Treatments for Midterm Flashcards
What vaccines can help prevent otitis media
pneumococcal and influenza
2 primary treatments for acute otitis media if antibiotic therapy required
- amoxicillin 80-90 mg/kg/day in 2 doses
- augmentin 90 mg/kg/day with 6.4 mg/kg/day clavulanate in 2 divided doses
Alternative treatment for acute otitis media if a penicillin allergy
cephalosporins
if a patient is receiving treatment for 48-72 hours for acute otitis media and not having improvement, what are further options
Previous options but added option of Clindamycin
Duration of treatment for acute otitis media
-if severe
-if less than 2
-if 2-5 years old
-if >/= 6 years old
10 days if severe
10 days if < 2
7 days if 2-5 years old
5-7 days if >/= 6 years old
when to treat rhinosinusitis
when persistent and not improving >10 days
if severe and worsening > 3 days
first line treatment for rhiosinusitis
augmentin 45-90 mg/kg/day in 2 doses (500 mg TID or 875 mg BID if adult)
alternative treatments for rhinosinusitis
doxycycline 100 mg BID (adult only)
clindamycin + 3rd gen ceph
unasyn
duration of treatment for rhinosinusitis
-if adult
-if pediatric
-if chronic
5-7 days if adult
10-14 days for pediatric
>/= 21 days if chronic
First line treatments for Pharyngitis
Amoxicillin 1000 mg daily for 10 days
Penicillin V or G
treatment options for Pharyngitis if penicillin allergy
cephalexin 500 mg BID for 10 days
azithromycin 500mg for 1 day then 250 mg daily for 4 day
Treatment for laryngotracheobronchitis
-cool mist or steam
-nebulized racemic epinephrine 0.05-0.1 ml/kg q20 mins prn
-dexamethasone 0.6 mg/kg
Prevention methods for RSV
RSV vaccine Abrysvo or passive immunity with nirsevimab or palivizumab
Treatment for RSV
supportive care with fever and pain management and fluids
Treatment for epiglottits
-Maintain airway
-Rocephin (3rd gen ceph) + vanc or clindamycin (anti staph agent)
Treatment for rhinovirus
symptomatic relief with decongestants, antihistamines, and analgesics
How to prevent influenza virus
Vaccine against type A and B strands
treatment options for influenza
Neuraminidase inhibitors Oseltamivir (tamiflu)
Zanamivir (Relenza Diskhaler)
Treatment for acute bronchitis
supportive care
-dextromethorphan or guaifenesin for cough
-antihistamine/decongestant for cold
-APAP or NSAIDS for aches and pains
-antibiotics if pertussis
Antibiotic treatments for treatment of acute bronchitis due to pertussis
Macrolides (specifically azithromycin if < 1 month)
Bactrim (alternative)
How to prevent acute bronchitis
stop smoking
flu and pneumococcal vaccines
Treatment option for outpatient CAP if no comorbid conditions or risk factors for MRSA or Pseudomonas
Monotherapy with
Amoxicillin
Doxy
Macrolides
For 7-10 days
Treatment option for outpatient CAP if comorbid conditions
-Cephalosporin or augmentin plus macrolide or doxy
-monotherapy with respiratory FQ
for 7-10 days
Treatment option for inpatient CAP if non severe
-B-lactam + macrolide
-respiratory FQ
-B-lactam + doxy
ADD MRSA or Pseudomonas coverage if needed
Treatment option for inpatient CAP if severe
B-lactam + macrolide
B-lactam + respiratory FQ
ADD MRSA or Pseudomonas coverage if needed
Treatment options for Ventilator associated pneumo if low MRSA and single antipseudomonal agent has >90% activity
-cefepime
-primaxin
-levo
-meropenem
-zosyn
7 day treatment duration
Treatment options for Ventilator associated pneumo if MRSA and single antipseudomonal agent has <90% activity
-Anti-pseudomonal B-lactam + antipseudomonal FQ
-Aminoglycoside +/- MRSA coverage
7 day treatment duration
Treatment options for non ventilator associated hospital acquired pneumonia if not in septic shock and without IV antibiotic use within 90 days and low MRSA
antipseudomonal B-lactam
Treatment options for non ventilator associated hospital acquired pneumonia if not in septic shock and without IV antibiotic use within 90 days and MRSA prevalence
-antipseudomonal B-lactam + antipseudomonal FQ
-aminoglycoside +/- MRSA coverage
t or f? add MRSA coverage if septic shock
true
Treatment options for community acquired parapneumonic effusion and empyema
-cefotaxime or ceftriaxone + metronidazole
-amp/sul
-levaquin or aztreonam +metronidazole (if allergy to pen)
-imipenem or meropenem (if allergy to pen)
Treatment options for hospital acquired parapneumonic effusion and empyema
-vancomycin + metronidazole and cefepime or ceftazidime
-pip/tazo
-ticarcillin/clavulanate
-metronidazole + cipro (if pen allergy)
-imipenem or meropenem (if pen allergy)
inpatient and outpatient treatments for COVID
remdesivir for inpatient
Paxlovid for emergency use outpatient
preferred antibiotics for acute COPD exacerbation
augmentin
azithromycin
doxycycline
respiratory FQ
