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Fall 2024 > MSK Infection treatment > Flashcards

MSK Infection treatment Flashcards

1
Q

Gram + bacterial organisms?

A

MRSA
Staph
Strep

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2
Q

Gram - bacterial organism?

A

Pseudomonas
E. coli
ESBL

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3
Q

Anaerobes?

A

Streptococci (+)
Clostridia (+)
Bacteroides (-)

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4
Q

Problematic resistant organisms?

A

MRSA (+)
VRE (+)
ESBL (-)

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5
Q

Beta-Lactams: Penicillin

A

Amoxicillin
Oxacillin
Penicillin G

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6
Q

Penicillin/Beta-Lactamase

A

Amoxicillin/clavulanate
Piperacillin/tazobactam

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7
Q

First gen cephalosporin

A

Cephalexin*
cefazolin
cefadroxil

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8
Q

Second gen cephalosporin

A

Cefaclor
Cefoxitin
Cefotetan

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9
Q

Third gen cephalosporin

A

Ceftriaxone*
cefotaxime

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10
Q

Fourth gen cephalosporin

A

Cefepime*

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11
Q

Carbapenems

A

Ertapenem*
Meropenem

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12
Q

Aminoglycosides

A

gentamicin
tobramycin
Amikacin

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13
Q

Quinolones

A

Ciprofloxacin*
Levofloxacin
Moxifloxacin

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14
Q

Macrolides

A

Erythromycin
Clarithromycin
Azithromycin*

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15
Q

Glycopeptides

A

Vancomycin*

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16
Q

Sulfonamides

A

Sulfamethoxazole/trimethoprim *

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17
Q

Inhibition of cell wall synthesis

A

PCN, Cephalosporins, Imipenem, Meropenem, Aztreonam, Vancomycin

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18
Q

Inhibition of bacterial protein synthesis

A

Aminoglycosides
Macrolides

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19
Q

Mechanisms of resistance

A

Enzymatic inactivation of target site or antimicrobial
Alteration of target site
Decreased permeability

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20
Q

Bacteriostatic

A

Clindamycin
Erythromycin
Sulfamethoxazole
Tetracycline
Trimethoprim

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21
Q

Bactericidal

A

Cephalosporin
Fluoroquinolones
Metronidazole
Penicillin
Vancomycin

22
Q

Majority have what side effects

A

N/V/D
Rash
Thrush

23
Q

ASE Penicillin

A

Hypersensitivity
Skin reactions

24
Q

Cephalosporin ASE

A

C. diff

25
Q

Macrolides ASE

A

QT interval prolongation

26
Q

Quinolone ASE

A

QT prolongation

27
Q

Aminoglycosides ASE

A

Nephrotoxicity
Ototoxicity

28
Q

Vancomycin ASE

A

“Red man syndrome”

29
Q

Clindamycin ASE

A

C. Diff

30
Q

Sulfonamides ASE

A

SJS
Blood dyscrasias

31
Q

Drugs that do not need renal adjustment

A

Oxacillin
Ceftriaxone
Clindamycin
Azithromycin
Doxycycline
Rifampin

32
Q

What should be done prior to administering AB for SA

A

Synovial fluid
2 sets of blood cultures
Radiographs

33
Q

What is an important part of SA treatment

A

Joint drainage

34
Q

SA treatment is MSSA

A

Cefazolin 2g IV q8hrs
Oxacillin 2g IV q4hrs
If penicillin allergy, keep Vanco

34
Q

SA treatment for MRSA

A

Vancomycin
Alternatives: Daptomycin or Linezolid

35
Q

Gram + cocci SA

A

Empiric Vancomycin

36
Q

Gram - Bacilli SA

A

Cephalosporin:
Ceftriaxone
Cefotaxime
Cefepime

37
Q

Pseudomonas Aeruginosa (IVDU concern)

A

Initial therapy - 2 antipseudomonal drugs
Cephalosporin + Ciprofloxacin
Aztreonam is alternative to cephalosporin

38
Q

Staph aureus infection with bacteremia but no endocariditis

A

IV ABx for 4 weeks

39
Q

Staph aureus no bacteremia or endocarditis

A

IV 14 days the oral 7-14 days

40
Q

Septic arthritis + osteomyelitis

A

4-6 week course of antibiotics

41
Q

SA monitoring protocol

A
  1. Culture/sensitivity of synovial fluid and blood at initiation of treatment
  2. WBC weekly until within normal range
  3. Daily monitoring - evaluate clinical signs
  4. Reinforcement of compliance
42
Q

OM empiric therapy

A

Vancomycin + agent with activity against gram negative organisms

43
Q

OM MSSA

A

Oxacillin
Cefazolin

44
Q

OM MRSA

A

Vancomycin
Linezolid with allergy

45
Q

OM anaerobes

A

Clindamycin

46
Q

OM Enterobacteriaceae (E. coli - quinolone resistant)

A

E. coli - quinolone resistant
Piperacillin/tazobactam (Zosyn)

47
Q

OM Enterobacteriaceae (E. coli - quinolone sensitive)

A

Ciprofloxacin

48
Q

OM Pseudomonas

A

Cefepime + Ciprofloxacin
Piperacillin/Tazobactam

49
Q

OM Streptococcus

A

Penicillin G 2-4 million units IV every 4 hours

50
Q

Chronic OM

A

Ciprofloxacin
Linezolid
Sulfamethoxazole/Trimethoprim

51
Q

OM duration

A

generally 4-8 weeks
prosthetic joint replacement: 3-6 months or longer

Fall 2024 (34 decks)

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