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Phar 761 > SSTI's > Flashcards

SSTI's Flashcards

1
Q

Appearance of Cellulitis

A

Usually on the limbs
Red and spreading quickly
Usually due to puncture of some sort

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2
Q

Appearance of Erysipelas

A

Usually on the face

Red and spreading quickly

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3
Q

Appearance of Impetigo

A

Usually on the face
Like cold sores
Small, thick golden crusts = Impetigo contagiosum
Large, thin ligh-brown crusts = Bullous impetigo

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4
Q

Appearance of Lymphangitis

A

Connected through lymphatic system.

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5
Q

Appearance of Necrotizing infections

A

Very painful, and pain extends further than the visible portion of the infection.
Rapidly progressive.

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6
Q

Appearance of Bite wounds

A

Obvious

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7
Q

Appearance of Osteomyelitis

A

Deep infections

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8
Q

Appearance of Osteomyelitis

A

Deep infections, often connected to DM in this module’s context.

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9
Q

Erysipelas pathogens

A

Almost exclusively Group A Strep (pyogenes)

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10
Q

Impetigo pathogens

A

Group A Strep (pyogenes)

S. aureus becoming more common

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11
Q

Impetigo pathogens

A

Group A Strep (pyogenes) - Contagiosum

S. aureus becoming more common - Bullous

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12
Q

Purulent skin infection pathogens

A

CA-MRSA* - Increasing

MSSA a little bit

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13
Q

Necrotizing skin infection pathogens

A

Polymicrobial (70%)
- Anaerobes, Strep, Enterobacter: surgery, bowel penetration, decubitus ulcer, IVDA, perianal

Monomicrobial (30%)

  • S. pyogenes: minor trauma
  • Clostridium perfringens (gas gangrene): surgery or major trauma
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14
Q

Bite infection pathogens

A

Cats

  • Human: Polymicrobial: Gram + skin flora, oral anaerobes (Eikenella corrodens - need to cover)
  • Cat: Pasteurella multocida
  • Dog: Pasteurella multocida, capnocytophaga carimorsus
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15
Q

DM Foot Infection pathogens

A

Often polymicrobial

  • Gram + early on
  • Gram - in chronic infections
  • Anaerobes when foul smell
  • MRSA if been in hospital recently
  • Pseudomonas if patient has been soaking feet
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16
Q

Treatment duration Cellulitis

A

5 days

Longer if delayed clinical response

17
Q

Treatment duration Erysipelas

A

5 days

Longer if delayed clinical response

18
Q

Treatment duration Impetigo

A 
Usually non-pharm
- soapy wash
Pharm if bad enough
- Topical mupirocin/retapamulin if few lesions
- diclox
- cephalexin
- Augmentin
19
Q

Treatment duration Necrotizing

A

3-4 days

20
Q

Treatment duration Necrotizing

A

Until debridement complete + 3-4 days

21
Q

Treatment duration Bites

A

3-5 days

22
Q

Treatment duration DM Foot Infections

A

PEDIS 1: ?
PEDIS 2: 10-14
PEDIS 3-4: 21+ days
With associated osteomyelitis: 6-12 WEEKS

23
Q

Treatment duration Osteomyelitis

A

6-12 weeks depending on surgical situation

24
Q

Cellulitis agents

A

Mild: dicloxacillin, clinda, Augmentin, cephalexin
Moderate: IV: ceftriaxone, cefazolin, clinda
- systemic signs

25
Q

Cellulitis agents if MRSA suspected

A

Oral: SMXTMP, clinda, doxy, linezolid
IV: vanco, dapto, linezolid, clinda

26
Q

Erysipelas agents

A

Penicillin - drug of choice

Guidelines recommend same treatment as cellulitis

27
Q

Appearance of Purulent Skin Infections

A

Pus
Furuncles, carbuncles, and abscesses
Fluctuant mass

28
Q

Purulent skin infection treatment

A 
Mild: IAD
Moderate: IAD + ABX
- if > 5cm or SIRS
- SMX/TMP (unless B-hemolytic suspected)
- doxy, clinda, linezolid, vanco/dapto if inpatient
29
Q

Necrotizing skin infection treatment

A

Surgical debridement and possible amputation.
Broad spectrum ABX as adjunctive:
- Vanco + Pip/tazo
- Carbapenem
- Cephalosporin + metronidazole
- Linezolid + clinda often within first 48-72hrs

30
Q

Bite infection treatment

A

Surgery if necessary.
Augmentin - drug of choice.
- Penicillin allergy: Clinda or metro+FQ or SMXTMP
Consider prophylaxis right after bite if:
- Immunocomprimised
- Edema of face

31
Q

DM Foot infection treatment

A

Imaging and culture down to bone.
Treatment setting
- PEDIS 1 : outpatient, no ABX
- PEDIS 2 : outpatient, toical/oral ABX
- PEDIS 3 : out/inpatient, oral or initial IV ABX
- PEDIS 4: Initial inpatient, initial IV ABX

32
Q

Classification of Diabetic Ulcer Infections (PEDIS Grade)

A 
1 = not infected
2 = erythema < 2cm
3 = erythema > 2cm
4 = SIRS
33
Q

Osteomyelitis pathogens

A

Hematogenous: S. aureus most commonly
Contiguous: Staph, strep, gram -, and anaerobes

34
Q

Osteomyelitis Treatment

A 
Surgery right away.
ABX once cultures have been collected: IV whole time
Empiric therapy only if unstable (vertebral) or culture negative.
Children: cover S. aureus
- First line: cefazolin, nafcillin
Adults: cover S. aureus
- First line: cefaczolin, nafcillin
- If MRSA risk: vanco, dapto, clinda
IV drug users
- First line: ceftazidime 
Contiguous/Diabetic ulcer
- same

Phar 761 (5 decks)

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