Treatment Flashcards
Legionella
quinolone
macrolide
Mycoplasma
macrolide
tetracycline
Chlamydia
macrolide
tetracycline
quinolone
Outpatient CAP
Macrolide or doxycycline
Outpatient CAP with comorbidities
Quinolone or beta-lactam + macrolide
Inpatient CAP
Quinolone or beta-lactam + macrolide
ICU (no pseudomonas)
B-lactam + azithromycin or quinolone
ICU w/ pseudomonas
B-lactam + cipro or levo
or B-lactam + aminoglycoside & azith
or B-lactam + aminoglycoside & quinolone
Lung abscess
Clindamycin (or other agents with good gram positive anaerobic activity)
Pseudomonas
Anti-pseudomonal beta-lactam AND aminoglycoside (also can add quinolones)
Antipseudomonal beta lactams
piperacillin, aztreonam, carbapenem, defepime, ceftazidime
Stenotrophomonas maltophilia
only sensitive to TMP sulfa
Pneumocystis jirovecci
TMP sulfa
add corticosteroids if PaO2 70 or A-a gradient 35 within 72 hrs
TMP sufla for prophylaxis when necessary
Nocardia
sulfonamides
TB - first line
Isoniazid
rifampin
pyrazinamide
ethambutol
TB - second line
aminoglycosides
Quinolones
ABPA
steroids + itraconazole (antifungal)
Zygomycosis
emergency surgical debridement
amphotericin B
Coccidiodes immitis
fluconazole, itraconazole, or ampothericin B
Histoplasmosis
Itraconazole or amphotericin B
Early HAP
ceftriaxone
Late HAP
antipseudomonal cephalosporin or carbepenem or beta-lactam/beta-lactamase inhibitor PLUS quinolone or aminoglycoside
PLUS linezolid or vanco
Cefuroxime
2nd gen cephalosporin
haemophilus, moraxella, other GNRs
Ceftriaxone
3rd gen cephalosporin
gram negs EXCEPT pseudomonas
Ceftazidime
3rd gen cephalosporin
gram negs + pseudomonas
(not as good pneumococcal)
Cefepime
4th gen cephalosporin
pneumococcal + pseudomonas
Ceftoraline
5th gen cephalosporin
GNR & MRSA
