Drug/Bug Combos - Cases, PBL, + need to knows Flashcards

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1
Q

Staphylococcus aureus

A

cloxacillin

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2
Q

MRSA

A

vancomycin

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3
Q

Strep pyogenes

A

penicillin

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4
Q

Enteroccus faecalis

A

ampicillin +gentamicin (synergy)

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5
Q

Viridans group streptococci

A

penicillin or ceftriaxone

e.g. S. mitis

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6
Q

Haemophilus influenzae

A

cefuroxime or amoxicillin/clavulanate

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7
Q

Strep pneumoniae

A

amoxicillin (PO), penicillin or ceftriaxone (IV)

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8
Q

Enterobacteriaceae

A

gentamicin, ciprofloxacin, ceftriaxone

e.g. E. coli, Enterobacter spp. Salmonella spp. Proteus spp.

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9
Q

Anaerobes

A

metrinidazole

e.g. G+ : peptostreptococcus spp. clostridium spp. acintomyces spp. G- : bacteroides

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10
Q

Syphilis

A

organism: Treponema pallidum
Tx: IM benzathine penicillin

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11
Q

Giardia

A

metronidazole

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12
Q

4 TB medications

A

rifampin
isoniazid
pyrazinamide
ethambutol

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13
Q

Chlamydia tx

A

Doxycycline

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14
Q

MAC prophylaxis

A

Azithromycin

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15
Q

Toxoplasmosis prophylaxis

A

TMP/SMX

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16
Q

PJP tx

A

prophylaxis: TMP/SMX
treatment: TMP/SMX with prednisone

17
Q

UTI tx

A

organism 90% of time E. coli

1st line: Nitrofurantoin
Other empiric options: fosfomycin or amoxicillin/clavulanate
High resistance levels: TMP/SMX, Cipro
If pregnant: Amoxicillin

18
Q

Acute Bronchitis - cause and tx

A

most common cause: common cold viruses (e.g. rhinovirus)
invasive respiratory viruses cause more sever symptoms (e.g. influenza, adenovirus, parainfluenxa, RSV)

Tx: NO antibiotics. wash hands, stop smoking, fluids, cough suppressants, bronchodilator if coughing for significant amount of time

19
Q

Is ear pain common with colds without it being AOM?

A

Yes! due to fluid building up in Eustachian tube. If normal movement of tympanic membrane, not AOM

Tx with analgesic

20
Q

Tx of AOM

A

Children >2 yrs with unilateral AOM: acetaminophen and watchful waiting for 48 hrs

Antibiotics if: not better in 48 hr, eardrum perforated, unresponsive to analgesic, recurrent, < 6 mo old, bilateral, unlikely to return for follow up

Tx: amoxicillin to cover for S. pneumo

21
Q

Otitis Media With Effusion - cause and when do you start to treat

A

fluid remaining post infection.
not an issue unless prolonged for >3-6 months
50% of children will have fluid in their ears for 1 month post AOM

22
Q

Tx of severe cellulitis in diabetic pt

A

begin broad and narrow with improvement and C/S results

Piperacillin-Taxobactam, 4th gen cephalosporin (cefepime) or carbapenem

If at risk for MRSA (known colonization, Hx, pop prevalence 30-50%): IV vancomycin

23
Q

Pseudomonas

A

Ciprofloxacin or Pipercillin-tazobactam

24
Q

Asymptomatic bacteruria tx

A

No symptoms = no UTI = no antibiotics
very common in elderly pts (50% of nursing home pt)

2 situations to treat: pregnant, urologic procedure

25
Q

VZV tx

A

acyclovir, famciclovir, and valacyclovir are effective at reducing severity and duration of symptoms and shedding if started withint 72 hours of rash onset

reduce risk of exposing susceptible individuals: neonates, pregnant women, immmunocompromised

26
Q

What skin infection commonly complicates zoster? Organisms, tx

A
cellulitis 
common organisms: beta-hemolytic strep and staph aureus 
Tx: cephalexin or cloxacillin 
MRSA - vancomycin 
B-lactam allergy - clindamycin
27
Q

What is the complication of zoster leading to long-term pain and paresthesias? Tx

A

Post-herpetic neuralgia

1st line: Amitriptyline (Tricyclic antidepressant; low dose for pain control) Gabapentin (anticonvulsant; useful for nerve pain)

2nd line: opiods b/c of abuse and addition potential

28
Q

Treatment of mild and severe traveller’s diarrhea

A

often self-limited (~3 days) so no need for antibiotics
give support therapy (fluids, etc)

if prolonged, severe, or b/c of shigellosis, typhoid fever or cholera treat with abx

29
Q

When are antibiotics contraindicated for diarrhea?

A

if its caused by enterohemorrhagic E. coli

30
Q

TB treatment

A

Drug sensitive disease: 2 months of rifampin. pyrazinamide and isoniazid (INH) followed by 4 months of INH and rifampin

If not sensitive to all first line drugs, add ethambutol

31
Q

HSV tx in children

A

acylovir

note: valacylovir not approved for children

32
Q

Treatment of P. vivax (from PBL case)

A

Chloroquine followed by primaquine

choloroquine works on erythrocyte stage and primaquine eliminates liver forms