Pharm Small Group - Infectious Diseases 2

Question 1

If a C.Difficile patient is unable to tolerate by mouth medications, what are the other options and why?

Answer 1

IV Metronidazole may be given, however IV Vanc is ineffective.

Question 2

While confirmation of the organism is being performed, which empirical therapy should be instituted?

Answer 2

• Vancomycin + gentamicin

- Rifampin can be added for treatment of endocarditis in the presence of a prosthetic heart valve.

Question 3

What would you give infective endocarditis patients empirically who have intolerance to vancomcin or resistant organisms?

Answer 3

• Linezolid or

- Daptomycin

Question 4

In all regimens, what is the replacement for patients with penicillin allergy?

Answer 4

Vancomycin

Question 5

What is the main indication of aminoglycosides?

Answer 5

mostly Aerobic gram negatives

Question 6

Why are b-lactam antibiotics often combined with aminoglycosides?

Answer 6

Extend coverage to include potential gram positive pathogens and to take advantage of the synergism between the two classes of drugs:

-b-lactam inhibit cell wall synthesis and thefore increase permeability of bacterium to aminoglycosides.

Question 7

Why should aminoglycosides never be mixed in the same solution with penicillins?

Answer 7

Penicillins inactivate aminoglycosides to a certain degree.

Question 8

What are the potential adverse effects of aminoglycosides?

Answer 8

• Nephrotoxicity (reversible): 5-7 days after therapy

- Ototoxicity (irreversible)

Question 9

What is the standard regimen recommended for endocarditis prophylaxis during oral-dental or respiratory tract procedures

Answer 9

Amoxicillin

Question 10

What is the regimen recommended in patients allergic to oral penicillin for endocarditis prophylaxis during oral-dental or respiratory tract procedures

Answer 10

• Clindamycin
• Cephalexin
• Azithromycin or clarithromycin

Question 11

What is the regimen recommended in patients unable to take oral medication for endocarditis prophylaxis during oral-dental or respiratory tract procedures

Answer 11

Ampicillin IV or IM

Question 12

What is the regimen recommended in patients allergic to penicillin for endocarditis prophylaxis during oral-dental or respiratory tract procedures

Answer 12

Clindamycin IV

or

Cefazolin IV