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Phar 506 > Infectious Diarrhea > Flashcards

Infectious Diarrhea Flashcards

1
Q

What are risk factors for infectious diarrhea

A

Child care facilities, foodborne or waterborne, international travel, antimicrobial agents

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2
Q

What are the three most common organisms that cause infectious disease

A

Shigella, camplyobacter, and non-typhoidal salmonella

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3
Q

What are the two types of medications should be considered when someone has diarrhea

A

anti-motility agents and antibiotics

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4
Q

T/F: Inflammaotry diarrhea is a self limiting illness and should be considered for antibiotics but instead anti-motility

A

False: Non-inflammatory diarrhea is self-limiting and antibiotics are not needed but anti-motility drugs usually are. Inflammatory diarrhea should have antibiotics considered specific to pathogens and hosts

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5
Q

What are characteristics of inflammatory diarrhea

A

Appearing ill, febrile, stool WBCS, bloody diarrhea

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6
Q

T/F: In patients with fever or bloody diarrhea anti-motility drugs may worsen illness by impairing elimination of pathogens and their toxins

A

True

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7
Q

What is the recommended anti-motility drugs

A

Loperamide

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8
Q

If the infectious diarrhea is acute (less than 14 days) what are the two ways routes for exposure

A

Community acquired or travel, hospital exposure

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9
Q

What are the organisms associated with community-acquired or travel infectious diarrhea

A

Salmonella, shigella, camplyobacter, E. coli (shiga-toxin)

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10
Q

What is the organism associated with hospital acquired with infectious diarrhea

A

C. difficile

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11
Q

If the infectious diarrhea is chronic (greater than 14 days) what is the usual route of exposure, what organism is associated

A

Recreational water exposure, giardia

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12
Q

When are antibiotics generally recommended

A

Severely ill patients, Immunocompromised patients (organ transplantation, AIDS), Treatment of extra-intestinal infections, specific pathogens

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13
Q

What are adverse consequences of antiboitcs

A

Prolonged fecal excretion of pathogens, emergence of resistant bacteria, side effects

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14
Q

What empiric treatment choices for antibiotics

A

Floriquinolones, azithromycin, ceftriaxone, cefotaxime

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15
Q

What is the salmonella species that is most likely to cause a systemic infection the will require antibiotics, what is the name of the disease associated with this type of salmonella

A

S. Typhi, Typhoid fever

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16
Q

What are the resistance patterns for Salmonella Typhi

A

Fully susceptible to all relevant antibiotics, multi drug resistance but fully fluroquinolone susceptible, fluroquinolone resistant

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17
Q

What are the first line antibiotics for S. typhi that is fully susceptible and how long they used, what are the alternatives and how long are they used

A

Fluoroquinolones for 5-7 days/ Ampicillin OR Bactrim OR Chloramphenicol for 14-21 days

18
Q

What are the first line antibiotics for multi drug resistance but fully fluroquinoline susceptible strands of S. typhi

A

Fluroquinolones for 5-7 days

19
Q

Resistance to what prototype structure may predict fluroquinolone resistance

A

Nalidixic-acid

20
Q

T/F: The lower the MIC the more the less likely that resistance is present

A

True

21
Q

What are the treatment options for low-level fluroquinolone resistance

A

Maximum dose of a FQ OR Azithromycin OR Ceftriaxone for 7 days

22
Q

What are the treatment options for high-level fluroquinolone resistance

A

Ceftriaxone for 10-14 days OR Azithromycin for 7 days

23
Q

What is the diseae that can be caused by chronic carrying of S. typhi in the gallbladder, how can this be treated

A

Typhoid fever, 1-3 months of antibiotics

24
Q

What are the the spectrum of illness in non tyhphi salmonella

A

Gastroenteritis, bacteremia

25
Q

If a patient presents with gastroenteritis are antibiotics indicated, why

A

generally not indicated in healthy adults, antibiotics may prolong fecal excretion of salmonella

26
Q

T/F: Bacteremia is a systemic infection that happens in less than 5% of patients

A

True

27
Q

What instances when pre-emptive antibiotics before extra intestinal infections occur

A

age less 1 year or greater than 50, immunosuppressed, severe symptoms such as fever and bloody diarrhea,

28
Q

How long should antibiotics be taken for bactermia and pre-emptive antibiotics what are those antibiotics as well

A

Ceftriaxone (empiric choice) 3-7 days, floriquinolone, ampicillin/amoxicillin, bactrim

29
Q

If a patient has shigella and a mild to moderate illness what shoud the antibiotic therapy be

A

1 to 2 doses of a fluroquinolone

30
Q

If a patient has shigella and a severe illness caused by S. dysenteria what should the antibiotic therapy be, what if there is fluroquinolone-resistanace

A

3 to 5 days of a fluroquinolone, ceftriaxone or azithromycin

31
Q

T/F: Camplyobacter usually requires antiboitic treatment

A

False: Camplyobacter is usually a self-limiting illness with a 1 week duration

32
Q

If someone has camplyobacter when is antibiotics recommended

A

High fever, bloody diarrhea, pregnancy, the illness last longer than one week

33
Q

What antiboitic regimen should be used to treat camplyobacter

A

Azithromycin or erythormycin

34
Q

What type of presentations come from Shiga-toxin diarrhea

A

Bloody diarrhea without fever

35
Q

What is the Shiga-toxin, sympotoms

A

Key virulence factor in the development of hemolytic uremic syndrome/ renal insufficiency, anemia, thrombocytopenia

36
Q

T/f: Shiga-toxin E coli. should not recieve antibiotics

A

True

37
Q

What practices will reduce the incidince of C. difficile diarrhea

A

Proper handwashing, limiting use of clindamycin, limiting use of cephalosporins, limiting use of fluroquinolones, only treating as long as is necessary to cure the infection

38
Q

What should severe C. difficile be treated with, if recurring change to what, only for an titial episode of non-severe infection

A

Vancomycin, fidaxomycin, metronidazole

39
Q

T/F: If a patient has S. typhi there should always be antibiotics used and if there is shig=toxin producing E. coli antibiotics should never be used

A

True

40
Q

How is levofloxacin/ciprofloxacin eliminated, azithromycin, ceftiaxone

A

Renal, liver, Renal/liver

Phar 506 (37 decks)

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