ID:2 Flashcards by Nafi Dewan

pre op abx timing

cephazolin / cefuroxime 60 mins (clinda if beta lactam allergy)
vanc/quinolones 120 mins

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during op

if >3-4 hours or major blood loss
additional dose

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post opp

abx not required or d/c by 24 hours

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colo rectal sx what abx should be used

cefotetan/cefoxitin unasyn ertapenem
metronidazole +ceftriaxone

if beta lactam allergy then use clinda+aminoglycoside
metro + amino glycoside

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meningitis

> 1 month to 50 years ceftriaxone +vanco
50 amp+ceftriax+vanc
<1 month amp+cefotaxime or getna
*ceftriaxone for neo nates is a no no

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acute otitis media

tylenol
observe for 2-3days temp<102
amoxicillin or 1st 2nd 3rd gen cephalosporin

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bronchitis

abx for 5-7days
augmentin
azithromycin
doxycycline

if dypsnea increase, sputum inncrease, mechanical ventilation
abx not recommended unless pertussis or pneumonia

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hospital acquired pneumonia

> 48 hours after hospital admin
risk for MRSA is IV use of abx in the last 90 days
also >10% in hospital
also nasal swab test

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ventilator associated pneumonia

> 48 hours after ventilation admin

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tx of HAP and VAP

p. areugenisa
- zosyn/ cefepime
MRSA
- vanc or linezolid
use 2 for p.aruginosa
- MDR risk - cipro/ genta
- do not use 2 beta lactams together

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latent TB tx

isoniazid and rifapentine for 12 weeks
rifampin for 4 months
isoniazid +rifampin for 3 months

** alternate tx
Isoniazid for 6 months or 9 months- pref in gregnancy

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active TB tx

RIPE for 2 months
rifampin
isoniazid
pyrazinamide
ethambutol

extended tx will include RI

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rifampin AE

orange red discolaration of body fluids
increase LFTs
hemolytic anemia
flu like symptoms

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isoniazid AE

peripheral neuropathy- use B6 pyroxidine to halt these AE
hepatitis
DILE

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pyrazinamide AE

acute gout
increase LFTs

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ethambutol

increase LFTs
optic neuritis
confusion
hallucinations

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DDI of rifampin

PI
warfarin
contraceptives

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Tx resistant to ripe

use quinolones
do not use Pyrazinamide in gout

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infective endo carditis tx

IV abx for 4-6 weeks
vanc mono
naf + genta

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ntal prophylaxis

amoxcillin
alt
amp/cefazolin
clinda azithro

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SBP

ceftriaxone 5-7 days \

alt
ampi/genta/quinolone

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SBP prophylaxis

bactrim cipro

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cholecystitis

metronidazole
4-7 dayse
7-14 days
>14 days

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peritonitis cholangitis mild

cefoxitin
ertapenem
moxifloxa

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peritonitis cholangitis severe

carbapenem zosyn ceftaz+metro cipro +metroni cefazolin + amino +metro

SSTI diagnosis

mild- sx absent moderate - systemic signs temp>100.4 HR >90 wbc >12000 severe- failed oral abx + incision and drainage

petigo golden in mouth

cephalexin PO wet compress mupirocin topical

folliculitis /carbuncles

cephalexin MRSA- bactrim doxycycline warm compress decrease inflammation

cellulitis

cephalexin if allergic clindamycin

abcess (ammu)

bactrim doxycycline minocycline clindamycin

severe SSTI

vanc dapto linezolid

necrotizing fascitis

vanc + beta lactam

diabetic foot infection

MRSA coverage Anerobic pseudomonas

UTI

cystitis pyelonephritis vaginal candi

acute uncomplicated cystitis

macrobid 5 days bactrim 3 days fosfomycin 1 dose alternate pregnancy -cephalexin -amoxicillin -fosfomycin non pregnant alternative -cipro/levo beta lactam

acute pyelonephritis

cipro levo ceftriaxone ertapenem bactrim 14 days beta lactam if severe 5-14 days ceftriaxone/zosyn/quinolone / carbapenem

omplicated uti

carbapenem and similar to pyelonephritis 7 days 10-14 days

pregnancy

beta lactams fosfomycin macrobid and bactrim avoid in 1st trimester

Travellers diarrhe a

azithro quinolone rifaximin

c diff

GP toxin A abd B DC abx dc antidiarrheal isolate patients diagnose toxin or culture

1st episode of c diff

vanc 125mg PO QID 10 days/ FDX 200mg BID 10 days alt- METRO 500 TID 10 days if complicated vanc 500 QID and metro IV TID

2nd episode of C diff

whatever first used change to next

subsequent episode of C diff

vanc 125 QID for 10 days then rifaximin for 20 days or FDX 200mg for 10 days QID

condoms can help decrease STD

true

which STI doesnt need to be treated for both

bacterial vaginosis

SX chamydia

genital discharge no sx

SX gonnorhea

same as chlymydia

syphilis

painless genital sores

HPV

genital warts or no symptoms

bacterial vaginosis

clear white or gray fishy odor pH >4.5 no pain

trichomonaisis

yello green frothy vaginal discharge, painful intercourse

syphilis tx

pen G Bicillin LA IM also can use doxy or tretracycline X14 days ** HIV and preg should get desencitized with PENG since doxy cannot be taken

other syphilus tx

pen G procaine IV

gonorrhea tx

ceftriaxone if no chlamydia if clamydia then add doxycycline

chlamydia tx

doxy mono X7days or azithro mono X1 ** can also use levo pregnanct? use amox +azithro

bacterial vaginosis tx

metronidazole ** clinda

trichomiasis tx

metro ** pregnant? still metro

genital warts HPV

imiquimod cream vaccine gardasi

tularimia

aminoglycosides

lyme

DOxy amoxic/cefuroxime