Gastro Flashcards
If a pregnant lady in the third trimester came with infectious diarrhea what antibiotics can be given
Erythromycin is gategory B in pregnancy so it can be given
When should antibiotics be used in Campylobacter enteritis?
Only in specific cases:
- High fever or bloody diarrhea
- Symptoms >1 week
- Age ≥ 65
- HIV positive or immunocompromised
- Pregnant patient
What is the preferred antibiotic for Campylobacter enteritis and why?
Erythromycin is preferred due to increasing resistance to fluoroquinolones.
What is the role of macrolides like azithromycin and clarithromycin in Campylobacter enteritis?
They can replace erythromycin but are costlier without added clinical benefit.
Why are antibiotics contraindicated in EHEC enteritis ?
They can worsen Shiga toxin release, increasing the risk of HUS.
What is Hemolytic Uremic Syndrome (HUS)?
A triad of:
Microangiopathic hemolytic anemia
Thrombocytopenia
Acute kidney injury
Often caused by EHEC and is potentially lethal.
What is the treatment approach for HUS?
Mainly supportive. In severe cases, eculizumab or plasma therapy may be considered.
Why was erythromycin preferred over fluoroquinolones in pregnant women with Campylobacter enteritis?
Erythromycin has less resistance
Safe in pregnancy (Category B vs. fluoroquinolones’ Category C)
Q: Why should antibiotics be avoided in EHEC enteritis ?
EHEC is not responsive to antibiotics
Antibiotics may increase Shiga toxin release → HUS riskantibiotics
Antibiotics may increase Shiga toxin release → HUS risk
How should EHEC enteritis be managed?
Supportive care only. Avoid antibiotics. Use antidiarrheals cautiously and only in non-bloody diarrhea cases (e.g., travelers’ diarrhea).
What causes the complications in HUS like kidney injury?
Toxins from EHEC → microangiopathic injury
Prothrombotic state → microthrombi
Occlusion of renal vessels
What are advanced treatment options for severe HUS cases?
Eculizumab (monoclonal antibody)
Plasma exchange/therapy (if CNS involvement or poor prognosis)
