LRTI Tx Guidelines Flashcards
1
Q
Inpt CAP - w/ MRSA RF
A
ADD Vanc or Linezolid
2
Q
Inpt CAP - w/ Pseudomonas RF
A
SWAP B-lactam choice for either Zosyn, Cefepime, or Meropenem
3
Q
Outpt CAP - WITH comorbidities (chronic heart, lung, or renal disease, DM, alcoholism, malignancy, asplenia, immunocomped)
A
- MonoTx: Levo or Moxiflox
- ComboTx (DOC): Augmentin, Cefpodixime, or Cefuroxime AND Macrolide or Doxycycline
Minimum 5 days and clinically stable
4
Q
VAP
A
- Pick 2 diff classes IF RF for Pseudo Resistance: Zosyn, Cefepime, Imipenem, Meropenem OR Levoflox OR Tobra, Amikacin (cover Pseudo)
- AND Vanc or Linezolid (cover MRSA)
7 days if clinically stable
5
Q
Inpt CAP - Non-Severe
A
- MonoTx: Levo or Moxiflox
- ComboTx (DOC): Unasyn or Ceftriaxone AND Macrolide
(Doxy can be swapped if FQ or MAC can’t be used)
Minimum 5 days and clinically stable
6
Q
HAP - not at high risk for mortality (no vent support or septic shock)
A
Zosyn, Cefepime, Imipenem, Meropenem, or Levofloxacin (cover MSSA + Pseudomonas)
7 days if clinically stable
7
Q
Outpt CAP - Healthy Adult, NO comorbidities
A
- Amoxicillin (DOC)
- Doxycycline
- Azithromycin
Minimum 5 days and clinically stable
8
Q
HAP - high risk for mortality and MRSA risk
A
- PICK 2 diff classes: Zosyn, Cefepime, Imipenem, Meropenem OR Levoflox OR Troba, Amikacin (cover MDR Pseudomonas)
- AND Vanc or Linezolid (cover MRSA)
7 days if clinically stable
9
Q
Inpt CAP - Severe
A
- Unasyn or Ceftriaxone AND Macrolide (DOC)
- Unasyn or Ceftriaxone AND Levo/Moxiflox
Minimum 5 days and clinically stable
10
Q
HAP - not at high risk for mortality (no vent support or septic shock), but MRSA risk
A
- Zosyn, Cefepime, Imipenem, Meropenem, or Levofloxacin (cover Pseudomonas)
- AND Vanc or Linezolid (cover MRSA)
7 days if clinically stable
11
Q
When to use 2 Pseudomonal coverages in VAP
A
- Prior IV antibiotics in last 90 days
- Septic shock at time of Dx
- Acute respiratory distress syndrome prior to Dx
- HD
- ≥5d of hospitalization prior to Dx
