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MNI (immuno pharm) > L33- Antibiotic Clinical Uses > Flashcards

L33- Antibiotic Clinical Uses Flashcards

1
Q

discuss the general guidelines and treatment options for bacterial endocarditis

A
  • IV antibiotics (prolonged course)
  • valve debridement, repair, replacement

Note- usually give empiric therapy after cultures are taken (not before)

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2
Q

Bacterial Endocarditis, empiric therapy:

  • (1) choice therapy
  • (2) possible adjunct, especially with (3) Pts
  • (4) alternate therapy
A

1- vancomycin, gentamicin (aminoglycoside)

2- rifampin
3- prosthetic valve

4- linezolid, daptomycin

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3
Q

α-hemolytic Streptococci Endocarditis:

  • (1) choice treatment
  • (2) alternatives
A

1- Penicillins (IV): penicillin G, ampicillin + Gentamicin (aminoglycoside, limit 5-7 days)

2:

  • Vancomycin; penicillin allergy [+ Gentamicin]
  • IV ceftriaxone (3rd gen. cephalosporin) + Gentamicin
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4
Q

list the types of S. aureus Endocarditis and associated therapy

A

i) Oxacillin-sensitive strain: nafacillin or oxacillin +/- gentamicin
ii) Penicillin-allergic (nonanaphylactoid) Pt: cefazolin +/- gentamicin
iii) Oxacillin-resistant strain: vancomycin +/- gentamicin

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5
Q

list the surgical conditions for which bacterial endocarditis prophylaxis is used

A
  • **dental surgeries
  • respiratory surgeries

-GI, GU, MSK surgeries involving area with established infections

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6
Q

list the cardiac conditions for which bacterial endocarditis prophylaxis is used

A
  • prosthetic cardiac valves
  • previous infective endocarditis
  • CHD
  • cardiac transplant recipients with valvulopathy
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7
Q

bacterial endocarditis prophylaxis:

  • (1) choice therapy
  • (2) alternatives
A

1) Oral: amoxicillin
2) penicillin allergy, Oral: (many options) clindamycin, cephalexin, azithromycin, clarithromycin

3) oral therapy not possible, IV/IM: ampicillin
4) no oral + penicillin allergy, IV: clindamycin, cefazolin

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8
Q

bacterial pharyngitis, GAS Strep.:

  • (1) choice therapy
  • (2) alternatives
A

1- penicillin V (oral)

2:

  • amoxicillin (oral)
  • penicillin G benzathine (IV/IM)
  • macrolide (penicillin-allergy)
  • clindamycin
  • 1st/2nd gen. cephalosporin
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9
Q

bacterial sinusitis:

  • (1) choice therapy
  • (2) alternatives
A

1- amoxicillin (oral)

2:

  • amoxicillin-clavulanic acid
  • macrolide (penicillin allergy)
  • co-trimoxazole
  • 2nd/3rd gen. cephalosporin
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10
Q

acute otitis media:

  • (1) choice therapy
  • (2) alternatives
A

1- amoxicillin (oral)

2:

  • amoxicillin-clavulanic acid
  • macrolide (penicillin allergy)
  • co-trimoxazole
  • 2nd/3rd gen. cephalosporin
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11
Q

CA-pneumonia, out-patient empiric therapy: healthy + no antibiotics in last 3 mos

A

-macrolide (pregnancy and children)
OR
-doxycyclin (no pregnancy, children)

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12
Q

CA-pneumonia, out-patient empiric therapy: indicate the therapy for complicated status (include criteria for complicated status)

A

-co-morbidities, immuno-suppressing conditions, immuno-suppression therapy, antimicrobials in last 3 mos

-respiratory fluoroquinolones
OR
-β-lactam (penicillin/cephalosporin) + macrolide

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13
Q

CA-pneumonia, in-patient, no ICU empiric therapy

A

-respiratory fluoroquinolones
OR
-β-lactam (penicillin/cephalosporin) + macrolide

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14
Q

CA-pneumonia, in-patient, in ICU empiric therapy

A
  • β-lactam (penicillin/cephalosporin) + azithromycin / respiratory fluoroquinolones
  • (penicillin allergy): respiratory fluoroquinolones + aztreonam (monobactam)
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15
Q

aspiration pneumonia (anaerobes)

  • (1) preferred agent
  • (2) second line agent
A

1- clindamycin

2- metronidazole

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16
Q

bordetella pertussis:

  • (1) preferred agent
  • (2) second line agent
A

(whooping cough)
1- macrolide
2- co-trimoxazole

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17
Q

chlamydia pneumoniae:

  • (1) preferred agent
  • (2) second line agent
A

1- macrolide, doxycycline

2- 3rd/4th gen. fluoroquinolones

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18
Q

H. influenzae, non-β-lactamase producing- otitis media, sinusitis:

  • (1) preferred agent
  • (2) second line agent
A

1- amoxicillin

2- 2nd/3rd gen. cephalosporin, co-trimoxazole

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19
Q

H. influenzae, β-lactamase producing- otitis media, sinusitis:

  • (1) preferred agent
  • (2) second line agent
A

1- 2nd/3rd gen. cephalosporin OR amoxicillin-clavulanic acid

3- co-trimoxazole

20
Q

Klebsiella pneumoniae:

  • (1) preferred agent
  • (2) second line agent
A

1- ceftriaxone, cefotaxime

2- fluoroquinolones

21
Q

Legionella spp.:

  • (1) preferred agent
  • (2) second line agent
A

1- fluoroquinolone, azithromycin

2- doxycycline, co-trimoxazole

22
Q

Moraxella catarrhalis:

  • (1) preferred agent
  • (2) second line agent
A

(HEENT infections)
1- amoxicillin-clavulanic acid, 2nd/3rd gen. cephalosporins, co-trimoxazole

2- macrolides

23
Q

Mycoplasma pneumoniae:

  • (1) preferred agent
  • (2) second line agent
A

1- macrolide, doxycycline

2- 3rd/4th gen. fluoroquinolones

24
Q

Pseudomonas aeruginosa:

  • (1) preferred agent
  • (2) second line agent
A

1- anti-pseudomonal penicillin (ticarcillin, piperacillin)

2- levofloxacin, aztreonam (monobactam), aminoglycoside

25
Q

Staph. aureus (non-MRSA):

  • (1) preferred agent
  • (2) second line agent
A

1- anti-staphylococcal penicillin (nafcillin, oxacillin, dicloxacillin)

2- 2nd/3rd gen. cephalosporins, clindamycin, fluoroquinolones, imipenem

26
Q

MRSA:

  • (1) preferred agent
  • (2) second line agent
A

(methicillin resistant S. aureus)
1- vancomycin, linezolid
2- ceftaroline

27
Q

Strep. pneumoniae (non-penicillin resistant):

  • (1) preferred agent
  • (2) second line agent
A

1- penicillin G, amoxicillin

2- cephalosporin, clindamycin, fluoroquinolone, macrolide, co-trimoxazole

28
Q

Strep. pneumoniae, penicillin resistant:

  • (1) preferred agent
  • (2) second line agent
A

Note- depends on culture sensitivity testing
1- 2nd/3rd gen. cephalosporin, 3rd/4th gen. fluoroquinolones

2- vancoomycin, linezolid, streptogramins

29
Q

Tularemia:

  • (1) preferred agent
  • (2) second line agent
A

1- streptomycin

2- gentamicin, chloramphenicol

30
Q

list the antibiotic that cause Clostridium difficile colitis:

  • (1) most common antibiotic
  • (2) frequently cause it
  • (3) occasionally cause it
A

1- Clindamycin

2- ampicillin/amoxicillin, cephalosporins, fluoroquinolones

3- penicillin, erythromycin, trimethoprim

31
Q

Clostridium difficile:

  • (1) preferred agent
  • (2) second line agent
  • (3) third line
  • (4) non-antibiotic treatment
A

1- vancomycin
2- fidaxomicin
3- metronidazole
4- fecal microbiota transplant

32
Q

Traveler’s diarrhea (indicate organism):

  • (1) preferred agent
  • (2) second line agent
A

(ETEC)
1- ciprofloxacin

2- amoxicillin, azithromycin, doxycycline

33
Q

Bacterioides fragilis in suspected intra-abdominal infections: therapy options

A

Alone: metronidazole, carbapenems, clindamycin

Combo: β-lactam + β-lactamase inhibitor

34
Q

Giardia therapy

A

metronidazole

35
Q

list the H.pylori therapies

A

1st: clarithromycin + amoxicillin + metronidazole + PPI

2nd (penicillin allergy): clarithromycin + metronidazole + PPI

3rd: clarithromycin + amoxicillin + PPI
4th: bismuth subsalicylate + metronidazole + tetracycline + PPI

36
Q

Uncomplicated UTI:

  • (1) preferred agent
  • (2) second line agent
A

(E. coli is majority cause)
1- co-trimoxazole

2- ciprofloxacin, nitrofurantoin, amoxicillin-clavulanic acid

37
Q

Uncomplicated UTI / Simple Cystitis in pregnancy therapy

A
  • penicillins
  • cephalosporins
  • nitrofurantoin (not close to term- hemolytic anemia)
  • sulfonamides (not close to term- kernicterus)
38
Q

acute bacterial prostatitis therapy

A
  • fluoroquinolones: ciprofloxacin, levofloxacin
  • co-trimoxazole
  • doxycycline
39
Q

Syphilis:

  • (1) preferred agent
  • (2) second line agent
A

1- penicillin G benzathine

2- doxycycline, azithromycin

40
Q

Gonorrhea:

  • (1) preferred agent
  • (2) second line agent
A

1- ceftriaxone

2- doxycycline, azithromycin

41
Q

Chlamydia (STI)

A

azithromycin, doxycycline

42
Q

Trichomoniasis:

  • (1) preferred agent
  • (2) second line agent
A

1- metronidazole

2- tinidazole

43
Q

bacterial vaginosis:

  • (1) preferred agent
  • (2) second line agent
A

1- metronidazole

2- clindamycin

44
Q

bacterial meningitis empirical therapy

A

vancomycin + ceftriaxone

45
Q

bacterial meningitis prophylaxis

A

rifampin
ciprofloxacin
ceftriaxone

MNI (immuno pharm) (15 decks)

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