Infection and Antimicrobials

Question 1

Timing of antimicrobial prophylaxis

Answer 1

Deliver within one hour of incision (2 if vanco or FQ)

Question 2

Does the presence of a drain require antimicrobial prophylaxis?

Answer 2

No

Question 3

Do patients with asymptomatic bacteriuria require prophylaxis before procedures?

Answer 3

No, except pregnant patients

Question 4

Should patients undergoing cysto/UDS have prophylaxis?

Answer 4

No

Question 5

Should patients with prosthetic valve get prophylaxis?

Answer 5

Not for routine GU procedures

Question 6

Should prophylaxis be given to patients with prosthetic joints?

Answer 6

Yes, especially if joint is within 2 years

Question 7

Should prophylaxis be given to patients before a Foley/drain pull?

Answer 7

Consider it

Question 8

Should antibiotics be given before SWT?

Answer 8

NoI

Question 9

Is antifungal prophylaxis recommended for patients with asymptomatic funguria undergoing routine tube exchange?

Answer 9

No, but IDSA thinks yes
It IS necessary for surgery though
It is also necessary for neutropenic patients

Question 10

Treatment of fungal ball

Answer 10

Fungal culture/sensitivities
Periprocedural treatment strongly recommended

Question 11

When should AmB be used instead of fluconazole?

Answer 11

candida with fluconazole resistance (e.g. krusei)
Allergy to fluconazole
Prolonged QTc
Acute liver injury
if giving amB, MONITOR CR