MICRO Flashcards
Simple UTI
Triple Sulfas or TMP-SMX
Chlamydiae (2)
- Azithromycin
- Doxycycline
PID
Best initial therapy
2nd Gen Cephalosporin (Cefoxitin or Cefotetan) + Doxycycline
Otitis Media
Amoxicillin
Syphilis (2)
- Penicillin G
- Doxycycline (if allergic to Penicillin)
Community-Acquired Pneumonia
(3: Outpatient, Inpatient, ICU)?
- Outpatient -> Ceftriaxone + Macrolide
- Inpatient -> Fluoroquinolone
- ICU -> b-Lactam + Azythromycin OR Fluoroquinolone
Overall best therapy = Fluoroquinolones
Atypical Pneumonias (Chlamydia, Legionella, Mycoplasma)
Macrolides
Anaerobic infections in Aspiration Pneumonia / Lung Abscesses
Clindamycin
Bowel Surgery
Neomycin
Pneumocystis jiroveci Pneumonia
TMP / SMX
Minor MRSA Infections of Skin (4)
- TMP / SMX
- Clindamycin
- Doxycycline
- Linezolid
Lyme Disease
Tetracyclines
CHRONIC Lyme Disease
ie Brain + Heart involvement
Ceftriaxone
Actinomyces infection
Penicillin
M Tuberculosis
Prophylaxis, Treatment (4: “RIPE”)?
P = Isoniazid
T:
- Rifampin
- Isoniazid
- Pyrazinamide
- Ethambutol
- Pyra
M avium intracellulare
Prophylaxis (2), Treatment (2)?
P:
- Macrolide (Azithro- or Clarithromycin)
- Cipro or Rifabutin
T: More drug-resistant than M tuberculosis
- Macrolide (Azithro- or Clarithromycin)
- Ethambutol
M leprae- TUBERCULOID form
Treatment (2)?
T: Long-term
- Dapsone
- Rifampin
M leprae- LEPROMATOUS form
Treatment (Tuberculoid RX + 1)?
Tuberculoid RX + Clofazimine
Rickettsial / Vector-borne Dz
ie Rocky Mountain Spotted Fever, Typhus, Anaplasmosis / Ehrlichiosis, Q fever
Doxycycline
Bacterial Meningitis (3 options)
- Ceftriaxone + Vancomycin Empiric RX = Best initial
- Ampicillin (if Listeria)
- Chloramphenicol
ANTIBACTERIAL PROPHYLAXIS
Prevention of…
- Endocarditis with dental / surgical procedures -> ?
- Strep Throat in child with prior Rheumatic Fever -> ?
- Syphilis -> ?
- Group B Strep infection in pregnant woman -> ?
- Post-Op infection with S aureus -> ?
- Gonorrhea -> ?
- Recurrent UTIs -> ?
- Meningococcal infection -> (Adult vs Child)?
- Chlamydial / Gonococcal Conjunctivitis in newborn -> ?
- Penicillin
- Penicillin (Oral)
- Benzathine Penicillin G
- Ampicillin
- Cefazolin
- Ceftriaxone
- TMP-SMX
- Ciprofloxacin (Adult) / Rifampin (Child)
- Erythromycin ointment
PROPHYLAXIS for CONTACTS of children with H influenzae B
Rifamycins (Rifampin + Rifabutin)
‘Triple Therapy’ against H Pylori
- Amoxicillin or Tetracycline
- Bismuth
- Metronidazole
Penicillin + Aminopenicillins
Uses (3)?
USES: Best initial therapy
- Otitis Media
- Dental infection / Endocarditis prophylaxis
- UTI (pregnant women)
Penicillin (G, VK, Benzathine)
Bacteria Covered (2 Groups)?
- Strep: S pyogenes + S viridans
- Spirochetes: Borrelia (Lyme) + Leptospira + Treponema (Syphilis)
Aminopenicillins (Ampicillin, Amoxicillin)
Bacteria Covered (2), Indication?
- (same bacteria as Penicillin)
- E coli
INDICATION:
- Combine with b-lactamase Inhibitor
Amoxicillin
Bacteria Covered (5: “HELPS”)?
- H influenzae
- E coli
- Listeria
- Proteus
- Salmonella
Antipseudomonals (-cillin)
Bacteria Covered (3), Uses (5), Indication?
- E coli
- Proteus
- Pseudomonas
USES: Best initial therapy
- Bacteremia
- Neutropenia + Fever
- Pneumonia (Hospital + Ventilator)
- Pyelonephritis
- Ascending Cholangitis + Cholecystitis
INDICATION:
- Combine with b-lactamase Inhibitor
Penicillinase-Resistant Penicillins (Nafcillin + -xacillins)
Bacteria Covered, Uses (6)?
- Staph
USES: 6 Staph path:
- Staph Bacteremia
- Skin infections
- Meningitis
- Endocarditis
- Osteomyelitis
- Septic Arthritis
b-Lactamase Inhibitors
Bacteria Covered (2 Groups), Indication, Mech,
Drugs in Class (3),
Use?
- b-lactamase-sensitive Staph
- Anaerobes
INDICATION:
- Coadmin with b-lactamase / penicillinase-sensitive penicillins
MECH = Protect antibiotic from destruction by b-lactamase.
DRUGS:
- Clavulanic Acid
- Sulbactam
- Tazobactam
USE: Best initial therapy
- Abscesses (mouth + GI)
2nd Gen Cephalosporins (incl Cefprozil + Loracarbef)
Resp infections (ie Otitis Media, Sinusitis, Bronchitis)
Ceftriaxone
Bacteria Covered, Uses (4), CI?
- Pneumococcus 1st line
USES:
- Lyme Dz (involving Brain or Heart)
- Meningitis
- Pneumonia (Community)
- Gonorrhea
CI:
- Neonates (due to impaired biliary metab. Use Cefotaxime)
Cefotaxime
Uses (2)?
USES:
- Neonates
- Spontaneous Bacterial Peritonitis
Carbapenems
Bacteria Covered (2 LARGE Groups), Uses?
- Gram+ cocci (Staph + Strep)
- Gram- bacilli
USES:
- Neutropenia + Fever
Aminoglycosides
Indication?
INDICATION:
- Must monitor peak and trough to see what levels of drug are doing in body
Neomycin
Bowel Surgery
Trimethoprim (TMP)
(3)?
- UTIs (TMP-SMX)
- Salmonella + Shigella infections
- Pneumocystis jiroveci Pneumonia
Demeclocycline (a Tetracycline)
SIADH (ADH Antagonist = Diuretic)
Fluoroquinolones (3)
Indication?
Acidic drugs
- Gram- bacilli of GI + urinary tracts (incl pseudomonas)
- Diverticulitis
- Neisseria infections
INDICATION:
- For GI / Diverticulitis: EXCEPT Moxifloxacin, all must be combined with Metronidazole (b/c don’t cover anaerobes)
Metronidazole
(6 Organisms: “GET GAP”)?
- Giardia
- Entamoeba
- Trichomonas
- Gardnerella vaginalis
- Anaerobes (anaerobic infections BELOW diaphragm)
- H Pylori
Macrolides (-thromycin)
(5)?
- Atypical Pneumonia (Chlamydia, Legionella, Mycoplasma)
- URIs
- STDs
- Strep infections in patients allergic to Penicillin
- Neisseria infections
Chloramphenicol
Indication?
Meningitis
INDICATION: Conservative use owing to toxicities
Linezolid
Uses (2), Tox?
USES:
- MRSA infection
- VRE infection
TOX:
- Serotonin Sx
Amphotericin B
Uses (2), Indications?
USES:
- Serious systemic mycoses (Aspergillus, Blastomyces, Candida, Coccidioides, Cryptococcus, Histoplasma, Mucor)
- Cryptococcal + Fungal Meningitis
INDICATIONS:
- K + Mg supplementation (due to altered renal tubule permeability)
Systemic Mycoses (3)
- Amphotericin B
- Flucytosine (in combo with Amphotericin B)
- -azoles (for local infections)
Cryptococcal Meningitis (2)
- Amphotericin B
- Fluconazole (CM in AIDS patients because can cross BBB)
Fungal Meningitis
Amphotericin B
Candida infections (5)
- Topical -azole (Vaginal)
- Fluconazole or Caspofungin (Oral or Esophageal)
- Nystatin (Oral + Vaginal)
- Amphotericin B
- Caspofungin + Micafungin (Systemic)
Histoplasma infections
Itraconazole
Mucormycosis (Mucor / Rhizopus infection)
Amphotericin B
Aspergillus infections
Caspo- + Micafungin
Topical Fungal infections
Clotrimazole + Miconazole
Cutaneous Mycoses / Tineas (2)
- Topical Miconazole
- Selenium Sulfide (“Selsun”)
Toxoplasmosis (2)
Pyrimethamine + Sulfadiazine
African Sleeping Sickness (2)
- Suramin (for bl-borne dz)
- Melarsoprol (for CNS penetration)
** THINK: “It SURE is nice to sleep with MELAtonin”. **
Dermatophytoses
(Dermatophytes = Ringworm and Tinea)
(2)?
- Griseofulvin (esp superficial infections)
- Terbinafine (esp onychomycosis)
Both lipid-soluble = can cross BBB
Malaria
EMPIRIC RX, 2 other options?
Chloroquine (blocks Plasmodium heme polymerase).
(If resistant)
- Mefloquine
- Alovaquone / Proguanil
Life-Threatening Malaria
Precaution?
Quinidine (IV)
** Test for G6PD Def **
P vivax/ovale Malaria
Precaution?
(Standard Regimen) + Primaquine
** Test for G6PD Def **
Babesiosis (2)
Atovaquone + Azithromycin
Nematode / Roundworm Infections (4 General RX)
- Bendazoles
- Pyrantel Pamoate
- Ivermectin
- Diethylcarbamazine (Loa Loa + Wuchereria ONLY)
Cestode / Tapeworm + Trematode / Fluke Infections
Praziquantel
Albendazole for Neurocysticercosis + Hyatid Casts in liver ONLY
Influenza A + B
Zana- + Oseltamivir (only if within 48 hrs of symptom onset)
RSV infection
Prophylaxis, Treatment?
P = Palivizumab (ie P for high-risk infants)
T = Ribavirin
Herpes Zoster infection
Famciclovir
HIV PROPHYLAXIS
(2, depending on CD4 count)?
- CD4
CMV infection
Ganciclovir
… When Acyclovir + Ganciclovir FAIL …
Cidofovir + Foscarnet
Ribavirin (2)
- RSV
- Chronic Hepatitis C
