ID Part I

Question 1

Outpatient CAP Empiric Tx - No Risk Factors

Answer 1

Amoxicillin
Doxycycline
Macrolide (azithro or clarithro)

Duration min 5 days

Question 2

Outpatient CAP Empiric Tx - Risk Factors

Answer 2

Respiratory FQ (moxi, gemi, levo)
Macrolide or doxycycline + Augmentin or cefpodoxime or cefuroxime
Duration min 5 days

Question 3

Inpatient CAP Empiric Tx - Non-Severe

Answer 3

Respiratory FQ
Amb/sulbactam, ceftriaxone, or ceftaroline + macrolide

Duration min 5 days

Question 4

Inpatient CAP Empiric Tx - ICU

Answer 4

Amb/sulbactam, ceftriaxone, or ceftaroline + resp FQ or macrolide

Duration min 5 days

Question 5

Risk factors for MDR organisms

Answer 5

IV abx within past 90 days
Hospitalization of 5 days or more (VAP only)
Septic shock at time of VAP
Acute resp distress preceding VAP
ARRT before VAP

Question 6

VAP & HAP Single-Agent Empiric Tx

Answer 6

Zosyn, cefepime, levofloxacin, imipenem, meropenem

7 day duration

Question 7

VAP/HAP Empiric Tx with MDR organism risk factors

Answer 7

2 antipseudomonal agents + 1 MRSA agent
Antipseudomonal beta lactam + aminoglycoside or FQ, + vanco/linezolid
7 days duration - descalate

Question 8

Sinusitis Empiric Tx

Answer 8

Augmentin 5-7 days (kids up to 10 days)

Second line - doxycycline, FQ, cefpodoxime

Question 9

Cellulitis

Answer 9

Penicillin G, ceftriaxone, clindamycin for 5-10 days

Question 10

Erysipelas

Answer 10

Clindamycin, cefazolin, penicillin G for 5 days

Question 11

Necrotizing Faciitis

Answer 11

vanco or linezolid + Zosyn or carbapenem (can also use ceftriaxone with metronidazole)

Add clindamycin if group A strep/clostridium/S.aureus is suspected to suppress toxin release

Question 12

DM foot ulcers - mild

Answer 12

dicloxacillin, cephalexin, levofloxacin, clinda
If MRSA risk factors, Bactrim or doxycycline
1-2 weeks

Question 13

DM foot ulcers - mod-severe

Answer 13

Unasyn, ertrapenem, tigecycline, moxifloxacin or cirpro/levo + clindamycin, cefoxitin
2-3 weeks