Clindamycin, TMP-SMX

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4
Q

Staphylococcus epidermidis

A

-CoNS: coagulase negative
-can cause disease. but is often a contaminant
-bloodstream infections, endocarditis, and prosthetic device infections -> BIOFILM

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5
Q

Treat Staphylococcus epidermidis

A

-MRSA
I-f truly infected: Vancomycin

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6
Q

Staphylococcus saprophyticus

A

-often UTI in young females
-does NOT produce ß-lactamase (EXCEPTION)

-> So treat with PNC, TMP-SMX or FQ

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7
Q

Streptococcus pyogenes - Gr A

A

-do not produce a β-lactamase
-strep throat and cellulitis
-can cause necrotizing fasciitis (emergency - dead tissue) and toxic shock

-post-infection sequelae: glomerulonephritis and rheumatic fever

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8
Q

Treat Streptococcus pyogenes - Gr A
NO ß-L

A

-no resistance
-Penicillin
-In case of necrotizing fasciitis PNC and Clindamycin (against toxins, decrease inflammation)
-PNC allergic: Clindamycin, TMP-SMX

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9
Q

Streptococcus agalactiae Gr B

A

-Normal inhabitant of the GI tract and lower GU tract
-neonatal infections (eg meningitis)
-colonizer of the vagina

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10
Q

Treat Streptococcus agalactiae Gr B
No ß-L

A

Penicillin

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11
Q

Streptococcus bovis/S. gallolyticus
Gr D

A

-Normal in GI
-marker of colonic neoplasia if found in the blood
-can cause infective endocarditis

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12
Q

Treat Streptococcus bovis/S. gallolyticus
No ß-L

A

-Penicillin

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13
Q

Streptococcus pneumoniae

A

-Captain of the men of death
-AUT Syndrome: meningitis, endocarditis, and pneumonia
-Virulence increased by capsule

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14
Q

Treat Streptococcus pneumoniae
No-ß-L

A

-Penicillin resistance at 30%
-β-lactam or FQ

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15
Q

Viridans streptococci

A

-normal GI flora (including oral cavity)
-endocarditis, poor dentition, damaged heart valves
-Streptococcus anginosus belongs to this group (causes abscesses)

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16
Q

Treat Viridans streptococci

A

Penicillin
-ß-lactam resistance is rising

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17
Q

Enterococcus

A

-Normal bowel flora
-wound infections, endocarditis, and UTIs (NOT pneumonia)

-E. faecalis is often more drug-susceptible
-E. faecium is more drug-resistant

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18
Q

Treat Enterococcus faecalis

A

ß-lactams are only static against Enterococcus

-Amino penicillins plus an aminoglycoside (Ampicillin + Gentamycin - SYNERGY)
OR linezolid, daptomycin

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19
Q

Treat Enterococcus faecium

A

ß-lactams are only static against Enterococcus

-Vancomycin OR linezolid, daptomycin

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20
Q

Mycobacteria

A

-causes (tuberculosis, leprosy - lepra -skin, nerves)
-it has a lipid-rich cell wall causing it to stain poorly -> “acid-fast”

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21
Q

Treat Mycobacteria

A

-M. tuberculosis requires 4 drug therapy
-Non-tuberculosis Mycobacteria (NTM) have variable susceptibilities -> may be resistant to anti-tuberculosis agents

-NTM: M. chelonae, M. abscessus, M. fortuitum, M. marinum

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22
Q

Bacillus

A

-known are B. anthracis, B. cereus
-B. cereus produces an enterotoxin (Chinese food)

23
Q

Treat Bacillus

A

only supportive, antibiotics are not necessary
(for B. cereus foodborne illness)

B. anthrax: Ciprofloxacin?

24
Q

Listeria monocytogenes

A

-found in soil, water, and the GI tract of animals, home-made cheese, unpasteurized milk
-cause meningitis

25
Q

Treat Listeria monocytogenes

A

if invasive: Ampicillin or TMP-SMX
VNC or Meropenem
NO Cephalosporin is active against Listeria

26
Q

Clostridium

A

Anaerob Garam (+) rod

-C. perfringens: food-borne illness and gas gangrene
-C. difficile: pseudomembranous colitis
-C. tetani and C. botulinum: different typed paralysis

27
Q

Treat C. diff

A

ORAL VNC - the only one to treat with PO VNC!!
mild to moderate: PO VNC or fidaxomicin

severe: PO VNC + IV metronidazole

28
Q

Moraxella catarrhalis

A

-colonizer of the upper respiratory tract
-may cause many diseases: Comm. ac. pneumonia, otitis media, sinusitis
-produce ß-lactamase inconsistently

29
Q

Haemophilus influenzae

A

-similar to Moraxella
-colonizer of the upper respiratory tract
-Type B capsule versus non-typeable strain

-Vaccination available

29
Q

Treat Moraxella catarrhalis

A

-Amoxicillin
typically doesn’t produce ß-lactamase

30
Q

Acinetobacter spp.

A

-Essentially ubiquitous (isolated from food, hospitals, soil, skin)
-highly resistant and deadly
-ß-lactamase doesn’t work

-sulbactam (protects the ß-lactam drug - usually has no activity) here: has microbial activity

31
Q

Treat Acinetobacter spp.

A

-multiple ways to treat
-Carbapenems

32
Q

Neisseria

A

-N. gonorrhea and N. meningitidis
-N. meningitidis causes meningitis
-N. gonorrhoeae causes gonorrhea (STI) and PID (pelvic inflammatory disease)
-Both encapsulated

33
Q

Treat Neisseria

A

-N. meningitidis with 3rd Gen Cephalosporin/sometimes with Pen G bc some do not produce ß-lactamase

-N. gonorrhoeae with Cephalosporins

Alternative: FQ, Macrolides (high dose)

34
Q

Enterics

A

-belong to the family of Enterobacterales
-Salmonella and Shigella are NOT part of
normal human flora

-Ecoli and Klebsiella produce ESBL (ESBLs hydrolyze 3rd GEN cephalosporins)

-Enterobacter is the prototype organism for AmpC (ß-lactamases cutting many ß-lactams)

35
Q

Treatment Enterics
(E.coli, Enterobacter, Citrobacter)

A

-Treatment depends on the characteristics of the drug, the context of the patient
-Therapy should be broad
-piperacillin-tazobactam, cefepime, or a carbapenem -> depends on the case

35
Q

Treat E. coli and Klebsiella

A

Carbapenem

36
Q

Pseudomonas aeruginosa

A

-aerobic gram (-) rod
-multidrug-resistant

37
Q

Anaerobes

A

-often in a harmless commensal relationship with the host
-Trauma or immunocompromised can cause infection

38
Q

Treating Anaerobes

A

Metronidazole, Clindamycin, Carbapenem

39
Q

Zoonotics

A
40
Q

Treat Zoonotics

A

-Doxycycline 100mg BID for 7 days - NOT in pregnancy

-In pregnancy: chloramphenicol

41
Q

Borrelia burgdorferi

A

causes Lyme disease
-transmission via an arthropod vector – ticks
-Treat with doxycycline or a β-lactam

42
Q

Chlamydophila

A

causes atypical pneumonia (Chlamydophila pneumoniae)

treat with Doxycycline

43
Q

Chlamydia

A

-STD

Treat with high intracellular concentrations such as macrolides or tetracycline

44
Q

Which drug class is excreted via glomerular filtration (kidney)

A

Aminoglycosides and Tetracyclines

45
Q

Which drug is associated with Disulfiram reaction as an adverse effect?

A

Metronidazole

46
Q

Which drug class is appropriate for respiratory infections?

A

Macrolides

47
Q

Which drug class is associated with Nephrotoxicity - Ototoxicity - Neuromuscular blockade (N-O-N)

A

Aminoglycosides

48
Q

Which drug lacks activity to Acinetobacter - Pseudomonas - Enterococcus

A

Ertapenem

49
Q

Which drug can result in Falconi syndrome, when taken after expiration date?

A

Tetracyclines

50
Q

Which organisms are NOT covered by tigecycline?

A

-Pseudomonas
-Proteus
-Providencia
-Morgonella

51
Q

Which drug is associated with an increase in potassium level?

A

-Trimethoprim-sulfamethoxazole
-Trimethoprim structure is similar to triamterene = potassium-sparing diuretic)

Infectous Disease (29 decks)

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