TX

Question 1

CAP
NoN ICU

Answer 1

*** Fluroqulnolone **
* Moxifloxacin 400 PO or IV
* **OR **
* Levofloxacin 750 mg PO or IV QD

Question 2

CAP /Non-ICU
**Allergic to Fluroqunolone **

Answer 2

**Beta Lactam **
* Cefriaxone (Rocephin 1gm) IV **OR **
* Ampicillin
* **PLUS **
*** Macrolide **: Azithromycin 1gm x IV x 1 dose THEN 500 PO QD

Question 3

CAP

ICU

Answer 3

• **Beta Latam **
  * Cefriaxone (Rocephin) 2gm QD **OR **
  * Ampicillin 2gm 8 HRS

**PLUS **
Azithromycin Or Fluroquinolon (Levofloxacin )

Question 4

CAP
Pseudomona

Answer 4

**Antipseudomonal Beta Lactam
* Zosyn OR **
* Cefepime OR ** (4th Generation )
* Merreme
*
**PLUS **

* Fluroquinolon (Lev OR maxi ) **
——————————————————**
* Antipseudomonal Beta Lactam** PLUS **
* Aminoglycoside (Toracycin 1.7 mcg/kg/day or pharmacy dose)
* **PLUS **
* **Macrolid (Azithromycin ) **
——————————————————
Antipseudomonal Beta Lactam **PLUS **
Aminoglycoside **PLUS *
Antipneumococcal Fluroqunolone (maxi or Levo )

Question 5

CA -MRSA

Answer 5

• Zyvox OR
• Vancomycin
• **PLUS **
• Clindamycin (help with Pendadration deeper into the tissue

Question 6

CA
Duration Treatment

Answer 6

Uncoplicated x 5 days
Complicated : Consider extendign (bacteria, longer hospital stay or pseudomonas )

Question 7

Aspiration PNA :

Answer 7

Cefriaxone (Rocephin )1mg IV QD

Question 8

Aspiration PNA
Allergic to Betalactam

Answer 8

• Levofloxacin 750 IV QD +/-
• Flagyl 500 PO/IV Q 8 hrs (cover Anerobes )

Question 9

Aspitration PNA
Related to Abcess

Answer 9

-Ampicillin/Sulbactam (Unasyn ) 3g IV Q 6 hrs

**OR **

-Clindamycin 600 mg IV Q 8 hrs

Question 10

Aspiration PNA/
Nonsocomial PNA

Answer 10

Zosyn Pharmacy to dose W
Anti Pseudomona activity Covererage

Question 11

VAP
NO MDR

Answer 11

**TX W Single agent **
Zosyn 4.5 Q 6 hrs OR Cefepime 2mg Q 8hrs/OR
Levofloxacin
**OR **
Zosyn and Cefepime (more common TX b/c of negative coverage )

Question 12

VAP
+ MRSA

Answer 12

3 Different ABT: 2 for Pseudomonas & 1 MRSA
**Pseudomonas Ariginosis:
Zosyn, Cefepime OR Merrem
If severly Ill consider Double covereage:
-Aminoglycoside Or Fluroquinolone

**MRSA ** +/- Zyvox OR Vancomycin for MRSA

Question 13

Lungs Abscess
Threatment Plan
Primary

Answer 13

• Clindamycin 600 IV TID
  *NO FEVER
  Clindacin 300 mg PO QD
  **Alternative **
  Unasyn
  Transition
  Augmentin 14 wks

Question 14

TX
Secondary Abcess

Answer 14

Abcess > 6 to 8 cm diameter
Surgery
Less likely ABT