Peds Flashcards
Acute Otitis Media
-Inflammation in middle ear with fluid collection
Bugs
-Strep. pneumoniae
-Hae influenzae
-Moraxella catarrhalis
Mild bulging of the TM AND recent ear pain (< 48 h) OR intense erythema of TM
Acute Otitis Media TX
PCN Allergy?
= Cephalosporin
NO PCN Allergy
= Augmentin, if recent amox/recurrent aom/poor response or purulent conjunctivitis
NO PCN Allergy
= Amoxicillin, if no purulent conj
AOM Dosing
First Line
-Amox 80-90 mg/kg/day BID
-Amox/Clav 90 mg/kg/day BID
Alt for PCN Allergy
-Cefdinir 14 mg/kg/day
-Cefuro 30
-Cefodox 10
-Ceftriax 50
AOM Common Drugs AE
AMOX
-Diarrhea
-Rash
AMOX/CLAV
-More diarrhea
CTX (if abx failure)
-Painful when IM
-Allergy potential, rash
-GI, diarrhea
CAP, com acquired pneumonia
-Fever, cough, labored breathing, flaring nostrils
-Temp, tachy, WBC, wheezing, rales
Empiric Treatment for CAP
Outpatient for > 3 months old
< 5
-Bacteria: AMOX
-Atypical: AZITHRO
-Influenza: OSELT
5+
-Bacteria: AMOX (AC), can add macrolide
-Atypical: AZITHRO
-Influenza: OSELT, ZANA
Empiric Treatment for CAP
Inpatient for > 3 months old
Immunization status
-Fully: AMP, PCN G, CTRX, CEFOTAX
*can add vanco/clinda if MRSA
-Partial: CTRX, CEFOTAX with added vanco/clinda for MRSA
Severe but not in ICU
-CEFOTAX or CTRX
-PLUS AZITHRO, ERYTHRO, DOXY
ICU
-all 3: vanco, cefo/ceftriax, and azithro
CAP: Inpatient Empiric TX for < 3 months old
< 1: AMP + GENT
1-3: CEFOTAX, with vanco or clinda and macrolide
*not cftriaxone ever
GAT a CV for Me
Antibiotics for Staphylococcus aureus
-NAF, OXA, CEFAZOLIN
-VANCO
-CLINDA if D-test negative
CAP: Common AEs
Erythro
-Pyloric stenosis
Doxy
-Teeth/bone discoloration
CTRX
-Biliary slugging in < 1 mo
Levo
-Cartilage toxicity
Pharyngitis
-Sudden onset
-Sore throat
-Fever
-Scar rash
-Tonsillar exudates
-Empiric TX not necessary
Resolves on its own 3-5 days
*Abx tx indicated to minimize progression to serious complications
Pharyngitis TX
1: oral PCN V (pheno pcn)
-ana, rxns, diarrhea
2: IM benz PCN G
-rxns, pain at injection site
Can do amox, cepha
