Infectious Disease II Flashcards
Perioperative Surgical/Cardiac Prophylaxis Treatment
Cefazolin
Perioperative Colorectal Surgery Prophylaxis Treatment
CeFOTetan (disulfiram rxn + bleeding risk) CeFOXitin Unasyn Ertapenem Metronidazole + Ceftriaxone or cefazolin
Alternative Treatment for Beta-lactam allergy in surgical patient
Vancomycin or Clindamycin (cardiac/vascular)
Meningitis signs and symptoms
- fever, stick neck, severe HA
Meningitis Tx (0-28 days old)
Ampicllin (listeria)
PLUS
Gentamicin or CefoTAXime
Meningitis Tx (1 month- 50 years old)
Vancomycin
PLUS
Ceftriaxone or CefoTAXime
Meningitis Tx (>50 years or immunocompromised)
Ampicillin (listeria)
Vancomycin
PLUS
Ceftriaxone or CefoTAXime
When are steroids indicated for Meningitis Tx?
Dexamethasone can be given with 1st dose of antibiotic or prior to antibiotic but NOT with antibiotic
AOM Tx
AOM allergy
Augmentin or Amoxicillin
90 mg/kg/day
Ceftriaxone (IM)
Influenza
Tamiflu (Olmesartan)
<48 hours symptoms
Strep Throat Tx
S. pyogenes
- Pen VK, Amoxicillin, 1st or 2nd generation cephalosporin
Sinusitis Tx
When to treat?
Augmentin
Severe symptoms for at least 3 days
Non-severe symptoms for at least 10 days
Lower Respiratory Infection-Bronchitis Whooping Cough (Bordetella pertusis) Tx- BAC
Bactrim
Azithromycin
Clarithromycin
Lower Respiratory Infection- (Bronchitis)
COPD exacerbation Tx? ADD
When to treat?
Azithromcycin OR Augmentin OR Doxycycline
purulent sputum + 1 symptom OR
increase in purulent sputum, volume, SOB
CAP common pathogens
S. Pneumoniae
H. Influenzae
M. Pneumoniae
Chlamyclophilia Pneumoniae
CAP Tx in General
Beta-lactams~ Ceftriaxone or CefoTAXime (NEVER mono-therapy*)
Macrolides + Doxycycline
Respiratory Quinolones
*must include the other meds for atypical coverage
What do we need to know before administering antibiotics for CAP treatment?
If the patient has had antibiotics in the past 90 days AND
Co-morbidities and immunocompromised
Outpatient CAP- Healthy with NO antibiotics in the past 90 days- TX
Macrolides (Azithromax, Erythromycin, Clarithromycin)
OR
Doxycycline
Outpatient CAP- Category 2 Tx
- Co-mordities
- Immunocompromised
- At risk for drug-resistance (abx in the last 90 days)
JUST ADD B-lactams
1st line- Beta-lactam PLUS Macrolide OR Doxycycline
(amoxil, augmentin, cefuroxime, cefdinir, ceftriaxone)
Option 2- Respiratory Quinolones (My Good Lungs)
Inpatient CAP TX when Pseudomonas is suspected? MRSA?
Same general tx as outpatient: IV B-lactams (ceftriaxone, cefotaxime) + doxy or macrolide
Pseudomonas-Zosyn (pipercillin/tazobactam), Cefepime, Meropenem + levofloxacin or aminoglycoside
MRSA- Vancomycin (Vancocin) or Linezolid (Zyvox)~ best for renal failure
What would be used to treat Pseudomonas in the event that the patient has a Penicillin allergy?
Aztreonam (Azacatam)
HAP/VAP Coverage:
Pseudomonas + MSSA
- Zosyn
- Cefepime
- Levofloxacin
- Meropenem or imipenem/cilastatin
HAP/VAP Coverage:
Pseudomonas + MRSA
- Zosyn
- Cefepime or ceftazidime
- Levofloxacin or ciprofloxacin
- meropenem or imipenem/cilastatin
- aztreonam
PLUS aminoglycosides, polymixin B, colistimethate
Vancomcyin or linezolid
HAP/VAP Coverage:
MDR Pseudomonas + MRSA
- Zosyn
- Cefepime or ceftazidime
- Levofloxacin or ciprofloxacin
- meropenem or imipenem/cilastatin
- aztreonam
PLUS
Vancomcyin or linezolid
When treating infective endocarditis what should be added to the regimen of patient’s with a PROSTHETIC VALVE?
gentamicin or rifampin
Infective Endocarditis Treatment
Viridans group streptococci
Penicillin or Ceftriaxone +/- gentamicin
Pen allergy- vancomycin
Infective Endocarditis Treatment
MSSA
Nafcillin or Cefazolin
Pen allergy- Vancomycin
Infective Endocarditis Treatment
MRSA
Vancomycin
Infective Endocarditis Treatment
Enterococci
Penicillin or Ampicillin + gentamicin
Pen allergy- vancomycin + gentamicin
VRE- daptomycin or linezolid
IE Dental prophylaxis
Amoxicillin 2 grams 30-60 min prior to surgery
Pen allergy: Clindamycin 600 mg or Azithromycin/Clarithromycin 500 mg
Impetigo (SSI)
Bug/Presentation?
Treatment?
MSSA~ honey-colored crusts
Mupirocin (Bactrim)
KEFLEX 250 mg QID
Folliculitis/Furuncles/Carbuncles (SSI)
Bug/Presentation?
Treatment?
Boils~ CAP, MRSA
KEFLEX 500 mg QID
OR
Bactrim or Doxycycline
Non-purulent infection-Cellulitis
Bug/Presentation?
Treatment?
Localized swelling, redness, warmth~ S. pyogenes, S. aureus, Group A Strep
KEFLEX 500 mg QID
or Clindamycin 300 mg QID (Pen allergy)
Purulent infection-Abscess
Bug/Presentation?
Treatment?
Recurrent MRSA infections~ CA-MRSA
Bactrim DS
or
Doxycyline
