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Pharma- Antimicrobial drugs > specific infections > Flashcards

specific infections Flashcards

1
Q

Pharingitis, Tonsillitis

A

– Potential pathogen: Viral, S. pyogenes, (other Streptococcis, C. diphteriae, Gonococci etc.)

– Therapy: Penicillin V, Aminopenicillins, I. gen Cephalosporins, Macrolids, Clindamycin

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2
Q

Sinusitis, Otitis media:

A

– Potential pathogen: Pneumococci, H. influenzae, Moraxella catarrhalis, Staphylococci aureus, Anaerobes, Streptococci species

– Therapy: Amoxicilline-Clavulanic acid, Cefuroxime, Cefprozil, Macrolide, III. gen. Fluoroquinolones, Doxycycline

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3
Q

Bronchitis

A

• Acute:
– Potential pathogen: Viral, M. pneumoniae, C. pneumoniae, B. pertussis
– Therapy (if it is necessary): Macrolides

• Chronic with acute exacerbation:
– Potential pathogen: H. influenzae, Moraxella, and Streptococcus pneumoniae
– Therapy: Macrolides, Amoxicilline-Clavulanic acid, II. gen Cephalosporine,
III. gen Fluoroquinolones

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4
Q

Risk of Pseudomonas (Bronchitis)

A

Fluoroquinolons+ Amoxycilline, Piperacilline-Tazobactam, Ceftazidime, Meropenem

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5
Q

Community acquired pneumonia, Without comorbidity, <65 :

A

– Potential pathogen : Pneumococci, H. influenzae, M. pneumoniae, C. pneumoniae, viruses (sometimes: Legionella, S. aureus, aerob Gr- rods, TBC)

– Therapy: Amoxicillin-Clavulanic acid (Amox-Clav), Macrolids, Cefuroxim-axetil,

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6
Q

Community acquired pneumonia, Middle severe comorbidities or >65 :

A

– Potential pathogen : Pneumococci, H. influenzae, aerob Gr- rods, S. aureus, C. pneumoniae (M. catarhalis, Legionella, TBC)

– Therapy: po.: Amox-Clav or Cefuroxim-axetil ± Macrolid, 3. gen. Fluoroquinolones (FQ); iv: Ceftriaxone/ Cefuroxim ± Macrolid

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7
Q

Community acquired pneumonia, Hospitalisation is required:

A

– Potential pathogen: Pneumococci, H. influenzae, aerob Gr- rods, Legionella, S. aureus, C. pneumoniae, polymicrobal inf. with anaerobs, viral (M. pneumoniae, M. catarhalis, TBC)

– Therapy: iv: Amox-Clav, Amp-Sulb, cefuroxime, ceftriaxone/cefotaxime + macrolid, 3 gen. FQ. If suspected anaerob infection: cephalosporins + clindamycin / metronidazol, moxifloxacin

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8
Q

Community acquired pneumonia, Very severe (ICU treatment)

A

– Potential pathogen: Pneumococci, Legionella, S. aureus, Gr- rods, M. pneumoniae, Viral (H. influenzae, TBC)

– Therapy:
• If Pseudomonas is not suspected: Ceftriaxone/cefotaxime/ertapenem + Macrolid or 3 gen. FQ
• If Pseudomonas is suspected: Ceftazidime, Cefepime, Carbapenems, Piperacillin-Tazobactam + Macrolids or Fluoroquinolones ± Aminoglycozides

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9
Q

Urinary tract infections

Women - uncomplicated cystitis

A

– Potential pathogen: E. coli, Staphylococci Saprophyticus, Proteus, Klebsiella, E. faecalis

– Therapy: Nitrofurantoin, Fosfomycin-trometamol, Cotrimoxazol (Res!), Fluoroquinolons (Res!!), oral 3. gen cephalosporins

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10
Q

Urinary tract infections

Women - uncomplicated acute pyelonephritis

A

– Potential pathogen: E. coli (Proteus, Klebsiella, S. saprophyticus)

– Therapy: 2-3 gen. parent. cephalosporinok, 3. gen. oral cephalosporins, Amox-Clav (iv. Amp-Sul), aminoglycosid, 2. gen. Fluoroquinolones (Res!)

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11
Q

Urinary tract infections

Complicated urinary tract infections (in case of men is always complicated)

A

– Potential pathogen: E. Coli, Klebsiella, Pseudomonas, Enterobacter, other Enterobacteriaceae, Enterococci, S. epidermidis (Microbiol. diagnosis is important)

– Therapy: 2-3-4 gen Cephalosporins, Aminoglycosids, Carbapenems (ESBL), Fluoroquinolons (Res!!)

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12
Q

Intraabdominal infections

Colecystitis

A

– Potential pathogen: Enterobacteriaceae (most common. E. coli), Klebsiella, Enterobacter), Enterococci, Anaerobs, Clostridium strains

– Therapy: 3-4 gen. Cephalosporins + metronidazole/clindamycin, Piperacillin-Tazo (pip- tazo), carbapenems

– The resistancy is very changeable; the ESBL is very common (Klebsiella)

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13
Q

Intraabdominal infections

Spontaneous bacterial peritonitis

A

– Potential pathogen: Enterobacteriaceae, Enterococci

– Therapy: 3 gen cephalosporins, Pip-Tazo, carbapenems, ofloxacin/ciprofloxacin

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14
Q

Intraabdominal infections

Secondary surgical peritonitis (non nosocomial)

A

– Potential pathogen: E. coli , K. pneumoniae + anaerobs (B. fragilis)

– Therapy: Ceftriaxone+Metronidazol, Pip-Tazo, Carbapenems

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15
Q

Intraabdominal infections

Secondary surgical peritonitis (nosocomial)

A

– Potential pathogen: Multiresistant GI bacterias (E. coli, Klebsiella, Enterobacter), Pseudomonas, Acinetobacter, Enterococci

– Therapy: Carbapenems±aminogylcosides, 3-4. gen Cephalosporins+Metronidazole ± Vancomycin. VRE: tigecyclin, linezolid, MACI: colistin

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16
Q

Intraabdominal infections

Pseudomembranosus colitis

A

– Pathogen: C. difficile

– Therapy: oral metronidazole (for 10 days)

– severe case: iv. metronidazol (if orally is not possible) + oral vancomycin.

– In case of relapse: vancomycin or teicoplanin orally for 3 weeks (lower dose) or fidaxomycin (high price!)

17
Q

Meningitis

Newbornes

A

– Pathogen: H. influenzae (vaccine!), S. agalatiae, E. coli, Listeria, Staphylococci

– Therapy: cefotaxime + ampicillin

18
Q

Meningitis

1-3 months old

A

– Pathogen: S. agalatiae, Listeria, Gr- rods, Pneumococci, Meningococci, Haemophylus i.

– Therapy: cefotaxim + ampicillin ± vancomycicn

19
Q

Meningitis!!!

3 months – 60 year

A

– Pathogen: Pneumococci, Meningococci

– Therapy: cefotaxime/ceftriaxone ± vancomycin

20
Q

Meningitis

Meningitis >60 year

A

– Pathogen: Pneumococci, Meningococci, Listeria, Enterobacteriacae

– Therapy: cefotaxim/ceftriaxon + ampicillin, meropenem

21
Q

Meningitis

• Meningitis >60 year
in case of beta lactam allergy:

A

– Pathogen: Pneumococci, Meningococci, Listeria, Enterobacteriacae

– Therapy: Vancomycin + moxifloxacin ± cotrimoxazol (Listeria) , Gr-: chloramphenicol or meropenem (!)

22
Q

Meningococci contact profilaxis:

A

– Ciprofloxacin, Rifampicin

23
Q

Skin and soft tissue infections

• Erysipelas

A

– Pathogen: S. pyogenes (S. aureus)

– Therapy: penicillin G, penicillin V, Clindamycin (oxacillin, cefazolin, ceftriaxon, linezolid)

24
Q

Skin and soft tissue infections

• Cellulitis

A

– Pathogen: S. pyogenes, S. aureus (Gr- Bact., Clostridiums)

– Therapy: cefazolin, flucloxacillin, amox-clav, clindamycin, vancomycin

25
Q

Skin and soft tissue infections

• Stapylococci TSS

A

– Therapys: vancomycin + clindamycin + carbapenem/pip-tazo

– MRSA: glycopeptids, ceftarolin-fosamil, ceftobiprol, oxazolidinons, daptomycin, tigecyclin

26
Q

Skin and soft tissue infections

• Streptococci TSS

A

– Pathogen: S. pyogenes

– Therapy: penicillin G (24ME) + aminoglycosid + clindamycin

27
Q

Skin and soft tissue infections

• Gas gangrene

A

– Pathogen: Clostridium perfringens

– Therapy: Pip-Tazo + clindamycin

28
Q

Skin and soft tissue infections

• Diabetic leg:

A

– Pathogen: commonly polymicrobal: S. aureus, Streptococci, Gr- rods

– Therapy: 1-2 gen cephalosporins, amox-clav, clindamycin

29
Q

Skin and soft tissue infections

• Osteomyelitis

A

– Pathogen: S. aureus, Gr- bacterias (Pseudomonas!)

– Therapy:
• MSSA: oxacillin, cefazolin, clindamycin
• MRSA: vancomycin ± rifampicin, Gr- : ceftazidime, cefepim, fluoroquinolones.

30
Q

Skin and soft tissue infections

• Odontogenic infections:

A

– Pathogen: Streptococci, anaerob bacterias (Actinomyces, Spirochaetes and so)

– Therapy: amox-clav, clindamycin

31
Q

Sexually transmitted diseases(STD)

• Syphilis:

A

treponema pallidum

– Early (1. 2. stage): benzathin-penicillin im.(high dose). Alternative: amox (3g!) + probenecid, doxycylin, ceftriaxone

– Late without neurosyiphilis: benzathin-penicillin. Alternative: ceftriaxone, doxycyclin

– Neurosyphilis: penicillin G, procain-penicillin + probenecid , ceftriaxone

32
Q

Sexually transmitted diseases(STD)

• Gonorrhea:

A

Neisseria gonorrhea

– Ceftriaxone + azithromycin . Spectimomycin

33
Q

Sexually transmitted diseases(STD)

• NGU -> nongonococcal urethritis

A

(C. trachomatis, M. hominis, Ureaplasma)

Azithromycin 1*1g orally or doxycyclin

34
Q

Zoonotic infections

• Lyme disease

A

(Borellia burgdorferi)

– Early stage (local or disseminated): amoxicillin (+ probenecid), doxycyclin, cefuroxim-axetil, Ceftriaxone, (macrolids?) (+tinidazol?)

– Late stage: Ceftriaxone iv.

35
Q

Zoonotic infections

• Plague

A

(Yersinia pestis)

– Streptomycin (gentamicin) + doxycyclin
– (Chloramphenicol)
– Ciprofloxacin, levofloxacin, moxifloxacin

36
Q

Zoonotic infections

• Tularemia

A

Francisella tularensis?

– Streptomycin (gentamicin) / doxycyclin / ciprofloxacin

37
Q

Zoonotic infections

• Brucellosis

A

Brucella ..?

– Streptomycin + doxycyclin or doxycylin+rifampicin (ciprofloxacin)

38
Q

Zoonotic infections

• Rickettsiosis:

rocky mountain spotted fever?

A

rickettsia…?

– Doxycyclin, chloramphenicol (in case of pregnancy or children below the age of 9)

Pharma- Antimicrobial drugs (12 decks)

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