TBL Dec 13 URI Flashcards
Four reasons to use early ABX treatment in URI?
- Epiglottitis
- Pertussis
- Acute otitis media
- Group A Strep (strep progenes)
Give pt’s with acute laryngitis?
NOT abx
Why give pt’s with streptococcal pharyngitis ____ ?
Give penicillin to reduce risk of rheumatic fever
- to alleviate symptoms
- to decrease communicability
Bacterial rhinosinusitis, if acute and uncomplicated, tx?
Short-course abx therapy
- amoxicillin (need ammo to kill a rhino)
Cough and phlegm only is?
Acute bronchitis - NO abx
Treat acute otitis media?
Divided doses of amoxicillin
Nasal obstruction Nasal discharge, can be purulent Face pain Cough Decreased sense of smell
Acute rhinosinusitis
- watch and wait for mild
Amoxicillin for severe/complicated (bacterial)
Common cold symptoms
Runny nose, cough, sore throat, sneezing, nasal congestion
Symptomatic treatment
Dysphagia + voice change Tachycardia SOB, tachypnea > 24 Stridor, respiratory distress Leaning forward Fever Drooling
Epiglottitis
- IV 3rd gen cephalosporin
- PLUS anti-staph agent against MRSA
Could do just: IV ceftriaxone, cefotaxime, ampicillin+sulbactam
Sore throat
Fever > 100.4
No cough
Treat based on modified Centor score
Pharyngitis and/or tonsillitis
How diagnose bacterial sinusitis?
Symptoms for 10+ days
- often Strep pneumonia, H-flu, or moraxella cat.
Nasal obstruction
Drainage
Facial pain
Decreased smell
Rhinosinusitis
- shorter than 10 days - viral
- longer than 10, consider amoxicillin
3 Main Causes of Otitis Media?
H-flu
M. catarrhalis
S pneumo
Always treat AOM in?
Child < 35 months of age
- bilateral or not
Who gets rapid strep test for Pharyngitis/Tonsillitis?
the following five each get 1 point and test for pt’s w/ 2-3 points; treat for those 4+
No Cough Age 3-14 Anterior cervical lymphadenopathy Fever Tonsillar erythema/exudates
