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ID 1183 > ID 2 > Flashcards

ID 2 Flashcards

1
Q

Pathogens that can cause meningitis 6

A
  1. Strep pneumo
  2. Neisseria menintidis
  3. Haemophilus Influenzae
  4. Group B Streptococcus/E. Coli (Young patients)
  5. Listeria (young and old)
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2
Q

Common pathogens in the mouth 3

A
  1. Mouth flora (peptostreptococcus, actinomyces)
  2. Anaerobe GNR (provetella, others)
  3. Viridans group streptococcus
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3
Q

Upper respiratory pathogens 4

A
  1. Streptococcus pyrogenes
  2. Strep pneumo
  3. H. Influenzae
  4. Moraxella Catarrhalis
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4
Q

Lower respiratory pathogens (community)

A
  1. Strep pneumo
  2. H. Influ
  3. Atypicals: legionella, Mycoplasma
  4. Enteric GNR: Alcoholics, IC
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5
Q

Lower respiratory hospital 4

A
  1. Staph aureus, including MRSA
  2. Pseudomonas
  3. enteric GNR
  4. Strep pneumo
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6
Q

Heart/Endocarditis pathogens

4

A
  1. Staph aureus (MRSA)
  2. Staph epidermidis
  3. Streptococci
  4. Enterococci
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7
Q

Intraabdominal pathogens 4

A
  1. Enteric GNR
  2. Enterococci
  3. Streptococci
  4. Bacteroides specis
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8
Q

Skin and Soft Tissue Pathogens

A
  1. Staph aureus
  2. Strep pyrogenes
  3. Staph epidermidis
  4. Pateurella multocida
  5. +- aerobic/anaerobic GNR (diabetes)
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9
Q

Bone and Joint Pathogens 5

A
  1. Staph aureus
  2. Staph epidermidids
  3. Streptococci
  4. Neisseria gonorrhoe
  5. GNR only in specific situations
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10
Q

Urinary tract pathogens

A
  1. E.coli
  2. Klebsiella
  3. Staph sapro
  4. Streptococci
  5. Enterococci
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11
Q

Surgical prophylaxis

Cardiac or vascular surgeries

A
  • Cefazolin or cefuroxime
  • If allergic to beta lactams, vanc or clinda
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12
Q

Hip fracture repair or total joint replacement

A
  • Cefazolin
  • Allergy vanc or clinda
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13
Q

Colon (colorectal)

A
  • Cefotetan
  • Cefoxitin
  • Amp/sul
  • ertapenem
  • or Metronidazole + cefazolin or ceftriaxone
  • Allergy: Clinda+(AMG or quinolone or aztreonam)
  • Or metronidazole + (AG or quinolone)
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14
Q

Hysterectomy

A
  • Cefotetan, cefoxitin, cefazolin or amp/sul
  • Allergy clinda/vanc + (AMG or quinolone or aztreonam)
  • Mettro+ (AMG or quinolone)
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15
Q

Classic Meningitis Symptoms, diagnosis, and commone pathogens

A
  • HA, nuchal rigidity (stiff neck), and altered mental status
  • Diagnosed with a lumbar puncture
  • Strep pneumo, Neisseria meningtigis, H. Influenzae
  • Listeria monocytogenes (neonates and patients > 50, and immunocompromised patients)
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16
Q

What can be given to patients with meningitis to prevent neurologic symptoms

A
  • Dexamethasone 15-20 minutes prior to abx admin
  • 0.15 mg/kg rounded to 10 mg IV q6h
17
Q

What is meningitis treatment duration dependent on and what is it?

A
  • 7 days for N. Meningit and H. FLu
  • 10-14 for S. pneumo
  • 21 days for listeria
18
Q

Empiric treatment recommendations for meningitis

<1mo

1-23 months

age 2-50 years

>50 or immunocompromised

A

< 1 mo

  • Ampicillin for listeria coverage
    • cefotaxime (not ceftriaxone due to risk of biliary sludging in neonates)
  • or Gentamicin

1-23 months

  • Ceftriaxone or cefotaxime
    • Vanc

2-50 years

  • Adult dose
  • Ceftriaxone 2 g IV q12 or Cefotaxime 2 g q4-6h
    • vanc 30-45 mg/kg/day in divided doses

>50

  • Ceftriaxone or cefotaxime
    • Vanc
    • Ampicllin for listeria coverage
19
Q

What Abx is added for neonates or people > 50 or immunocompromised to cover listeria

A

Ampicillin

20
Q

If pt has a serious PCN allergy what is the treatment regimen for meningitis?

A
  • Quinolones (moxi or levo) + vanc +- Bactrim for listeria
21
Q

First line treatment and alternatives for Acute Otitis Media

A
  • First:
    • Amox 80-90 mg/kg/day in 2 divided doses
    • or Augmentin 90 mg/kg/day, 6.4 mg/kg/day of clav
    • 14:1 amox clav ration
  • Alt if PCN allergy
    • Cefdinir
    • Cefuroxime
    • Cefpodoxime
    • Ceftriaxone
  • Treatment failure
    • Augmentin
    • or Ceftriaxone

ID 1183 (19 decks)

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