Infectious Disease: Anaerobic Bacteria

Question 1

How would you treat oral/throat/neck gram + anaerobe infection?

Answer 1

Clindamycin, augmentin, unasyn

Question 2

How would you treat a moderate/severe GI/pelvic abscess of gram + anaerobe IV?

Answer 2

Ertapenem or ceftriaxone + metronidazole

Question 3

How would you treat a severe GI/pelvic abscess of gram + anaerobes?

Answer 3

Imipenem

Question 4

How would you treat a lung abscess with gram + anaerobic bacteria?

Answer 4

Beta-lactam + beta-lactam inhibitor (ampicillin-sulbactam) or carbapenem or clindamycin

Question 5

How would you treat outpatient aspiration pneumonia from gram + anaerobes?

Answer 5

Augmentin or doxycycline

Question 6

How would you treat inpatient aspirational pneumonia caused by gram + anaerobes?

Answer 6

Beta-lactam plus a beta-lactam inhibitor (ampicillin-sulbactam)
or metronidazole plus either amoxicillin or Penicillin G

Question 7

What would you use for abscess prevention in a dental procedure in patients with joint implants?

Answer 7

PCN or amoxicillin

Question 8

What would you use for prophylaxis before dental or minor procedures in order to prevent endocarditis (gram + anaerobic infections)?

Answer 8

Amoxicillin

Question 9

What would you use for prophylaxis prior to colorectal surgery (to prevent gram + anaerobic infection)?

Answer 9

Metronidazole plus 2/3 gen cephalosporin or ciprofloxacin, carbapenems

Question 10

How do you treat a Clostridial soft tissue infection?

Answer 10

Drainage and debridement
Antibiotic treatment: pip/taz plus clindamycin (for strep and clostridium)

If only strep/clostridium, PCN + clindamycin (after culture)
Hyperbaric therapy

Question 11

What is treatment for C. Tetani?

Answer 11

Hospitalization
Supportive care: respiratory care, drugs for muscle spasms
Wound debridement
Tetanus immune globulin IM within 24 hrs of presentation
Full series of tetanus vaccine
PCN or metronidazole

Question 12

How do you treat botulism?

Answer 12

Hospitalization
Supportive care: respiratory care, GI/nutrition care- NG tube
Antitoxin (available through CDC)
If wound botulism: PCN G or metronidazole

Question 13

How would you treat mild to moderate C. Difficile?

Answer 13

Fidaxomicin, vancomycin

Question 14

How would you treat severe c. Diff?

Answer 14

Vancomycin (can do enema, but rarely used) or fidaxomicin, may add metronidazole

Question 15

How would you treat recurrent/resistant c. Diff colitis?

Answer 15

Fidaxomicin or vancomycin

Question 16

How would you treat resistant/refractory c. Diff?

Answer 16

Fecal transplant

Question 17

How do you treat an oral/throat/neck gram - anaerobic infection?

Answer 17

Drainage and debridement-fistula tract excision
Clindamycin or metronidazole

Question 18

How would you treat a GI/pelvic abscess gram - anaerobic infection?

Answer 18

Pip/taz or carbapenems or metronidazole plus cephalosporin

Question 19

What is the treatment for bacterial vaginosis?

Answer 19

Metronidazole (oral or vaginal) or clindamycin (oral or vaginal) or tinidazole (oral)

Question 20

How would you treat a gram + anaerobic infection of the GI/pelvis orally?

Answer 20

Moxifloxacin