ID:2 Flashcards
pre op abx timing
cephazolin / cefuroxime 60 mins (clinda if beta lactam allergy)
vanc/quinolones 120 mins
during op
if >3-4 hours or major blood loss
additional dose
post opp
abx not required or d/c by 24 hours
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
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
acute otitis media
tylenol
observe for 2-3days temp<102
amoxicillin or 1st 2nd 3rd gen cephalosporin
bronchitis
abx for 5-7days
augmentin
azithromycin
doxycycline
if dypsnea increase, sputum inncrease, mechanical ventilation
abx not recommended unless pertussis or pneumonia
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
ventilator associated pneumonia
> 48 hours after ventilation admin
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
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
active TB tx
RIPE for 2 months
rifampin
isoniazid
pyrazinamide
ethambutol
extended tx will include RI
rifampin AE
orange red discolaration of body fluids
increase LFTs
hemolytic anemia
flu like symptoms
isoniazid AE
peripheral neuropathy- use B6 pyroxidine to halt these AE
hepatitis
DILE
pyrazinamide AE
acute gout
increase LFTs
ethambutol
increase LFTs
optic neuritis
confusion
hallucinations
DDI of rifampin
PI
warfarin
contraceptives
Tx resistant to ripe
use quinolones
do not use Pyrazinamide in gout
infective endo carditis tx
IV abx for 4-6 weeks
vanc mono
naf + genta
ntal prophylaxis
amoxcillin
alt
amp/cefazolin
clinda azithro
SBP
ceftriaxone 5-7 days \
alt
ampi/genta/quinolone
SBP prophylaxis
bactrim cipro
cholecystitis
metronidazole
4-7 dayse
7-14 days
>14 days
peritonitis cholangitis mild
cefoxitin
ertapenem
moxifloxa
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
