Respiratory Infections

Question 1

what is the DOC for GAS pharyngitis?

Answer 1

Penicillin V

children? Amoxicillin (tastes better)

Question 2

Treating GAS with a penicillin allergy

Answer 2

• type I HSN allergy: azithromycin, clarithromycin, clindamycin
• non-type I HSN: 1st gen cephalosporin- cephalexin

Question 3

what is the DOC for bacterial sinusitis/otitis media?

Answer 3

amoxicillin

Question 4

CAP Empirical Treatment:

outpatient, previously healthy
no antimicrobials within last 3 months

Answer 4

• macrolide (erythromycin, clarithromycin, azithromycin, telithromycin)
• doxycycline

Question 5

CAP Empirical Treatment:

outpatient - but presence of comorbidities / immunosuppressed/
use of IC drugs/ antimicrobials in the last 3 months

or

inpatient, non-ICU

Answer 5

• respiratory fluoroquinolone (levofloxacin, gemifloxacin, moxifloxacin)
• B-lactam (cefotaxime, ceftriaxone, ampicillin-sulbactam) + macrolide (TACE -mycin)

Question 6

CAP Empirical Treatment:

inpatient, ICU

Answer 6

B-lactam + azithromycin or respiratory fluoroquinolone

penicillin allergy patients?
respiratory fluoroquinolone (levofloxacin, gemifloxacin, moxifloxacin) + aztreonam

Question 7

aspiration pneumonia (anaerobes)

Answer 7

DOC: Clindamycin

2. metronidazole

Question 8

bordetella pertussis

Answer 8

DOC: macrolide

2: cotrimoxazole

Question 9

chlamydia pneuomiae

Answer 9

DOC: macrolide, doxcycline

2: resp fluoroquinolone

Question 10

hemophilus influenzae (otitis media, sinusitis) 
non-b-lactamase producing

Answer 10

DOC: amoxicillin

2: 2nd/3rd gen Cephalosporin, cotrimoxazole

Question 11

hemophilus influenzae (otitis media, sinusitis) 
b-lactamase producing

Answer 11

DOC: 2nd/3rd gen cephalosporin or
amoxicillin-clavulanic acid (child)

2. co-trimoxazole

Question 12

klebsiella pneumoniae

Answer 12

DOC: ceftriaxone, cefotaxime

2: fluoroquinolones

Question 13

Legionella sp.

Answer 13

DOC: fluoroquinolones, azithromycin

2: doxycycline, co-trimoxazole

Question 14

moraxella catarrhalis

Answer 14

DOC: amoxicillin-clavulonic acid, 2nd/3rd gen cephalosporins, co-trimoxazole

2: macrolide

Question 15

mycoplasma pneumoniae

Answer 15

DOC: macrolide, doxycycline

2: resp fluoroquinolone

Question 16

pseudomonas aeruginosa

Answer 16

DOC: antipseudomonal penicillin, ciproflaxacin

2: levofloxacin, aztreonam, aminoglycoside

Question 17

s. aureus methicillin susceptible

Answer 17

DOC: antistaph penicillin

2: 2nd/3rd gen cephalosporin, clindamycin, fluoroquinolone, imipenam

Question 18

s. aureus methicillin resistant

Answer 18

DOC: vancomycin, linezolid

2: ceftaroline

Question 19

strep pneumoniae penicillin non-resistant

Answer 19

DOC: Pen G, amoxicillin

2: cephalosporin, clindamycin, fluoroquinoline, macrolide, cotrimoxazole

Question 20

strep pneumoniae penicillin resistant

Answer 20

DOC: 2nd/3rd gen cephalosporins, resp fluoroquinolones

2: vancomycin, linezolid, streptogramins

Question 21

tularemia

Answer 21

DOC: streptomycin

2: gentamicin, chloramphenicol