Infectious Disease: Bacterial Infection Treatments Flashcards by Lauren Vande Hei

How would you treat a staphylococcus skin infection outpatient with low risk of MRSA?

Cephalexin, dicloxacillin

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How would you treat a staphylococcus skin infection outpatient with a high risk of MRSA?

Clindamycin, tetracyclines (doxycycline, minocycline), or sulfamethoxazole/trimethoprim

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How would you treat a staphylococcus skin infection inpatient?

Vancomycin

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How would you treat an inpatient staphylococcal skin infection if allergy to vancomycin?

Clindamycin, cefazolin, Nafcillin or oxacillin, linezolid

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How would you empirically treat staphylococcal osteomyelitis?

Vancomycin + 3rd or 4th generation cephalosporin

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How would you treat staphylococcal osteomyelitis with MSSA on culture?

Nafcillin, oxacillin, or cefazolin

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How would you treat staphylococcal osteomyelitis with MRSA on culture?

Vancomycin IV

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How would you treat toxic shock syndrome empirically?

Vancomycin plus clindamycin plus pip/taz or cefepime or carbapenem (meropenem, doripenem, imepenem)

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How would you treat scalded skin syndrome with MSSA?

Supportive measures: fluid management, skin care, Nafcillin or oxacillin

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How would you treat scalded skin syndrome with a high risk of MRSA?

Vancomycin

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How would you treat staphylococcal food poisoning?

No treatment, self limiting and typically resolves within 12 hours

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How would you treat a coagulase negative staphylococcal infection (s. Epidermidis, s. Saprophyticus, s. Lugdunensis)

Vancomycin and prosthetic device removal if infected

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How would you treat strep pyogenes pharyngitis?

Benzathine PCN G, Penicillin VK or amoxicillin

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How would you treat strep pyogenes pharyngitis with a allergy to penicillin?

Cephalosporin such as cephalexin

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How would you treat scarlet fever?

Benzathine PCN G, penicillin VK or amoxicillin

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How would you treat impetigo without suspected MRSA?

Topical mupirocin, cephalexin, dicloxacillin

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How would you treat impetigo with suspected MRSA?

Sulfamethoxazole/trimethoprim, doxycycline, clindamycin

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How would you treat outpatient erysipelas?

penicillin, amoxicillin

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What are alternatives to penicillin, amoxicillin in treatment of outpatient erysipelas?

Dicloxacillin, cephalexin, clindamycin/erythromycin

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How do you treat erysipelas inpatient?

Vancomycin if severe and s. Aureus suspected, cefazolin, ceftriaxone, clindamycin

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How would you treat cellulitis outpatient?

Empiric treatment directed at both organisms depending on severity

Dicloxacillin, cephalexin, penicillin

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How would you treat cellulitis with MRSA outpatient?

Clindamycin, doxycycline/minocycline, bactrim

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How would you treat cellulitis inpatient?

Vancomycin

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How do you treat other GABHS infections: necrotizing fasciitis, streptococcal toxic shock syndrome, arthritis?

Penicillin or ampicillin and clindamycin

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How do you treat strep agalactiae prophylactively?

PCN G or ampicillin, cefazolin

What is alternative treatment for strep agalactiae?

Clindamycin or vancomycin

How would you treat otitis media?

Amoxicillin

How would you treat otitis media if allergy to penicillin?

Omnicef (cefdinir)

If otitis media is still present after 2 weeks of treatment, how would you treat?

Augmentin or omnicef

If otitis media is still not better after 4 weeks, how would you treat?

Referral to ENT and rocephin

How would you treat acute sinusitis?

Augmentin

What are alternatives to augmentin for treatment of acute sinusitis?

Doxycycline or clindamycin

What are treatments for outpatient pneumococcal pneumoniae?

Amoxicillin, doxycycline, azithromycin (only in areas <25% resistance)

How would you treat pneumococcal pneumoniae outpatient in patients who have COPD/comorbidities?

Levofloxacin, (amoxicillin/clavulanate (augmentin) or cephalosporin) + (zmax or doxycycline)

How would you treat pneumococcal pneumoniae inpatient?

Levofloxacin or macrolide + beta-lactam

How would you treat endocarditis?

Ampicillin + gentamicin

How would you treat mild or complicated skin/wound/UTI infection due to enterococcus?

Ampicillin or vancomycin

How would you treat complicated skin/wound/UTI infections due to enterococcus?

Ampicillin or vancomycin

How would you treat vancomycin resistant skin/wound/UTI enterococcus infection?

Linezolid or Daptomycin

How would you treat bacillus anthracis?

Ciprofloxacin for 7-10 days if cutaneous, up to 60 days if inhalation, multiple antibiotics can be used

What can you use for bacillus anthracis instead of ciprofloxacin?

Doxycycline

How can you treat bacillus cereus?

Supportive treatment: fluids and rest

How would you treat listeriosis inpatient?

Ampicillin and gentamicin

How would you treat listeriosis outpatient?

Amoxicillin

How would you treat corynebacterium diphtheria?

Diphtheria equine antitoxin (obtained from CDC, for all suspected causes of diphtheria), PCN or erythromycin

How would you treat contacts of patients with corynebacterium diphtheria?

Erythromycin

How would you treat meningococcal meningitis?

PCN G (if susceptible to penicillin) or Ceftriaxone for coverage of other agents

How would you treat close contacts of a patient with meningococcal meningitis?

PCN G or ceftriaxone

How would you treat a patient with OE/UTI/RESP infection due to pseudomonas outpatient?

Ciprofloxacin or levofloxacin (oral) Tobramycin (inhaled)

How would you treat a patient with OE/UTI/Resp infection due to pseudomonas inpatient?

Pip/taz, ceftazidime, cefepime, meropenem, aztreonam “You’re CCAMP(ing) indoors

How would you treat whooping cough (bordetella pertussis)?

Supportive care, azithromycin

How would you treat whooping cough if patient can’t take azithromycin?

Bactrim

How would you treat haemophilus influenzae?

Empiric antibiotic treatment depending on area of infection

How would you treat legionnaires?

Macrolide (azithromycin, clarithromycin), fluoroquinolone (levaquin) typically for 10-14 days/21 day course of therapy for immunocompromised patients

How would you treat klebsiella (klebsiella pneumoniae)?

Susceptibility testing required due to resistance, empiric treatment with respiratory fluoroquinolone, carbapenem

How would you treat traveler’s diarrhea (E Coli)?

Tends to resolve itself, but if does not improve: antimotility agents/antidiarrheals: loperamide, etc. Bismuth subsalicylate

How would you treat severe traveler’s diarrhea (E Coli)?

Antimotility agents/antidiarrheals, bismuth subsalicylate, antibiotics for severe symptoms: ciprofloxacin for 3-5 day course

How would you treat campylobacter jejuni?

Ciprofloxacin empiric treatment, azithromycin

How would you treat shigellosis?

Rehydration to treat hypotension in severe cases, ciprofloxacin (single dose), bactrim

How would you treat cholera (vibrio cholerae)?

Tetracycline/doxycycline, bactrim, azithromycin, quinolones (cipro), susceptibility testing to decide Note: this little girly is out drinking river water with cholera so you gotta tell her: get BACT over here!!! (B)actrim (A)zithromycin (C)ipromycin (T)etracyclines (doxycycline)"

How would you treat non-cholerae vibrio infections?

Doxycycline or ciprofloxacin

How would you treat typhoid fever (salmonella)?

Ciprofloxacin/levofloxacin, ceftriaxone, azithromycin

How would you treat enterocolitis?

Supportive care

How would you treat complicated enterocolitis with severe illness?

Supportive care, ciprofloxacin, ceftriaxone, azithromycin, bactrim

How would you treat UTI/uncomplicated cystitis?

Bactrim, nitrofurantoin (furadentin, macrodantin, macrobid), fosfomycin, cephalosporins, ciprofloxacin

Who could you not give bismuth subsalicylate for traveler’s diarrhea?

Children, pregnant women or ASA allergy

Who would you not give nitrofurantoin for uncomplicated cystitis?

Last trimester of pregnancy

How would you treat bubonic plague?

Streptomycin x 10 days or gentamicin x 10 days or doxycycline x 10 days or fluoroquinolone (cipro, levo, moxi), respiratory isolation

How would you prophylactically treat someone exposed to bubonic plague?

Doxycycline and ciprofloxacin x 7 days

How would you treat tularemia?

Streptomycin, gentamicin, doxycycline, fluoroquinolones

How would you treat a fever of unknown origin?

No empiric treatment, treatment towards etiology once determined, referral if etiology cannot be determined

How would you treat sepsis?

Antibiotic therapy initiated within 1 hr of suspected diagnosis, multiple empiric antibiotics used, IV fluids, vasopressors, central lines, other means of organ perfusion