Random ID Tidbits Flashcards
How does ertapenem compare to the other carbapenems?
Cons: Lack pseudomonas coverage! Also isn’t active against enterococci or acinetobacter.
Pro: Once daily admin. Nice for use at home. Retains ESBL activity for Enterobacteriaceae
What is a normal CRP?
< 10 is normal
> 10 indicates infection/inflammation.
What’s a normal ESR?
Erythrocyte sedimentation rate.
0-30 is normal
Higher may indicate infection or inflammation.
Can Ancef be used for brain infections?
No, poor penetration
Can Nafcillin be used for brain infections?
Yes
Can oxacillin be used in CNS infections?
Yes
How do you treat fungal native valve endocarditis?
Ampho + flucytosine for 6 weeks Plus valve replacement
Then lifelong suppression with an oral -azole
Metalo-beta-lactamases hydrolyze all beta lactams except which one?
Aztreonam.
EDTA can inhibit what kind of beta-lactamase?
metalo-beta-lactamases.
What are the 3 metalobetalactamases?
IMP, VIM, NDM
MexXY, MexAB, and AdeABC are examples of what?
Efflux pumps.
Testing for inducible clinda resistance is indicated if:
For staph that is clinda susceptible but erythromycin resistant.
At what age do you switch from dtap to tdap?
7 years old.
Can appendicitis be treated with abx alone, and no surgery?
No. Need both.
What is the duration of therapy for initial episode of C diff? And what is recommended therapy?
10 days of PO Vanc 125 mg q6h OR fidaxomicin 200 mg BID. (Flagyl is an alternative, but outcomes are worse)
*If the infection is fulminant (hypotension, shock, megacolon) VANC dose is 500 mg QID.
When should you add flagyl to c diff therapy?
When there’s illeus present. (Give IV). Can also consider rectal vancomycin.
What about first recurrence of C diff?
Try something new, including VAN pulsed and tapered, and FDX.
What about second recurrence of C diff?
Can now consider following VAN 125 mg QID with 20 days of rifaximin 400 mg TID.
Can also consider FMT.
When is C diff presentation considered severe (but not fulminant?)
WBC >/= 15k or SCr >/=1.5
What is the significance of β-D-glucan testing?
β-D-glucan is a cell wall constituent of Candida and other fungal species. The use of a serum β-D-glucan has been approved by the FDA as an adjunct to blood cultures for the diagnosis of invasive fungal infections.
What is the recommended duration of therapy for an initial non-severe C. difficile infection?
10 days
Which FQ provides anaerobic coverage?
Moxifloxacin
What about FQ’s and divalent cations?
Take the FQ 2 hours before or 6 hours after.
Regarding HepB serology titers, what level of HBsAb indicated immunity?
10 mIU/L is the minimum. Less than that and you should receive a HebB booster shot.
Can you use TAF in pts with CrCl = 15 ml/min?
Yes you can. Dose adjustment though?
