Typhoid CPG Flashcards
yous suspect typhoid fever if patient presents with how many days of fever?
more than or equal to 5
fever should be documented to be how many degrees celcius?
more than 38
the following are symptoms associated with typhoid fever except? headache diarrhea body malaise abdominal pain/distention GI bleeding change in sensorium epistaxis
epistaxis
the rest mentioned above are associated with typhoid
typhoid fever that warrants hospital admission?
- complicated typhoid
- typhoid in pregnancy
- social circumstances not favoring home care
the following are direct detection method to confirm the diagnosis of typhoid fever
a. culture and isolation
b. PCR
c. tubex test
C.
PCR and culture and isolation are direct methods
true or false widal test is still recommended for the diagnosis of typhoid espcecially in our country?
False. local CPG does not recommend using widal test for diagnosis of fever
the following are recommended medications for treatment of uncomplicated typhoid fever
a. amoxicillin
b. amoxicillin+clavulanic acid
c. ceftriaxone
d. levofloxacin
A. amoxicillin
for uncomplicated typhoid fever the following antibiotics are recommended
a. amoxicillin, chloramphenicol, cotri, cefixime, azithromycin, ciprofloxacin, ofloxacin
recommended dose for amoxicillin for uncomplicated typhoid fever?
500 mg 2 caps q 6 x 14 days
recommended dose for chloramphenicol for uncomplicated typhoid
500 mg 2 caps q 6 x 14 days
recommended dose for cotri for uncomplicated typhoid
800/160 1 tab q12 x 14 days
recommended dose for azithromycin for uncomplicated typhoid
500 mg 1-2 tabs q24h x 7 days
recommended dose for cefixime for uncomplicated typhoid
200 mg q 12 x 7 days
recommended dose for ciprofloxacin for uncomplicated typhoid
500 mg q12 x 7 days
recommended dose for ofloxacin for uncomplicated typhoid
400 mg 1 tab a 12 x 7 days
mnemonic for drugs used to treat uncomplicated typhoid for 14 days C-A-T
chloramphenicol-amoxicillin- tmp-smx
the rest are given x 7 days
patient was treated for uncomplicated typhoid fever and developped SJS what drug most likely caused this?
TMP-SMX
patient treated for uncomplicated typhoid came to you with cbc results showing signs of bone marrow suppression. you suspect what drug?
chloramphenicol
these drugs used to treat uncomplicated typhoid are associated with prolonged QT interval?
Azith, cipro, oflox (A-C-O)
the treatment duration for azithromycin when used to treat complicated typhoid fever is how many days?
7 days
recommened dose for ceftriaxone for treatment of complicated typhoid fever?
2 - 3 grams iv q 24 x 14 days
recommened dose for azihromycin for treatment of complicated typhoid fever?
1 gram q 24 x 7 days
recommened dose for ciprofloxacin for treatment of complicated typhoid fever?
400 mg q12 x 14 days
recommened dose for ofloxacin for treatment of complicated typhoid fever?
400 mg q12 x 14 days
when should iv antibiotics be stepped down to oral antibiotics?
48 hours afebrile, able to tolerate PO medication
first line treatment for pregnant patients with typhoid fever?
ampicillin 1-2 grams iv q 6 x 10-14 days
ceftriaxone 2-3 grams iv q24 x 7 days
multidrug resistant typhoid fever is resistant to the following medications except?
a. cotrimoxazole
b. amoxicillin
c. ampicillin
d. TMP-SMX
b. Amoxicillinn
MDR resistant to Chloram-Ampicillin-TMP-SMX
when to suspect if patinet has MDRTF
- failure to respond after 5-7 days
- household contact with MDR strain
- documented epidemic of MDR strain
emperic treatment for MDR strain
cefixime 200 mg q12
ciprofloxacin 500 mg 12
ofloxacin 400 mg q12
azithromycin 500 1-2 tabs q 24
all treatment given fro 7 days PO
how do you define a chronic carrier?
positive stool or rectal swab a year after recovery
treatment for chronic carriers?
TMP - SMX 800/160 1 tab q 12 x 6-12 weeks Amox 100 mg/kg/day x 6-12 weeks ampicillin 100 mg/kg/day x 6-12 weeks norfloxacin 400 1 tab q12 x 4 weeks ciprofloxacin 750 1 tab q12 x 4 weeks
typhoid vaccines indicated for?
- travel to endemic area
- person with intimate contact to carrier
- lab workers routinely exposed
endemic areas?
sub-saharan africa, cetral asia, indian subcontinent, latin america, middle east, south and southeast asia
vi polysaccharide vaccine
1 dose booster 1 dose every 2 years
live attenuated ty21a vaccine
1 capsule 4 doses, booster every 5 years
days 0,2,4,6
