Infectious Disease Flashcards
What are the three most common bacteria associated with CAP?
Unidentifiable, M. pneumoniae, s. pneumoniae, h. influenzae
What are the three most common bacteria associated with HAP?
Unidentifiable, s. aureus, pseudomonas aeruginosa, enterobacter
What is the empiric treatment of CAP for non-hospitalized pt with no comorbidities?
Amoxicillin or doxycycline or macrolide
What is the empiric treatment of CAP for non-hospitalized pt with comorbidities?
Respiratory FQ, macrolide or doxy w/ Augmentin or cefuroxime
What are the respiratory FQs?
moxifloxacin, Gemifloxacin, levofloxacin
What is the empiric treatment of CAP for hospitalized pt with no comorbidities?
respiratory FQ or Unasyn, ceftriaxone, or ceftaroline +macrolide
What is the empiric treatment of CAP for hospitalized pt with severe pneumonia
Unasyn +FQ/macrolide
Ceftriaxone +FQ/macroide
Ceftaroline +FQ/macrolide
What are risk factors for MRSA?
recent hospitalization or parenteral antibiotics within last 90 days
What antibiotics cover pseudomonas
Zosyn, cefepime, ceftazidime, imipenem, meropenem, aztreonam
What antibiotics cover MRSA?
Vancomycin and linezolid
What should the emperic treatment of VAP include?
should cover MSSA, p. aeruginosa, and other GN organisms
–(1)Zosyn, cefepime, levo, imipenem, or meropenem
–Using two antibiotics with activity against p. Aeruginosa if resistance is >10% or cholistinuse (1) plus AG, FQ
–Add MRSA coverage if MRSA NS positive
How long should VAP be treated for?
7 days
What patients should receive treatment for influenza A and B?
Confirmed or suspected influenza for high risk patients who’s illness onset <48 hours
What antiviral class is not effective against influenza B?
Adamantanes (Amantadine and rimantadine
What is the MOA of adamantanes?
Inhibits viral uncoating and release of viral nucleic acid
What is the MOA of adamantanes?
Inhibits viral uncoating and release of viral nucleic acid
What is considered a relapsed UTI?
Reinfection with the same organism within 14 days of discontinuing antibiotics
How many CFUs constitute bacteriuria?
> 10^2 CFU/ml
Why should nitrofurantoin be avoided in CrCl <30?
Efficacy is dependent on its concentration in the bladder. As renal function decreases the nitrofurantoin bladder concentration (efficacy) decreases and plasma levels increase (SE)
What are three main recommended therapies for uncomplicated cystitis?
-Bactrim DS BID x3 days
-Nitrofurantoin 100mg BID x5 days
-Fosfomycin 3g x1
-FQ x3 days
-Beta-lactams x5-7 days
Recommended therapies for uncomplicated pyelonephritis
Bactrim DS BID x14 days
Levofloxacin x5 days or Cipro x7 days
Beta-lactams x14 days
Antibiotics to avoid in pregnancy
-FQ
-Tetracyclines
-AG
-Bactrim (especially in late 3rd trimester)
How long should acute bacterial prostatitis be treated?
2-4 weeks, extend for an additional 2 weeks if pt still symptomatic
When should cellulitis be treated empirically for MRSA?
Penetrating trauma, IVDU, purulent drainage, nasal w/ MRSA, SIRS
What are PO options for MRSA?
Clindamycin, Bactrim (does not cover strep), doxycycline (does not cover strep)
Empiric treatment for necrotizing fasciitis?
Vanco or LInezolid + Zosyn or a carbapenem or CTX w/metronidazole
-Add clindamycin if concern for group A strep, s. aureus or clostridium spp
-If strep nec fasciitis -HD penicillin +clindamycin
What are considered risk factors for MRSA infections
MRSA colonization, high local prevalence of MRSA, or a severe infection
What are considered risk factors for MRSA infections
MRSA colonization, high local prevalence of MRSA, or a severe infection
What are considered risk factors for pseudomonas infections?
uncommon in diabetic foot infections–> higher risk of exposure of foot to water, severe inf, and failure of previous therapy
What are 5 anti-pseudomonal antibiotics?
Zosyn, ceftazidime, cefepime, meropenem, or imipenem
