E3 URTI Flashcards
acute bronchitis:
most common pathogens
he just says respiratory viruses
4 things listed under acute bronchitis
- self-limiting
- symptomatic management
- corticosteroids not necessary
- antibiotic therapy not necessary (please) *
number needed to harm for antibiotic use in acute bronchitsi
5!!!!!
established diagnosis of chronic bronchitis
chronic cough with productive sputum on most days for >3 consecutive months for 2 consecutive years
3 hallmark signs of acute bronchitis exacerbation
- inc sputum purulence
- inc sputum volume
- inc cough or SOB
3 most common organisms for acute bronchitis
strep pneumo
h. influenzae
moraxella
2 common organisms for pts with frequent antibiotic use
- enterobacterales
- pseudomonas
3 preferred treatment options for acute exacerbation of chronic bronchitis
- augmentin
- cefuroxime
- cefpodoxime
3 alternate treatment options for acute exacerbation of chronic bronchitis
- doxy
- bactrim
- azithro
1 treatment option for acute exacerbation of chronic bronchitis WITH risk for pseudomonas
levofloxacin
2 most common pathogens for acute pharyngitis
- respiratory viruses
- strep pyogenes (group A)
5 things for clinical pres of acute pharyngitis
- sudden onset of sore throat with fever
- pharyngeal hyperemia and tonsillar swelling
- enlarged, tender lymph nodes
- red, swollen uvula
- petechiae on soft palate
2 main testing things for acute pharyngitis
- culture of the throat
- rapid antigen detection tests (RADT)
what should you do if the RADT test comes back negative for pharyngitis?
backup testing with culture or PCR-based test*
targeted treatment/organism and 2 drugs of choice for acute pharyngitis
target: strep pyogenes
drugs: penicillin VK, amoxicillin
what are the alternative options for acute pharyngitis if there is a pen allergy
- cephalexin
- cefadroxil
- cefuroxime
- cefpodoxime
2 treatment options for acute pharyngitis with an anaphylactic reaction to pen
azithromycin
clindamycin
4 types of bacterial rhinosinusitis
acute
viral
acute bacterial
recurrent
descriptions for acute rhinosinusitis:
(3)
- purulent nasal drainage
- nasal obstruction, facial pain/pressure
- may last >4 weeks
descriptions for viral rhinosinusitis:
(2)
- acute rhinosinusitis thought to be due to a viral pathogen
- sxs present < 10 days, not worsening
descriptions of acute bacterial rhinosinusitis:
(4)
- acute rhinosinusitis thought to be due to bacterial pathogen
- persistent sxs >10 days with no improvement
- severe sxs - feveer, purulent nasal discharge, facial pain for 3-4 consecutive days at beginning of illness
- worsening sxs - new onset of symptoms after initial improvement in sxs
1 description for recurrent acute rhinosinusitis
- 4 or more episodes of ABRS per year
3 main things to know from acute bacterial rhinosinusitis (he said this in class)
- persistent sxs: >__ days
- severe sxs: (list most imp one)
- worsening sxs: (description)
- 10
- fever
- start to feel better than relapse
description of chronic rhinosinusitis
> 2 signs/sxs for 12 weeks or longer
3 most common pathogens for acute bacterial rhinosinusitis
- strep pneumo
- h flu
- moraxella
2 additional pathogens for acute bacterial rhinosinusitis in pts with frequent antibiotic use
staph a (MRSA/MSSA)
pseudomonas
what are the two approaches to ABRS treatment
- initiate antibiotic tx as soon as bacterial infection established
- watchful waiting up to 7 days to observe if improvement occurs w/out tx
what are the 2 first line tx options for ABRS? (kinda)
normal and high dose amox/clav
3 second line treatment options for ABRS
- doxy
- levo
- moxi
what 3 classes and one drug are NOT recommended for tx of ABRS and why
- oral 2nd gen cephs
- oral 3rd gen cephs
- macrolides
- bactrim
due to S. pneumoniae resistance
ABRS treatment if there is a concern for MRSA (4)
doxy
bactrim
linezolid
clindamycin (he had a ? by this)
important pearl for treating ABRS with concern for MRSA
you want to keep coverage of the other common organisms unless culture suggests that it is monomicrobial for MRSA
treatment for ABRS with concern for pseudomonas and little pearl that goes along with that
levofloxacin, use 750 mg dose instead of 500 *****
supportive care for ABRS:
a lot of them are easy but i highlighted two so what are they
- avoid antihistamines -> thickens mucus, harder to clear
- caution w/ decongestants -> concern for rebound congestion
