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Infectious Disease > Surgery, Meningitis, lower respirtory tract, Bronchitis > Flashcards

Surgery, Meningitis, lower respirtory tract, Bronchitis Flashcards

1
Q

When should surgical prophylaxis start and end?

A

30 minutes to 1 hours before the first incision

Continued for 24 hours.

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2
Q

What are the drugs of choice for non-bowel surgery prophylaxis?

A

cefazolin (Kefzol)

cefuroxime (Ceftin, Zinacef)

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3
Q

A patient is having colon surgery (bowel), what can I use for surgery prophylaxis?

A

ceftriaxone(Rocephin) + metronidazole (Flagyl)
cefotetan
ertapenem(Invanz)

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4
Q

If a patient has a Beta-lactam allergy, what is the second line agent for surgical prophylaxis and when should it be used?

A

Vancomycin at least 2 hours prior to incision

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5
Q

What medications are used based on susceptibility results to treat Meningitis?

A

ceftriaxone (Rocephin) 2g IV q4-6

ampicillin 2g IV q4h

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6
Q

What is the typical duration of treatment for meningitis?

A

7-14 days

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7
Q

What is the treatment regimen in PCN/Rocephin intermediate or resistant patients with meningitis?

A

Vancomycin + Rocephin+/- Rifampin

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8
Q

what is emepric therapy for meningitis?

A

Rocephin 2g q12H or cefotaxime 2g q4-6H or Merum 2g q8H
+
Vancomycin 30-45mg/kg/day +/- dexamethasone 0.15mg/kg/dq6H x2-4 days

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9
Q

What medication is added to emperic therapy for meningitis if Listeria is the possible cause

A

ampicillin 2g q4H

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10
Q

What is emerpic therapy for immunocompromised patients or those >50 or <1 with meningitis

A

Vancomycin + ampicillin + Rocephin or cefotaxime

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11
Q

What is emperic meningitis therapy for a 16 yo patient with a severe PCN allergy?

A

Chloramphenicol 4-6g/day x4days + Vancomycin 30-45mg/kg/day

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12
Q

What is emperic meningitis therapy for a 16 yo patient with a severe PCN allergy and suspected cause as listeria ?

A

Chloramphenicol 4-6g/day x4days + Vancomycin 30-45mg/kg/day + SMX/TMP 5mg/kg IV q6h

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13
Q

How is pain treated in </= 5?

A

Tylenol: 10-15mg/kg q4-6h
Motrin: 5-15mg/kg q6-8h

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14
Q

What topical agents can be used ONLY in children >5 for otiis media pain

A

topical benzocaine, procaine or lidocaine

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15
Q

What criteria must be present for an observational period to be considered

A
  1. patient >/= 2yo
  2. No otorrhea (unilateral or bilateral)
  3. No severe symptoms (unilateral or bilateral)
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16
Q

What symptoms indicate sever otitis media?

A

otalgia >48h

temprature >/= 39C or 102.2F in past 48 hours

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17
Q

What are the recommended drugs of choice for otitis media?

A

Amoxicillin 80-90mg/kg/d or

Augmentin 90mg/kg/d

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18
Q

What is the recommended drug of choice for otitis media if patient has failed therapy with Amox?

A

Augmentin 90mg/kg/d

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19
Q

What is the recommended drug of choice for otitis media if patient has failed therapy with Augmentin?

A

Rocephin 80mg IV/IM x3 days

20
Q

What are the recommended alternative therapies for otitis media (2nd line)

A

Cefdinir 14mg/kg 1-2 doses
Ceftin 30mg/kg/d in 2 doses
cefpodoxime 10mg/kg in 2 doses
Rocephin 50mg IV/IM x1 or 3 days

21
Q

What is the duration of therapy for a child <2 with otitis media

22
Q

What is the duration of therapy for a child 2-5 yo with otitis media?

23
Q

What is the duration of therapy for a child >/= 6yo with otitis media?

24
Q

What vaccine should be given to all children 2-23 months to prevent/ decrease changes otitis media, prevent pneumococcal meningitis & pnumonia?

A

Prevnar 13

25
should prophylactic antibiotics be given to prevent otitis media in children?
NO
26
In most cases upper respiratory infections are viral in origin therefore antibiotics are not used. In which types of upper respiratory infections will antibiotics be used
Pharyngitis & sinusitis
27
When will antibiotic therapy be used in pharyngitis?
1. Fever 2. Tonsil or lymph node swelling 3. rapid antigen diagnosit test (RADT) is positive for strep 4. NO cough
28
What are the treatment options for pharyngitis?
Penicillin Amoxicillin 1st/2nd generation cephlasporin Macrolides
29
what is the typical duration of therapy for pharyngitis
5-10 days
30
When are antibiotics indicated in the treatment of sinusitis?
1. Symptoms for >7-10 days 2. Tooth/ face pain 3. Nasal drainage/ discharge 4. Congestion or severe worsening of symptoms
31
What are the first line options for sinusitis
Amoxicillin SXM/TMP Doxycycline
32
What are the second line agents for sinusitis ( failure of 1st line)
Azithromycin 10mg/kg/d x day1 , then 5mg/kg/d x day2-5 Augmentin Oral 3rd gen cephlasporin respiratory quinalones
33
What OTC class of agents can be used for sinusitis
Nasal corticosteroids decongestants tylenol NSAIDs
34
What is the typical duration of therapy for acute sinusitis
7-14 days
35
What is the duration of therapy for chronic sinusitis
>/= 21 days +/- surgery
36
What medications are used for the management of acute bronchitis
antitussives +/- inhaled bronchodilators (albuterol, codiene, dexmethorphan) should be recommended. Antibiotics are not indicated as most cases of acute bronchitis are viral & self limiting.
37
What is considered severe bronchitis
1. symptoms & persistent cough >14 days or a whooping cough
38
What medications can be used in the management of severe bronchitis?
Azithromycine (Z-pak)- 500mg x1, then 250mg xday 2-5 Erythromycin estolate(E.E.S)- 500mg QID x14 Clarithromycin (Biaxin)-500 mg BID or 1g ER qd x7 days SMX/TMP DS(Bactrim, Septra)- 1 tab BID x14 days
39
What symptoms of an Acute Exacerbation of Chronic Bronchitis must be present to start antibiotics?
2/more of: increased dyspnea, increased sputum production, increased sputum purulence.
40
What are the symptoms of Acute Bronchitis
symptoms of sore throat, malaise, HA, low grade fever &/or purulent sputum production, coryza (inflammation of mucus membrane of nose)
41
IF antibiotics were to be used in mild - moderate AECB, what can I choose from
Amoxicillin Bactrim cephlosporins doxycycline
42
What medications should be used in severe AECB
Inhaled anticholinergic bronchodilators + oral setroid, taper over 2 weeks
43
IF antibiotics were to be used in severe AECB, what agents are beneficial?
``` Augmentin Antipneumococcal FQ Bactrim 3rd generation cephalosporin Doxycyclin Macrolide ```
44
Augmentin & Anti-pneumococcal FQ use should be reserved for which AECB patients
Patients at risk for drug resistiance S. pneumo
45
What patients are at risk for drug resistant S. pneumo
``` >65 multiple comorbidities (HF, DM, cancer, renal/liver dysfunction, alcoholism, aplenia, immunosuppressed ```
46
how long should antibiotic therapy for severe AECb be?
5-7 days, but longer may be needed.

Infectious Disease (7 decks)

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