Infectious Disease - Bacterial Infections Flashcards
What are the three most common organisms causing infective endocarditis?
Staph
Strep
Enteroc
What is empiric therapy for infective endocarditis?
Naive valve - Vanc + ceftriaxone
Prosthetic valve - Vanc + cefepime/zosyn
What is the prophylaxis for infective carditis for dental patients?
Who is excluded?
Amoxicillin 2G PO 30-60min prior to procedure
Those with mitral valves
If PCN allergy: Cephalexin 2G PO ; azithro/clarithro 500mg PO, doxy 100 PO
What organisms mostly cause cellulitis?
Strep & MSSA
Empiric treatment for DFI’s (mild,mod,sev)
Mild - B-lactam
Moderate - Augmentin, quinolone + metro/clinds
Sev - Unasyn/zosyn/carbapenem OR quinolong/ceftas/cefepime + metro
What organisms are you worried about for post-surgical intra-abdominal infections?
B.fragilis
E.Coli
Enterococci
PSA
Empiric treatment for community and nosocomial acquired intra-abdominal infections
Community: Zosyn OR b-lactamase/quinolone + metro
Nosocomial - Zosyn/meropenem OR ceftaz/cefepime + metro
What are 4 main causes of acute gastroenteritis ?
Majority viral - Norovirus in adults and rotovirus in children
Bacterial - salmonella. e.coli, shigella
Giardia -
C.DiffW
Tx for diverticulosis and diverticulitis
Diverticulosis - High fiber diet
Diverticulitis - Cipro/Levo/bactrim + metro OR augmentin
Osteomyelitis
Organisms
Empiric Tx and duration
Staph aureus and aerobic gram negative (PSA)
Vanc + ceftriaxon/ceftaz x 6 weeks via PICC
Organisms of UTI and pyelonephritis
KPEEPS
Klebsiella, proteus, e.coli, enterococ, PSA, staph sapro
Acute cystitis treatment w/duration
What about in pregnancy?
Bactrim x 3d, nitrofurantoin x5d, fosfomycinx1 dose
Use beta-lactams x 7d or fosfomycin
Pyelonephritis tx w/duratipn
What about in pregnancy?
bactrim x 10-14d
Levo/cipro x 10-14d
IV ceftriaxone x 14d, zosyn, carbapenem
OUTPATIENT adult CAP empiric treatment
Healthy and with comorbidities (heart,lung,liver,renal disease, DM, malignancy, alcoholism, asplenia)
Healthy - Amox HD OR doxy OR macrolide
Comorbidities -
Augmentin/Cefpodoxime/cefuroxiime AND macrolide/doxy
OR
A respiratory FQ ( levo, moxi, dela)
INPATIENT adult CAP empiric treatment
Nonsevere and severe
Nonsevere-
IV beta lactam + macrolide
Severe-
Beta-lactam + macrolide/FQ
Pediatric CAP empiric treatment
Outpatient and inpatient
What if you are concerned for mycoplasma?
Outpatient - Amoxicillin HD
Inpatient - IV amp/PCN-G, ceftriaxone, cefotaxime
Add macrolide if concerned for mycoplasma
HAP and VAP empiric treatment
No risk for MDR
Risk for MDR
No risk - 1 anti-PSA agent
Risk - 2 anti-PSA agent and 1 anti-MRSA agents
Adult meningitis
Organisms
Empiric Tx
Pneumococcus, neisseria, Hib
Ceftriaxone + vanc
Add amp if >50y.o
Neonatal meningitis
Organisms
Empiric tx if hospital vs community acquired
E.coli, GBS, listeria
Hospital acquired - Amp + gent
Community acquired - Amp + gent + cefotaxime
Chlamydia treatment and alternative
Doxy 100mg BID x 7 days
Alternative - Azithro 1G PO x 1 OR levofloxacin 500mg PO x 7d
Gonorrhea treatment
Ceftriaxone 500mg since IM
Syphillis treatment and alternative
Benzathine PCN G IM 2.4million units x 1
If PCN allergy - doxy x 14-28 days
Gential herpes treatment
Valtrex 500mg PO QD
Acyclovir 400mg PO BID
Famciclovir 250mg BID
Trichomonas treatment
Metro 500mg PO BID x 7d - women
Metro 2G PO x1 - men
