Infection Flashcards
What type or organism is c.diff
Gram-positive, spore-forming, anaerobic, bacillus
Only toxin producing strains cause diarrhoea
Recent hospital stay within the last _______ is a risk factor for c.diff
3 months
Can C. difficile spores be inactivated by alcohol-based products
no
antibiotics associated with c diff (4)
Clindamycin
Co-amox
Quinilones
Cephlasporins
Can we give opioids in c. diff
Best not as they are constipating. Also avoid loperamide
Is there are difference in treatment of c .diff in terms of effectiveness?
No - Fidaxomycin, Vanc and metronidazole are euqivilent.
Fidax is much more expensive and has less chance of recurrance.
Treatment for non severe c. diff (WBC<15)
PO metronidazole 400mg TDS 10-14 days
Treatment for severe c. diff
PO Vanc 125mg 6 hourly 10-14 days.
Consider fidaxomycin 200mg BD if comorbidities/receiving concomittent antibitoics
Where do we tend to have gram +ve, -ve and anaerobic bacteria
+ve from the external environment
-ve gut or nosicomial
anaerobes are from the gut
Diabetes cellulitus - why use a broader spec?
Need better penetration
All betalactams have gram _______ activity
POSITIVE
But some are broader than others
MRSA is gram ____
So usually treated with
positive
Vanc or Teic
What is the only oral gram -ve agent
What IV options are there
Cipro (and other quinilones but cipro has the most -ve spectrum)
Gent
Amik
Penicillins are bacteria cidal or static
Cidal
if its not related to penicillin it tents to be static e.g. clindamycin, tetracyclines and linezolid
Which penetrates more vanoc or teic
Vanc
Aspiration shows was what on x ray
Mid zone consolidation
Why should we not use amik for HAP
Poor lung penetration
Why do we give gent for pylonephritis?
to cover -ve organisms while we wait for MCS
Treatment for ceullitis and causitive organisms (2)
Fluclox
covers staph and strep
Cellulitis in pen allergy
Clarithromycin
CAP pathogens
- Streptococcus pneumoniae
- Mycoplasma pneumoniae
- Haemophilus influenzae
- Chlamydophila pneumoniae
- Respiratory viruses.
HAP pathogens
`Infections occurring during the first four days of the hospital stay is usually caused by Streptococcus pneumoniae, Haemophilus influenzae and Moraxella catarrhalis.
Onset more than four days after admission is more often caused by Gram-negative Pseudomonas aeruginosa, enterobacteria, S. aureus, Klebsiella pneumoniae or L. pneumophila.
COPD exacerbation pathogens
- Streptococcus pneumoniaeand Haemophilus influenzaeand, less commonly,Moraxella catarrhalis.
- Staphylococcus aureusmay be the cause during the influenza season. Infection with Pseudomonas aeruginosamay also cause exacerbations of COPD.
In CAP if mycoplasma is suspected what would you recommend
Doxy + amox or doxy alone
