Exam 1 Flashcards
AOM 1st line therapy
No antibiotics within 30 days- Amoxicillin 90mg/kg divided q12h
Antibiotics within 30 days or severe symptoms- Amox-clav
Alternative: cefdinir 14mg/kg/day divided q12h
AOM Failed Therapy
Ceftriaxone 50mg/kg/day x3days
or
Clindamycin 30-40mg/kg/day divided q8h AND/OR cephalosporin
AOM Treatment Length
Under 2 yrs: 10 days
2-5yrs: 7 days
Over 6 yrs: 5-7 days
Adult: 10 days
ABS 1st line therapy
Amox-clav: 875/125- 1t q12h
ABS 2nd line therapy
Amox-clav: 1000/62.5- 2t q12h
Doxycycline: 100 mg bid
Clindamycin: 300-450 mg tid
AND
Cefpodoxime: 200mg bid
Levofloxacin: 750 mg daily
ABS Treatment Duration
Normal: 5-7 days
Severe: 7-10 days
Empiric Treatment of Meningitis
**1month-50yrs:
Ceftriaxone 2g IV q12h +
Vancomycin: 15-20mg/kg IV q8-12 hrs (2g loading dose and 1.25g q8-12hrs)
**Over 50yrs or complications: **
Ceftriaxone +
Vancomycin
+Ampicillin 2gIV q4h
Alternative:
Meropenem: 2g IV q8h
CAP, low risk, no comorbidities
Amoxicillin: 1g tid OR
Doxycycline: 100mg bid OR
Azithromycin: 500 mg x1 day, then 250mg x4days
CAP, low risk with comorbidities
Amox-clav: 875/125 1t bid OR
Cefpodoxime: 200mg bid OR
Cefuroxime: 500 mg bid
PLUS
Doxycycline 100mg bid OR
Azithromycin 500mg x1 day, then 250mg x4 days
OR JUST
Levofloxacin 750mg qd
CAP, high risk, not severe
Beta-lactam (ceftriaxone 1-2g IV q24h)
PLUS
Macrolide (azithromycin 500mg IV q24h)
OR
Doxycycline 100mg bid
OR FLUOROQUINOLONE MONOTHERAPY:
Moxifloxacin 400mg qd
Levofloxacin 750mg qd
CAP, high risk, severe
Beta-lactam (ceftriaxone 1-2g IV q24h)
PLUS
Azithromycin (500mg IV q24h)
OR
Fluoroquinolone
NO MONOTHERAPY
Amoxicillin AOM Dose
90mg/kg/day divided q12h
Cefdinir AOM Dose
14mg/kg/day divided q12h
Ceftriaxone AOM Dose
50mg/kg/day x3days
Clindamycin AOM Dose
30-40mg/kg/day divided q8h
Azithromycin AOM Dose
10mg/kg on first day
5mg/kg on days 2-5
Amox-Clav ABS Dose
875/125 1t bid
or
1000/62.5 2t bid
Doxycycline Dose
100mg bid
Clindamycin ABS Dose
300-450mg q8h
Levofloxacin ABS Dose
750mg qd
Ceftriaxone Meningitis
Ceftriaxone 2g IV q12h
Vancomycin Meningitis
Vancomycin: 15-20mg/kg IV q8-12 hrs (2g loading dose and 1.25g q8-12hrs)
Meropenem Meningitis
2g IV q8h
Ampicillin Meningitis
Ampicillin 2g IV q4h
CAP Amoxicillin
1g tid
Cefpodoxime CAP
200mg bid
Cefuroxime
500mg bid
CAP Ceftriaxone
1-2g q24h
Severe CAP Azithromycin
500mg IV q24h
Moxifloxacin CAP
400mg qd
Purulent Cellulitis
TMP-SMX: 2 DS Tablets q12h
Doxycycline: 100mg q12h
Vancomycin
Non-purulent cellulitis
Cephalexin: 500 mg q6h
Dicloxacillin: 500mg q6h
Clindamycin: 300mg q8h
Erysipelas
Penicillin G 1-2mu IV q6h
Necrotizing Fasciitis
Piperacillin-tazobactam: 4.5g IV over 30mins then 3.375g IV over 4 hrs q8h
Linezolid: 600mg IV q12h
HAP/VAP ,no mssa
Piperacillin-tazobactam
Cefepime
Levofloxacin
Imipenem/meropenem
HAP/VAP, mrsa
Piperacillin-tazobactam
cefepime/ceftazidime
levofloxacin/ciprofloxacin
imipenem/meropenem
aztreonam
AND
Vancomycin
Linezolid
HAP/VAP with risk factors
piperacillin-tazobactam
cefepime/ceftazidime
imipenem/meropenem
aztreonam
AND
Levofloxacin/ciprofloxacin
amikacin/gentamicin/tobramycolistin/polymixin B
AND
Vancomycin
linezolid
Piperacillin-tazobactam dose
4.5g IV x1, then 3.375g IV q8h
Cefepime dose HAP
2g IV q8h
Ceftazidime HAP
2g IV q8h
Imipenem HAP
500 mg q6h
Meropenem HAP
1g q8h
Amikacin HAP
15-20mg/kg q24h
Gentamicin HAP
7mg/kg q24h
Tobramycin HAP
7mg/kg q24h
Ciprofloxacin HAP
400mg q8h
Levofloxacin HAP
750mg IV q24h
Colistin HAP
5mg/kg IV x1, then 2.5mg/kg q12h
Polymixin B HAP
2.5-3mg/kg/day divided in 2 doses
Linezolid HAP
600mg q12h
Necrotizing Fasciitis if clostridium
penicillin G 3-4mu IV q4h
linezolid
if not clostridium, discontinue linezolid
Uncomplicated UTI
Nitrofurantoin: 100mg bid x5days
TMP-SMX: 160/800 bid x3days
Fosfomycin: 3g single dose
Complicated UTI
Levofloxacin: 750mg qd x5days
Ciprofloxacin: 500mg q12h x 7-14days
Acute pyelonephritis
levofloxacin: 750mg IV/PO q24h x5-7days
ciprofloxacin: 400mg IV (500mg PO) q12h x5-7days
Acute pyelonephritis and FQ resistance
Ceftriaxone 1g IV q24h x 10days
Acute pyelonephritis resistant organism risk
cefepime 2g IV q8h
meropenem 1g IV q8h
ertapenem 1g IV q24
Gonorrhea
<150kg: ceftriaxone 500mg IM x1
> 150kg: ceftriaxone 500mg IM x1
+(if chlamydia can’t be ruled out)
doxycycline 100mg bid x7days
or
azithromycin 1g po x1day (if pregnant)
Chlamydia
doxycycline: 100mg bid x7days
Alternatives:
azithromycin 1g po x1
levofloxacin 500mg po q24h x7days
syphilis
Benzathine penicillin G 2.4 mu IM x1
Late latent/tertiary:
Benzathine penicillin G 2.4 mu IM qwk x3 weeks
Neurosyphilis:
benzathine penicillin G 3-4 mu IM q4h x10-14days
Herpes
first clinical episode:
-acyclovir 400mg PO tid x7-10 days
-famciclovir 250mg PO tid x7-10 days
-valacyclovir 1g PO bid x7-10 days
Recurrent infection:
-aciclovir 400mg bid
-valacyclovir 500mg/1g qd
-famiciclovir 250mg bid