Exam 4 - Bacteremia Flashcards
how often should blood cultures be repeated
every 48-72 hours
who should get echocardiography
all SAB patients
what is the order of the echocardiography tests
TTE first then TEE
what if urine culture comes back positive for staph aureus
likely staph aur elsewhere in the body
what considerations should be taken for catheters and prosthetics
assume ALL are infected until it can be ruled out
if you cannot remove cath/prosthetic what should you do?
add rifampin
what is the main goal with catheters in SAB
control the source of infection
if its a short term cath what should you do?
remove
if its a long term cath what should you do?
remove unless contraindicated
when can catheters be replaced
when cultures are negative for 48-72 hours
SAB empiric coverage for MSSA and MRSA
vanc or dapto
what can you add on to SAB empiric coverage if you are worried about MSSA
may add on nafcillin if it is severe or really worried about MSSA
SAB confirmed MRSA bacteremia treatment
vanc or dapto
what can you add on to confirmed MRSA bacteremia if severe
can employ combo PBP-1 active B-Lactam or ceftaroline early on if severe
SAB confirmed MSSA bacteremia treatment
nafcillin, oxacillin, cefazolin
what should be avoided in MSSA bacteremia
avoid vanc, rifampin, and aminoglycosides
what is the treatment duration of uncomplicated bactermia
14 days
what are the criteria for uncomplicated bacteremia and how many must be met
MUST MEET ALL 5
-exclusion of endocarditis
-no implanted devices
-follow-up cultures 2-4 day later are negative
-patient improving
-no evidence of infection
treatment duration for complicated bacteremia
4 weeks
treatment duration for complicated bacteremia w/ metastatic infection
6-8 weeks
what route of admin should be used for treatment of all bacteremias
IV therapy for full duration
treatment of strep a or agalactiae bacteremia
penicillin x 14 days
treatment of s. pneumo bacteremia
ceftriaxone or penicillin x 14 days
treatment of e. faecalis bacteremia
amp or vanc x 7 days
treatment of e. faecium bacteremia
vanc or dapto x 7 days
