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Pediatric Empiric Antimicrobials > Pediatric Infections > Flashcards

Pediatric Infections Flashcards

1
Q

Sepsis (less than four weeks)

Most Likely Pathogens

A

Streptococcus agalactiae
Escherichia coli
Listeria monocytogenes
Herpes simplex virus

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2
Q

Sepsis (less than four weeks )

First choice antibiotics

A

Ampicillin plus gentamicin or cefotaxime

with or without Acyclovir

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3
Q

Sepsis (less than four weeks)

Penicillin allergy antibiotics

A

Vancomycin plus gentamicin or Cefotaxime

with or without acyclovir

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4
Q

Sepsis (greater than four weeks)

Most likely pathogens

A

Neisseria meningitidis
streptococcus pneumonia
Escherichia coli
staphylococcus aureus

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5
Q

Sepsis (greater than four weeks)

First choice antibiotics

A

Cefotaxime

With or without vancomycin

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6
Q

Sepsis (greater than four weeks)

Penicillin allergy antibiotics

A

Cefotaxime

with or without vancomycin

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7
Q

Meningitis (less than four weeks)

Most likely pathogens

A

Streptococcus agalactiae
Escherichia coli
Listeria monocytogenes
herpes simplex virus

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8
Q

Meningitis (less than four weeks)

first choice antibiotics

A

Ampicillin
plus Cefotaxime
plus acyclovir

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9
Q

Meningitis (less than four weeks)

Penicillin allergy antibiotics

A

Vancomycin
plus Cefotaxime
with or without Acyclovir

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10
Q

Meningitis (greater than four weeks)

most likely pathogens

A

Neisseria meningitidis
streptococcus pneumoniae
Haemophilus influenzae

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11
Q

Meningitis (greater than four weeks)

first choice antibiotics

A

Ampicillin
Plus vancomycin
With or without acyclovir

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12
Q

Meningitis (greater than four weeks)

Penicillin allergy antibiotics

A

Cefotaxime
Plus vancomycin
With or without acyclovir

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13
Q

Encephalitis

Most likely Pathogens

A

Herpes simplex virus

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14
Q

Encephalitis

First choice antibiotics

A

Acyclovir

Plus antibiotics as for meningitis

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15
Q

Encephalitis

penicillin allergy antibiotics

A

Acyclovir

Plus antibiotics as for “meningitis”

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16
Q

Cerebral abscess or subdural empyema

most likely Pathogens

A 
Streptococci species 
staphylococcus aureus 
anaerobic organisms 
gram-negative organisms 
streptococcus pneumonia 
Haemophilus influenza
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17
Q

Cerebral abscess or sub dural empyema

first choice antibiotics

A

Cefotaxime
Plus vancomycin
Plus metronidazole

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18
Q

Cerebral abscess or subdural empyema

penicillin allergy antibiotics

A

Cefotaxime
Plus vancomycin
Plus metronidazole

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19
Q

Streptococcal pharyngitis/tonsillitis

Most likely Pathogens

A

Streptococcus pyogenes (group A strep)

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20
Q

Streptococcal pharyngitis/tonsillitis

first choice antibiotics

A

Penicillin V PO
Or amoxicillin PO
Or penicillin G

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21
Q

Streptococcal pharyngitis/tonsillitis

penicillin allergy antibiotics

A

Cephalexin PO
Or clindamycin PO
Or clarithromycin PO
Or cefazolin

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22
Q

Bacterial acute otits media

most likely Pathogens

A

Haemophilus influenza
Streptococcus pneumoniae
Moraxella catarrhalis

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23
Q

Bacterial acute otitis media

first choice antibiotics

A

Amoxicillin PO

Or amoxicillin-clavulanate PO

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24
Q

Bacterial acute otitis media

penicillin allergy antibiotics

A

Cefprozil PO

Or clarithromycin PO

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25
Q

Mastoiditis most likely Pathogens

A 
Streptococcus pneumonia 
streptococcus pyogenes (group a strep) staphylococcus aureus
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26
Q

Mastoiditis

first choice antibiotics

A

Cefotaxime

With or without vancomycin

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27
Q

Mastoiditis

penicillin allergy antibiotics

A

Cefotaxime

With or without vancomycin

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28
Q

Sinusitis

most likely Pathogens

A 
Haemophilus influenza 
streptococcus pneumonia 
Moraxella catarrhalis 
staphylococcus aureus 
streptococcus pyogenes (group a strep) 
Anaerobic organisms (in older children)
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29
Q

Sinusitis

first choice antibiotics

A

Amoxicillin PO
Or amoxicillin-clavulanate PO
If IV treatment required, treat as for mastoiditis

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30
Q

Sinusitis

penicillin allergy antibiotics

A

Cefprozil PO
Or clarithromycin PO
Or cefixime PO plus clindamycin PO
If IV treatment required, treat as for mastoiditis

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31
Q

Cervical lymphadenitis

most likely Pathogens

A 
Staphylococcus aureus 
streptococcus pyogenes (group a strep)
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32
Q

Cervical lymphadenitis

first choice antibiotics

A

Cephalexin PO
Or clindamycin PO
Or cefazolin

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33
Q

Cervical lymphadenitis

penicillin allergy antibiotics

A

Clindamycin PO

Or cefazolin

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34
Q

Preseptal cellulitis

most likely Pathogens

A

Streptococcus pneumonia

Staphylococcus aureus

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35
Q

Preseptal cellulitis

first choice antibiotics

A

Cephalexin PO
Or clindamycin PO
Or cefazolin
Or vancomycin

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36
Q

Preseptal cellulitis

penicillin allergy antibiotics

A

Cefprozil PO
Or clindamycin PO
Or cefazolin
Or vancomycin

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37
Q

Orbital cellulitis

most likely Pathogens

A

Staphylococcus aureus
streptococcus pneumonia
other Streptococcus species
haemophilus influenza

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38
Q

Orbital cellulitis

first choice antibiotics

A

Cefotaxime

With or without vancomycin

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39
Q

Orbital cellulitis

penicillin allergy antibiotics

A

Cefotaxime

With or without vancomycin

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40
Q

Dental abscess with fever and/or extensive spread

most likely Pathogens

A 
Viridans streptococci 
Peptostreptococcus species 
Prevotella species 
porphyromonas melaninogenicus
fuslbacterium species 
usually polymicrobial
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41
Q

Dental abscess
with fever and or extensive spread
first choice antibiotics

A

Amoxicillin-clavulanate PO

Or penicillin G plus metronidazole PO

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42
Q

Dental abscess
with fever and or extensive spread
penicillin allergy antibiotics

A

Clindamycin PO/IV

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43
Q

Community acquired pneumonia (less than one month)

most likely Pathogens

A

Streptococcus agalactiae
Eacherichia coli
listeria monocytogenes

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44
Q

Community acquired pneumonia (less than one month)

first choice antibiotics

A

Ampicillin

Plus gentamicin or cefotaxime

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45
Q

Community acquired pneumonia (less than one month)

penicillin allergy antibiotics

A

Cefotaxime
Plus gentamicin
Plus vancomycin

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46
Q

Community acquired pneumonia (1 to 3 months)

most likely Pathogens

A

Streptococcus pneumonia Streptococcus agalactiae
staphylococcus aureus
Escherichia coli
chlamydia trachomatis

47
Q

Community acquired pneumonia (1 to 3 months)

first choice antibiotics

A

Cefotaxime
With or without vancomycin
With or without clarithromycin PO

48
Q

Community acquired pneumonia (1 to 3 months)

penicillin allergy antibiotics

A

Cefotaxime
With or without vancomycin
With or without clarithromycin PO

49
Q

Community acquired pneumonia (greater than three months)

most likely Pathogens

A 
Respiratory viruses 
streptococcus pneumonia 
haemophilus influenzae 
staphylococcus aureus 
mycoplasma pneumonia 
chlamydia pneumonia
50
Q

Community acquired pneumonia (greater than three months)
mild
first choice antibiotics

A

Amoxicillin PO

51
Q

Community acquired pneumonia (greater than three months)
mild
penicillin allergy antibiotics

A

Cefprozil PO

52
Q

Community acquired pneumonia (greater than three months)
moderate
most likely Pathogens

A

Ampicillin
With or without clarithromycin PO
With or without oseltamivir PO

53
Q

Community acquired pneumonia (greater than three months)
moderate
penicillin allergy

A

Cefotaxime
With or without clarithromycin PO
With or without oseltamivir PO

54
Q

Community acquired pneumonia (greater than three months)
severe
First choice antibiotics

A

Cefotaxime
With or without vancomycin
With or without clarithromycin PO
With or without oseltamivir PO

55
Q

Community acquired pneumonia (greater than three months)
severe
penicillin allergy antibiotics

A

Cefotaxime
With vancomycin
With or without clarithromycin PO
With or without oseltamivir PO

56
Q

Parapneumonic empyema

most likely Pathogens

A

Staphylococcus aureus
streptococcus pneumonia
Haemophilus influenza

57
Q

Parapneumonic empyema

first choice antibiotics

A

Cefotaxime

With or without vancomycin

58
Q

Parapneumonic empyema

penicillin allergy antibiotics

A

Cefotaxime

With or without vancomycin

59
Q

Hospital acquired pneumonia

most likely Pathogens

A

Staphylococcus aureus
Haemophilus influenza
Enterobacter species
Pseudomonas aeruginosa

60
Q

Hospital acquired pneumonia

first choice antibiotics

A

Cefotaxime or piperacillin-tazobactam

With or without vancomycin

61
Q

Hospital acquired pneumonia

penicillin allergy antibiotics

A

Cefotaxime
With or without vancomycin
With or without gentamicin

62
Q

Aspiration pneumonia

most likely Pathogens

A

Staphylococcus aureus
Haemophilus influenza
Enterobacter species
oral anaerobes (see “dental abscess”)

63
Q

Aspiration pneumonia

first choice antibiotics

A

Amoxicillin-clavulanate PO
Or cefuroxime PO
Plus metronidazole or clindamycin IV/PO

64
Q

Aspiration pneumonia

penicillin allergy antibiotics

A

Cefotaxime plus clindamycin IV/PO
Or C PO
Plus metronidazole or clindamycin IV/PO

65
Q

Infective endocarditis

most likely Pathogens

A

Viridans streptococci

Staphylococcus aureus

66
Q

Infective endocarditis

first choice antibiotics

A

As guided by blood culture results

consult ID and cardiology

67
Q

Infective endocarditis

penicillin allergy antibiotics

A

As guided by blood culture results

consult IT and cardiology

68
Q

Urinary tract infection (less than two months)

most likely Pathogens

A 
Escherichia coli
klebsiella species 
proteus species 
Enterobacter species 
enterococcus species
69
Q

Urinary tract infection (less than two months)

first choice antibiotics

A

Ampicillin plus gentamicin

Imperative to check blood and CSF cultures. If positive, exit UTI pathway.

70
Q

Urinary tract infection (less than two months)

penicillin allergy antibiotics

A

Cefotaxime or gentamicin

Imperative to check blood and CSF cultures. If positive, exit UTI pathway

71
Q

Urinary tract infection
mild
(greater than two months)
most likely Pathogens

A 
Escherichia coli 
klebsiella species 
proteus species 
Enterobacter species 
enterococcus species 
staphylococcus saprophyticus (in adolescents)
72
Q

Urinary tract infection
mild
(greater than two months)
first choice antibiotics

A

Cephalexin PO

73
Q

Urinary tract infection
mild
(greater than two months)
penicillin allergy antibiotics

A

Cephalexin PO

74
Q

Urinary tract infection
severe
(greater than two months)
most likely Pathogens

A

Escherichia coli
Klebsiella species
Proteus species
Enterobacter species

75
Q

Urinary tract infection
severe
(greater than two months)
first choice antibiotics

A

Cefotaxime or gentamicin

76
Q

Urinary tract infection
severe
(greater than two months)
penicillin allergy antibiotics

A

Cefotaxime or gentamicin

77
Q

Pelvic inflammatory disease

most likely Pathogens

A

Neisseria gonorrhea
chlamydia trichomonas
anaerobic organisms

78
Q

Pelvic inflammatory disease

first choice antibiotics

A

Cefixime PO or ceftriaxone IM
Plus doxycycline PO
With or without metronidazole PO

79
Q

Pelvic inflammatory disease

penicillin allergy antibiotics

A

Cefixime PO or ceftriaxone IM
Plus doxycycline PO
With or without metronidazole PO

80
Q

Bacterial gastroenteritis

most likely Pathogens

A 
Salmonella species 
shigella species 
Campylobacter species 
Escherichia coli
Plesiomonas shigelloides
 Aeromonas hydrophilic
81
Q

Bacterial Gastroenteritis

first choice antibiotics

A

Treatment not routinely required. If severe, then treat according to susceptibilities of organism isolated.

82
Q

Bacterial gastroenteritis

penicillin allergy antibiotics

A

Treatment not routinely required. If severe, then treat according to susceptibilities of organism isolated.

83
Q 
Secondary peritonitis (excluding peritoneal dialysis patients) 
Most likely Pathogens
A 
Escherichia coli
Klebsiella species
Pseudomonas aeruginosa
Enterococcus species 
bacteroides fragilis 
peptostreptococcus species
84
Q 
Secondary peritonitis (Excluding peritoneal dialysis patients) 
first choice antibiotics
A

Piperacillin-tazobactam
Or
Ampicillin plus gentamicin plus metronidazole

85
Q 
Secondary peritonitis (excluding peritoneal dialysis patients) 
penicillin allergy antibiotics
A

Cefotaxime plus metronidazole

86
Q

Primary peritonitis

most likely Pathogens

A

Streptococcus pneumoniae

Escherichia coli

87
Q

Primary peritonitis

first choice antibiotics

A

Cefotaxime

88
Q

Primary peritonitis

penicillin allergy antibiotics

A

Cefotaxime

89
Q

Ascending cholangitis

most likely Pathogens

A 
Escherichia coli
Klebsiella pneumoniae
Enterobacter species
Pseudomonas aeruginosa
Enterococcus species
Anaerobic organisms
90
Q

Ascending cholangitis

First choice antibiotics

A

Ampicillin plus cefotaxime
with or without Metronidazole
Or piperacillin-tazobactam

91
Q

Ascending cholangitis

Penicillin allergy antibiotics

A

Vancomycin with or without cefotaxime

With or without metronidazole

92
Q

Antibiotic associated colitis (clostridium Difficile infection)
First choice antibiotics

A

Metronidazole PO

Stop all other antibiotics if possible

93
Q

Cellulitis
Mild
Most likely pathogens

A 
Streptococcus pyogenes (group A strep)
Staphylococcus aureus
94
Q

Cellulitis
Mild
First choice antibiotics

A

Cephalexin PO

Or TMP-SMX PO

95
Q

Cellulitis
Mild
Penicillin allergy antibiotics

A

Cephalexin PO

Or TMP-SMX PO

96
Q

Cellulitis
Severe
Most likely pathogens

A 
Streptococcus pyogenes (group A strep)
Staphylococcus aureus
97
Q

Cellulitis
Severe
First choice antibiotics

A

Cefazolin with or without clindamycin PO

98
Q

Cellulitis
Severe
Penicillin allergy antibiotics

A

Cefazolin with or without clindamycin PO

99
Q

Soft tissue injury
Clean
Most likely pathogens

A

Not infected

100
Q

Soft tissue injury
clean
first choice antibiotics

A

Antibiotics not required

101
Q

Dog/cat/human bites
mild
most likely Pathogens

A 
Staphylococcus aureus 
streptococcus species 
Eikenella corrodens (human) 
pasteurella species (dog or cat)
Capnocytophaga cynodegmi (dog or cat) 
anaerobic organisms 
usually polymicrobial
102
Q

Dog/cat/human bites
mild
first choice antibiotics

A

Amoxicillin-clavulanate PO

103
Q

Dog/cat/human bites
mild
penicillin allergy antibiotics

A

Clindamycin PO plus TMP-SMX PO

104
Q

Dog/cat/human bites
severe
most likely Pathogens

A 
Staphylococcus aureus
Streptococcus species
Eikenella corrodens (humans)
Pasteurella species (dog or cat)
Capnocytophaga cynodegmi (dog or cat)
Anaerobic organisms
Usually polymicrobial
105
Q

Dog/cat/human bites
Severe
First choice antibiotics

A

Piperacillin-tazobactam

106
Q

Dog/cat/human bites
Severe
Penicillin allergy antibiotics

A

Clindamycin

TMP-SMX

107
Q 
Necrotising fasciitis (unknown etiology)
Most likely pathogens
A

Streptococcus pyogenes (group A strep)
Staphylococcus aureus
Aerobic and anaerobic organisms
May be polymicrobial

108
Q 
Necrotising fasciitis (unknown etiology)
First choice antibiotics
A

Piperacillin-tazobactam
Plus vancomycin
Plus clindamycin

109
Q 
Necrotising fasciitis (unknown etiology)
Penicillin allergy antibiotics
A

Ciprofloxacin
Plus vancomycin
Plus clindamycin

110
Q

Documented group A streptococcal necrotising fasciitis

First choice antibiotics

A

Penicillin plus clindamycin

111
Q

Documented group A streptococcus necrotising fasciitis

Penicillin allergy antibiotics

A

Cefotaxime plus clindamycin

112
Q

Osteomyelitis or septic arthritis (greater than 3 months)

Most likely pathogens

A 
Staphylococcus aureus
Streptococcus pyogenes (group A strep)
Streptococcus pneumoniae
Kingella Kingae
Neisseria species
Salmonella species
113
Q

Osteomyelitis or septic arthritis (greater than 3 months)

First choice antibiotics

A

Cefazolin or vancomycin

114
Q

Osteomyelitis or septic arthritis (greater than 3 months)

Penicillin allergy antibiotics

A

Cefazolin or vancomycin

Pediatric Empiric Antimicrobials (1 decks)

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