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BCACP > Infectious Diseases II > Flashcards

Infectious Diseases II Flashcards

1
Q

What is a Type I allergic reaction?

A

Immediate onset (< 1 hour)

IgE-mediated

Characterized by anaphylaxis, laryngeal edema, wheezing

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2
Q

Which generation of cephalosporins has the highest risk of cross-reactivity for patients with a PCN allergy?

A

First

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3
Q

Which patient population should receive treatment for asymptomatic bacteriuria?

A

Pregnant women

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4
Q

What are acceptable treatment regimens for uncomplicated cystitis?

A

-Nitrofurantoin (5-7 days)
-Fosfomycin (1 dose)
-Trimethoprim/sulfamethoxazole (3 days)
-FQs (levofloxacin or ciprofloxacin) (3 days)

Alternatives:
-Amoxicillin/clavulanate (5-7 days)
-Cefdinir, cefaclor, cefuroxime, cefpodoxime (5-7 days)

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5
Q

What are acceptable treatment regimens for uncomplicated pyelonephritis?

A

-Trimethoprim/sulfamethoxazole (7-14 days)
-FQs (levofloxacin or ciprofloxacin) (7-14 days)

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6
Q

What is the recommended duration of treatment for pregnant women with symptomatic UTIs?

A

7 days

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7
Q

What is the recommended duration of treatment for pregnant women with asymptomatic bacteriuria?

A

3-7 days

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8
Q

What are the preferred UTI antibiotics in pregnant women?

A

-PCNs and cephalosporins
*Amoxicillin/clavulanate
*Cefuroxime
*Cefpodoxime
*Amoxicillin
*Cephalexin
*Bactrim (avoid in 3rd trimester)

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9
Q

What are important co-morbidies to consider in patients with CAP?

A

-DM
-Chronic lung, heart, renal, or liver disease
-Alcohol abuse
-Active malignancy
-Asplenia
-Immunosuppressive conditions/medications

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10
Q

What are risk factors of MRSA and Pseudomonas as it pertains to CAP?

A

-Prior respiratory isolation of MRSA or Pseudomonas
-Recent hospitalization and receipt of IV antibiotics within previous 90 days

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11
Q

What are recommended treatment regimens for CAP patients without comorbidities?

A

-Amoxicillin 1 g TID
-Doxycycline 100 mg BID
-Azithromycin 500 mg on day 1 then 250 mg on days 2-5

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12
Q

What are recommended treatment regimens for CAP patients with comorbidities?

A

Combination:
-B-Lactam (amoxicillin/clavulanate BID, cefpodoxime BID, cefuroxime BID)
AND
-Macrolide (azithromycin 500 mg on day 1 then 250 mg on days 2-5) or doxycycline BID

Monotherapy:
-Respiratory FQ (levofloxacin 750 mg daily, moxifloxacin 400 mg daily)

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13
Q

What is the recommended treatment duration for CAP?

A

At least 5 days (afebrile for 48-72 hours and clinically stable)

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14
Q

What are recommended treatment recommendations for latent TB?

A

-Isoniazid (15 mg/kg - max of 900 mg) PLUS rifapentine 900 mg x 12 weeks
-Rifampin (10 mg/kg - max of 600 mg) x 4 months
-Isoniazid (5 mg/kg - max of 300 mg) PLUS rifampin (10 mg/kg - max of 600 mg) x 12 weeks

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15
Q

When are antibiotics indicated for acute bacterial rhinosinusitis?

A

-Signs/symptoms fail to improve or worsen after 10 days or more
-Severe symptoms for 3 days or more
-Worsening after initial improvement for 3 days or more

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16
Q

What antibiotics are preferred for treatment of acute bacterial rhinosinusitis?

A

Preference: Amoxicillin/clavulanate

Alternatives:
-Doxycycline
-Respiratory FQ

17
Q

What is the recommended treatment duration for acute bacterial rhinosinusitis?

A

5-7 days

18
Q

What antibiotics are preferred for treatment of group A strep?

A

Preferred:
-PCN VK 500 mg BID x 10 days
-Amoxicillin 500 mg BID x 10 days

PCN-Allergy:
-First-Generation Cephalosporin
-Clindamycin
-Macrolides

19
Q

When are antibiotics indicated for AOM?

A

-Otorrhea w/ diagnosis of AOM
-AOM w/ severe symptoms (toxic appearing, fever, otalgia greater than 48 hours)
-Bilateral AOM in children 6 mo to 2 years

20
Q

What antibiotics are preferred for AOM?

A

-Amoxicillin 80-90 mg/kg given in 2 divided doses (if no amoxicillin over past 30 days)
-Amoxicillin/clavulanate 90 mg/kg given in 2 divided doses (if amoxicillin in past 30 days)

If PCN-Allergy:
-Cefdinir
-Cefuroxime
-Cefpodoxime

21
Q

What is the recommended treatment duration for AOM?

A

5-10 days

22
Q

When is empiric coverage of MRSA indicated in treatment of SSTIs?

A

Purulent SSTIs (furuncles, carbuncles, abscesses)

23
Q

What antibiotics may be used for SSTIs?

A

-Amoxicillin/clavulanate 875/125 mg BID
-Cephalexin 250-500 mg QID
-Clindamycin 300-450 mg TID-QID
-Doxycycline 100 mg BID
-Bactrim 1-2 DS BID

24
Q

What is the recommended treatment duration for SSTIs?

A

7-10 days

25
Q

Which patients qualify for IE prophylaxis?

A

Conditions:
-Prosthetic heart valves
-Previous IE
-Congenital heart disease
-Cardiac transplantation with cardiac valvulopathy

Procedures:
-Dental procedures involving gingival or periapical tissue of teeth
-Perforation of oral mucosa

26
Q

What are recommended antibiotic prophylaxis regimens for IE?

A

-Amoxicillin 2 g one hour before procedure

PCN-Allergy:
-Clindamycin 600 mg one hour before procedure
-Cephalexin 2 g one hour before procedure
-Azithromycin 500 mg one hour before procedure

27
Q

Which antibiotics are the biggest culprits for CDI?

A

-Beta-lactams
-Clindamycin
-FQs

28
Q

How is severe CDI characterized?

A

WBC > 15 or SCr > 1.5

29
Q

What antibiotics may be used for initial CDI?

A

-Vancomycin 125 mg QID x 10 days
-Fidaxomicin 200 mg BID x 10 days

30
Q

What is the recommended treatment for the first recurrence of CDI?

A

-Fidaxomycin
-Standard vancomycin
-Tapered or pulsed vancomycin

31
Q

What is the recommended treatment for the second recurrence of CDI?

A

-Fidaxomycin
-Tapered or pulsed vancomycin
*125 mg QID x 10-14 days
*125 BID x 7 days
*125 mg daily x 7 days
*125 mg every 2-3 days for 2-8 weeks

BCACP (20 decks)

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