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Infectious Diseases > Traveler's Diarrhea > Flashcards

Traveler's Diarrhea Flashcards

1
Q

Option for children abx treatment?

A

Fluoroquinolones for 1-3 days

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2
Q

Bacterial causes

A

e. coli
campylobacter jejuni
Shigella sp.

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3
Q

symptoms of TD

A

abdominal cramps
watery stools
headache
fever

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4
Q

Tx choice for: stool < TID , does not affect ADL, no fever, no blood.

A

ORS, OTC loperamide or bismuth sub.

BSS - can be used for prevention
Loperamide - use as treatment for diarrhea symptoms

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5
Q

Tx choice: stools > TID, interferes with ADL, no fever/blood

A
  1. loperamide 4 mg po initial, then 2 mg post-loose stool (max 16 mg/day)
  2. BSS for prevention + treatment

-if symptoms continue > 2 weeks, refer

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6
Q

Tx choice if: stool > 5 times/day, prevents ADL, fever/blood present, severe

A

treat with ciprofloxacin 500 mg BID x 3 days OR…
Cipro 750 mg x single dose + ORS or loperamide after stool .

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7
Q

DDIs with bismuth subsalicylate?

A

avoid with anticoagulants, high dose salicylates, pregnancy and children.

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8
Q

For treatment of severe travellers diarrhea, if ciprofloxacin is ineffective or there is an allergy, what is the alternative drug?

A

SMX/TMP

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9
Q

can loperamide be used for prophylaxis?

A

no

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10
Q

Antibiotic of choice in Thailand (south east Asia?) Why?

A

Azithromycin.
The country is generally FQ- resistant. Most common bacteria is Campylobacter.I

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11
Q

Which country is cotrimoxazole effective in?

A

mexico during summer due to low rates of this infection.
*cotrimoxazole is ineffective against campylobacter.

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12
Q

Which antibiotics can be used for prophylaxis

A

FQs- cipro, norfloxacin, levo
-dose adjust in renal impairment.

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13
Q

Indication for Dukoral?

A

prevention of E. coli and cholera diarrhea (ETEC)

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14
Q

Dosing of Dukoral?

A

take 2 doses before travel - 1 week apart. effect begins 1 week after the 2nd dose

ages 2+

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15
Q

Booster dose recommendations for Dukoral?

A

if travelling after 3 months - 5 yrs after 1st vaccine (of 2 doses): one booster only

if travelling within 3 months only after 1st vaccine (of 2 doses): no booster

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16
Q

counselling point for dukoral and food?

A

take on empty stomach ; avoid food 1 hr before and after dose + space apart from other meds

17
Q

how many doses of dukoral for the primary immunization for cholera in children 2-6 years old?

A

3 doses

18
Q

after reconstituting dukoral, within how long is the suspension stable for at room temp?

A

2 hours

19
Q

Prophylactic dosing of Ciprofloxacin?

A

cipro 500 mg daily - start the 1st day of arrival, continue during stay (max 3 weeks) and 1-2 days after return from trip.

20
Q

Drug of choice in southeast asian countries - thailand or india?

A

azithromycin 500 mg daily x 3 days, or single dose of 1000 mg (used as treatment ONLY. safe in pregnancy and children)

21
Q

all quinolones are taken with or without food, except ____?

A

norfloxacin

22
Q

____(type of bacteria) is fluoroquinolone resistant.

A

Campylobacter

23
Q

Which antibiotics can be given as prophylaxis AND treatment?

A

FQs and cotrimoxazole

24
Q

Pathogens in travellers diarrhea?

A

ETEC (e. coli)
campylobacter
salmonella
shigella
viruses
Giardia intestinalis

25
Q

Why isn’t doxycycline no longer a form of treatment?

A

Significant bacterial resistance in southeast asian countries

26
Q

ORS is suitable for which population?

A

children, elderly/frail, pregnant women.

27
Q

Contraindications of loperamide?

A

Children < 3 y/o
bloody diarrhea
fever
allergy to opioids

28
Q

Can loperamide be used in children 3 and above?

A

yes.

29
Q

When should patients seek urgent medical care?

A

systemic symptoms - fever
dysentery
or if symptoms dont improve within 48 hrs of treatment

30
Q

Prophylaxis and treatment in MEXICO?

A

FQs - ciprofloxacin, norfloxacin, levofloxacin

Infectious Diseases (14 decks)

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