Gram negative Flashcards
Legionella treatment
Co-amoxicillin and levofloxacin
Fluoroquiniolone (better than doxy)or a newer generation macrolide
Where is the site of infection?
Rubor, dolor, calor, tumor
What do you do if you suspect endocarditis?
3 sets of blood culture in the 1st hour and give antibiotics after that
Side effects and complications of fluoroquinolones
generalised tnedonitis
achiles tendon rupture
epilepsy
ruptures of aortic aneurysms
Which is the common monobactam used and why is it used?
Aztreonam - purely active against gram negatives
Alternative to gentamicin for people whose kidneys can’t stand gentamicin
Workforce for gram negative sepsis in tayside?
Gentamicin
What is gentamicin not sensitive against?
gram positives or anaerobes
Common g. negative organisms shape
bacilli
When is pseudomonas seen more commonly?
CF and burns
What is the drug of choice for haemophilus influenzae?
Amoxicillin (covers for haemophilus and pneumoniae)
Doxcycycline active as well
What is atypical pneumonia?
pneumonia that is not typical of strep pneumonia
Treatment for atypical pneumonia?
Doxycycline
Clarithomycin (reserved)
Fluoroquinolones (only in Legionella)
What is the mortality rates assoctaed with legionella?
10% outside
25% mortality - if aquired in the hospital
How can the diagnosis of legionella be made?
Urine Legionella antigen
Important causes of gram negative sepsis - enterobacter
E.coli, Klebsiella, Pseudomonas, Neisseria meningitidis
Which drug will treat pseudomoas?
Ciprofloxacin (ONLY)
Ceftazidime (only cephalosporin that works)
Meropenem
Meningitis antigen importance
Capsule polysaccharides - to track outbreaks and make vaccines
Ecoli 0157 H7 antigens
O and H
Salmonella antigens
0
Which bugs can be identified with anitgens?
Haemophilus influenza Neisseria meningitis Ecoli 0157 Salmonella Shigella
Geatures of coliforms
g. negative rods
How does klebsiella cause resistance?
Due to plasmids -> colonisation with gram negative resistant bacteria
Which bug turns McConkey agar pink?
Ecoli
Perforated peritonitis treatment
Amoxicillin + gentamicin + metronidazole
Gentamicin (gram negative coliforms)
metronidazole - anaerobes
Which drugs won’t work in ESBL producing organisms?
Penicillin, cephalosporins and aztreonam
If it states that penicillin, cephalosporin and aztreonam works –> iwhat does it mean?
No ESBL production
If you have an ESBL and we don’t recognise and we have given a wrong antibiotic in SEPSIS, what happens?
2x risk of mortality
What is the major problem associated with gentamicin?
Nephrotoxicity
Would you use trimethoprim in a SEPSIS scenario?
No, as the bacteriostatic
