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Infectious Disease > Therapeutic Regimens > Flashcards

Therapeutic Regimens Flashcards

1
Q

Latent Tb in pregnancy, young children, HIV+

A

Isoniazid 300mg daily x 9 months

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2
Q

Latent Tb in isoniazid resistant or intolerant

A

Rifampin 600mg daily x 4 months

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3
Q

Latent Tb

Not used in HIV+, pregnancy, <2yo, presumed INH resistance or rifampin resistance

A

Rifapentine + isoniazid (Priftin)

Once weekly x 12 weeks

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4
Q

Active Tb

Preferred regimen

A

Intensive phase: 2 months
Rifampin, Isoniazid, Pyrazinamide, Ethambutol

Continuation phase: 4 months
Isoniazid, rifampin

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5
Q

Infective endocarditis - strep viridans

A

Penicillin, ampicillin or ceftriaxone +/- gentamicin for synergy

If beta lactam allergy then vancomycin monotherapy

4-6 weeks. Upper end if prosthetic valve or resistant organism

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6
Q

Infective endocarditis - staphylococcus MSSA

A

Nafcillin or cefazolin

Add gentamicin if prosthetic valve

If beta lactam allergy then vancomycin

4-6 weeks. Upper end if prosthetic valve or resistant organism

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7
Q

Infective endocarditis - staphylococcus MRSA

A

Vancomycin
Add gentamicin if prosthetic valve

4-6 weeks. Upper end if prosthetic valve or resistant organism

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8
Q

Infective endocarditis - Enterococcus

A

Penicillin or ampicillin + gentamicin for synergy

If beta lactam allergy then vancomycin

4-6 weeks. Upper end if prosthetic valve or resistant organism

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9
Q

Infective endocarditis dental prophylaxis

A

Amoxicillin 2g

If beta lactam allergy:
Clindamycin 600mg
Azithromycin or clarithromycin 500mg

One time dose given 30-60 minutes before procedure

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10
Q

Primary peritonitis (SBP) treatment

A

Ceftriaxone x 5-7 days

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11
Q 
Primary peritonitis (SBP)
Primary or secondary prophylaxis
A

SMX/TMP

Ciprofloxacin

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12
Q

SSTI impetigo

A

Cephalexin if multiple lesions

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13
Q

SSTI folliculitus/furuncles/carbuncles

A

Cephalexin

If doesn’t work- doxycycline or SMX/TMP

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14
Q

SSTI cellulitis nonpurulent

A

Cephalexin

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15
Q

SSTI abscesses purulent

A

SMX/TMP or doxycycline

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16
Q

Acute uncomplicated cystitis

A

Nitrofurantoin 100mg PO BID with foods 5 days

Or

SMX/TMP 1 DS tablet PO BID x 3 days

Or

Fosfomycin 3g x 1 time in 4oz of water

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17
Q

Acute uncomplicated pyelonephritis

A

Ciprofloxacin
Levofloxacin x 7 days

IV ceftriaxone if inpatient

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18
Q

pregnant patients with bacteriuria even with negative urinalysis and asymptomatic

A

3-7 days

Augmentin or oral cephalosporins

SMX/TMP and nitrofurantoin last line in 1st trimester and try to avoid last weeks before delivery

Fosfomycin can be used if drug allergies present

Avoid quinolones and tetracyclines

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19
Q

Urinary analgesic

A

Phenazopyridine (Azo, Uristat, Pyridium)

With food to minimize stomach upsets

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20
Q

Cdiff
Mild to moderate
1st infection

A

Metronidazole 500mg PO TID x 10-14 days

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21
Q

Cdiff
Mild to moderate
2nd infection (1st recurrence)

A

Metronidazole 500mg PO TID x 10-14 days

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22
Q

Cdiff
Mild to moderate
3rd infection(2nd recurrence)

A

Vancomycin taper/pulse

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23
Q

Cdiff
Severe
1st infection

A

WBC >= 15,000 OR SCr >= 1.5x baseline

Vancomycin 125mg PO QID x 10-14 days

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24
Q

Cdiff
Severe
2nd infection (1st recurrence)

A

Vancomycin 125mg PO QID x 10-14 days

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25
Cdiff Severe 3rd infection(2nd recurrence)
Vancomycin taper/pulse
26
Cdiff Severe complicated 1st infection
Ileus, toxic megacolon, hypotension, shock PO vanc + IV metronidazole
27
Cdiff Severe complicated 2nd infection (1st recurrence)
PO vanc + IV metronidazole
28
Cdiff Severe complicated 3rd infection (2nd recurrence)
Vancomycin taper/pulse
29
Travelers diarrhea | Bloody stools, fever, pregnant, pediatric
1-3 day course of azithromycin
30
Travelers diarrhea | NOT bloody, fever, pregnant or pediatric
1-3 day course of cipro, Levi, ofloxacin, rifaximin
31
Loperamide should be avoided in what type of travelers diarrhea?
Dysentery or bloody diarrhea Or Patients with a fever
32
Syphilis Primary, secondary Early latent <1year
Penicillin G benzathine (Bicillin LA) 2.4 million units IM x 1
33
Syphilis Tertiary Late latent >1 year
Penicillin G benzathine 2.4 million units weekly x 2-3 weeks
34
Gonorrhea
Ceftriaxone 250mg IM x 1 plus azithromycin(preferred) or doxycycline
35
Chlamydia
Azithromycin 1g PO x 1
36
Bacterial vaginosis Symptom Treatment
Fishy odor and pH>4.5 Metronidazole or metronidazole 0.75% gel
37
Trichomoniasis Symptoms Treatment
Yellow-green discharge Metronidazole 2g PO x 1
38
Rocky Mountain spotted fever
Doxycycline
39
Lyme disease
Doxycycline
40
Outpatient CAP Relatively healthy and no antibiotics the past 3 months
Macrolide (azithromycin, erythromycin, clarithromycin) Or Doxycycline
41
Outpatient CAP | Antibiotics within the past 3 months, immunosuppressed, or medical comorbidities
Beta lactam (high dose amoxicillin, Augmentin, cefpodoxime, cefdinir, cefuroxime, ceftriaxone) PLUS macrolide or doxycycline OR Respiratory fluoroquinolone monotherapy (gemifloxacin, moxifloxacin, levofloxacin)
42
Inpatient CAP | No pseudomonas risk
Beta lactam (ceftriaxone, cefotaxime, IV ampicillin) PLUS Macrolide or doxycycline Duration 5-6 days
43
Inpatient CAP | Pseudomonas risk
Zosyn, cefepime, imipenem/cilastatin, meropenem, levofloxacin PLUS Aminoglycoside (gentamicin, tobramycin, amikacin) PLUS Azithromycin Duration 5-7 days
44
Inpatient CAP Add which medications to regimen to cover MRSA?
Vancomycin | Linezolid
45
HAP/VAP MSSA and pseudomonas
``` Cefepime Zosyn Imipenem/cilastatin Meropenem Levofloxacin ``` Duration 7 days
46
HAP/VAP | Pseudomonas and MRSA
``` Aztreonam Meropenem Imipenem/cilastatin Zosyn Cefepime Ceftazidime Levofloxacin Ciprofloxacin ``` PLUS Vancomycin Linezolid Duration 7 days
47
HAP/VAP | MDR pseudomonas and MRSA
``` Choose 2 Cefepime Ceftazidime Zosyn Aztreonam Meropenem Imipenem/cilastatin Levofloxacin Ciprofloxacin Colistin, polymixin B Tobramycin, gentamicin ``` PLUS Vancomycin Linezolid Duration 7 days
48
Which amphotericin B formulation requires pre-medication for infusion-related reactions?
Conventional | Amphotericin B deoxycholate
49
Flucytosine should always be used with which agent to prevent resistance?
Amphotericin B
50
Fluconazole is active against which fungal species?
Candida albicans and tropicalis
51
Which azoles capsule and oral suspension is not interchangeable?
Itraconazole (Sporanox) | Posaconazole (Noxafil)
52
Which form of itraconazole should be taken without food?
Solution
53
Which form is itraconazole should be taken with food?
Capsule
54
Which azole is considered 1st line in treating c. Albicans?
Fluconazole (Diflucan)
55
Which azole is drug of choice for aspergillosis?
Voriconazole
56
Which azole has better coverage of c. Glabrata, c. Krusei, and aspergillosis?
Voriconazole
57
Which azoles should be taken with food
Tablet, capsule itraconazole | All forms posaconazole
58
Which azole requires a micron filter during administration because of particulates?
Isavuconazonium
59
Candida albicans in HIV pt
PO fluconazole
60
Moderate to severe Candida albicans
PO fluconazole
61
Esophageal Candida albicans infection
PO fluconazole or echinocandin
62
Candida glabrata or candida krusei
Echinocandins | Amphotericin B
63
Aspergillus
Voriconazole Amphotericin B Isavuconazonium
64
Nail bed infections
Terbinafine Itraconazole Fluconazole
65
When should neuraminidase inhibitors be initiated?
Within 48h of symptom onset
66
What is the benefit of a neuraminidase inhibitor?
Decrease flu by 1 day and avoid complications
67
Oseltamivir treatment
75mg PO BID x 5 days
68
Oseltamivir prophylaxis
75mg PO daily x 10 days
69
Which neuraminidase is an inhaler?
Zanamivir (Relenza diskhaler)
70
Which neuraminidase inhibitor is an injection?
Peramivir (Rapivab)
71
How to dose acyclovir in obese patients?
IBW
72
If HSV2 acyclovir-resistant, can you use Valtrex or Famvir?
No
73
Ideally when should HSV2 (genital herpes) be treated?
At prodrome onset or within 1 day of symptom onset.
74
HSV encephalitis
IV acyclovir
75
When is initiating therapy most effective for shingles?
Within 72h of symptom onset
76
Treatment of choice for CMV
Ganciclovir | Valganciclovir

Infectious Disease (14 decks)

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