ID Flashcards
Penicillin coverage?
Penicillin (G, VK, benzathine): Viridans group strept Strept. Pyogenes Oral anaerobes Syphilis Leptospira
Ampicillin / amoxicillin:
Penicillins + E. Coli + Lyme dz
*Amoxcillin HELPS! H. Influenzae E. Coli Listeria Proteus Salmonella
Penicillins are best initial Rx in what Dz?
Otitis media Dental + endocarditis prophylaxis Lyme dz (only rash, joint, 7CN). UTI in pregnant Listeria monocytogenes Enterococcal infections
Penicillinase-resistant penicillins?
Oxacillin
Cloxacillin
Dicloxacillin
Naficillin
Beta-lactam AB groups?
Penicillins
Cephalosporins
Carbapenems
Aztreonam
Methicillin sensitive organism are sensitive to oxacillin. (T or F)
True. And vise versa.
Penicillins that cover pseudomonas?
Pipracillin
Ticarcillin
Azlocillin
Mezlocillin
Pseudomonas covering penicillin are eat initial Rx for what Dz?
Cholecystits and ascending cholangitis.
Pyelonephritis.
HAP and VAP.
Febrile neutropenia.
What cephalosporin covers MRSA?
Cetfaroline
Agents that cover MRSA?
Vancomycin Daptomycin Cetfaroline. Linezolid. Trdizolid. Tigecycline. Dalbavancin. Telavancin.
Cross-reaction between penicillin and cephalosporins (T or F)
True.
Very small
Organisms sensitive to all cephalosporins?
Group A,B,C strept. Viridans group strept. E. Coli. Klebsiella. Proteus mirabilis.
Organisms resistant to all cephalosporins?
Listeria
MRSA
Enterococcus.
Patient with rash to penicillin?
Use cephalosporins.
Patient with anaphylaxis after penicillin?
Use non-Beta-lactam
What are the 1stG cephalosporins?
Cefazolin.
Cephalexin.
Cephradrine.
Cefadroxyl.
What are 2ndG cephalosporins?
Cefotetan Cefoxitin Cefaclor Cefprozil Cefuroxime Loracarbef
1stG cephalosporins Rx?
Staph (Methicillin sensitive) Strept G-ve bacilli not (Not pseudomonas) Osteomyelitis + septic arthritis. Endocarditis Cellulitis.
What cephalosporins cover anaerobes?
Cefotetan.
Cefoxitin
Best initial Rx for PID?
Cefotetan / Cefoxitin + doxycycline.
SE of cefotetan / Cefoxitin?
Bleeding
Disulfiram like reaction (w/ alcohol).
What are the 3rdG cephalosporins?
Ceftriaxone
Cefotaxime
Ceftazidime
When to avoid ceftriaxone?
Neonates > impaired biliary metabolism.
When to use cefotaxime instead of ceftriaxone?
Neonates.
Spontaneous bacterial peritonitis.
What 3G cephalosporins has pseudomonal coverage?
Ceftazidime
What is infective endocarditis?
Valvular infection leading two fever and murmur.
What are the risks to developing infective endocarditis?
- Prosthetic valve.
- Valvular disease.
- IV drug user.
What are the complications of infective endocarditis?
- Splinter hemorrhage, janeway lesions, Osler nodes.
- Roth spots + conjunctival petechiae.
- Septic emboli to lung.
- Mycotic aneurysm of brain.
- Kidney = glomerulonephritis.
- Splenomegy
What is the best initial test for infective endocarditis?
- Blood Cx
2. Echo (transthoracic 100% specific)
Blood Cx of IE shows strept. Bovis or C. Septicum? (Next step)
R/o colonic pathology via colonoscopy?
How to Dx IE if blood Cx is negative?
- Vegetations on echo
- 3 minor criteria:
Fever > 38
High risk patient (prosthetic valve / IV drug)
Signs of embolic phenomena
Best initial treatment for infective endocarditis?
Empiric therapy of vancomycin and gentamicin.
When is surgery the answer for infective endocarditis?
- CHF
- AV block
- Fungal infection
- Abscess
- Recurrent emboli while on Rx
What is the most common cause of culture negative infective endocarditis?
Coxiella.
What are the e-Hack organisms of IE?
Eikenella H. Aphrophilus H. Parainfluenza Actinobacillus Kingella
Rx of e-Hack IE?
Ceftriaxone
When to prophylax against IE?
Heart defect + dental / resp surgery.
Heart defects: Prosthetic valve. Hx of IE. Cardiac transplant w/valve Dz Untreated cyanotic heart dz.
What to use for prophylaxis of IE?
Amoxicillin
If allergic: macrolide
