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Renal/Resp > URI antibiotics > Flashcards

URI antibiotics Flashcards

1
Q

Outpatient CAP

previously healthy

A

Macrolide

Doxycycline

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2
Q

Pneumonia in Transplant pt most likely

A

Cytomegalovirus

RSV

Aspergillus

Mucormycosis

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2
Q

atypical p organisms

A

chalmydia pneumoniae

mucoplasma penumoniae

legionella pneumophilia

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3
Q

DOC for penuococcus

A

cefotaxime

ceftriaxone

(not cephalosporin)

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3
Q

FQ spectrum

A

intracellular atypicals (mycoplasma, chlamydia, legionella_

second line for some mybacterials (MTB, MAC)

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4
Q

treatment duration CAP

conditions

A

minimum 5 days

afebrile 48-72 hours, breathing without O2

(2 weeks for coagulase positive Staph or Pseudomonas)

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5
Q

for Penicillin resistant strep pneumo MIC > 2.0mcg/ml

for non-meningeal infection?

A

Vanco and rifampin

non-miningeal = cefotaxime/ceftriaxone,

high dose ampicillin

carbapenems

flouroquinolone (levofloxacin, moxifloxacin)

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6
Q

best anti-pneumoccocal FQ

A

levofloxacin

(also moxifloxacin)

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7
Q

in patient CAP if pseudomonas is considered

A

a-penumococcal, a-pseudomonal B lactam

(piperacillin, tazobactan, cefepime, meropenem)
PLUS
a-pseudomonal flouroquinalone

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7
Q

drugs for resistant gram positive bacteria

A

Vancomycin - not VRE (oral for c dif only)

**Linzezolid - **bone marrow suppression and neuropathy prolonged use

Daptommycin - not for use in pneumonia (bound by surfactant)

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7
Q

CURB criteria for pneumonia,

A

Confusion

BUN >19mg/dL

RR >30breaths/min

Systolic < 60

Age 65

0-1=home

2= home or short inpt

3-5 = Admit, consider ICU

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7
Q

Penicillin resistant (0.1<1.0)

treat with

A

high dose penicillin G or ampicillin,

cefotaxine /ceftriaxone

(otherwise pen G and amoxicill for MIC

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9
Q

Inpt, non-ICU CAP with not PCN allergy

with allergy?

A

Beta lactam plus macrolide

a-pneumoccocal flouroquinolone

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11
Q

inpatient, ICU CAP with no PCN allergy

with allergy

A

B-lactam plus macrolide

OR a pneumococcal floruroquinolone

a-penumoccoccal FQ

PLUS aztreonam

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12
Q

extra side effectsm flouroquinolines

A

tendonitis

profoudn hypoglycemia

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12
Q

Typical CAP organism

A

Strep pneumo

Haemophilus influenzae

Moraxella catarrhalis

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13
Q

pneumonia in early HIV infection most likely

A

Step pneumo

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15
Q

outpatient CAP

co-modbidities present

A

a-pneumococcal Flouroquinolone

B-lactam plus macrolide

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17
Q

linezolid interacts with

A

antidepressents > 5HT syndrome

18
Q

most common causes of outpatient CA Pneumonia

A

Strep pneumo

mycoplasma pneumo

haemophilus influenzae

chlamydophila pneumo

resp viruses (influenza A+B, adenovirus, RSV, parainfluenza)

18
Q

DOC CAP with aspiration

A

add clindamycin to cover oral anaerobes

18
Q

General guidlines for emperic therapy
Typical,

Atypical

allergies

A

Typical = beta lactams

Atypical =Doxycycline or macrolides

For Beta lactam allergy, Flouroquinolones (levo, Moxi)

19
Q

pneumonia with exposure to rabbits most likely

A

francisella tularensis

19
Q

pneumonia with structural lung disease (cystic fibrosis, COPD, bronchiectasis)

A

Pesudomonas aeruginosa (esp Cystic fibrosis)

staph aureus

Non-tuberculous myobacteria

aspergillus

20
Q

extra side effects cepalosporins

A

altered mental status

22
Q

Tetracyclines spectrum (tetracycline, doxycycline, minocycline)

A

wide gram pos and gram negative strain

atypicals - mycoplasma, legionella, chlamydia

(tetracycline less effective, but cheaper)

(minocycline more lipophilic - skin, soft tissue, bone infection)

23
Q

pneumonia with exposure to farm or parturient naimals

A

coxiella burnetti

(odd fever, infiltrate, cattle)

25
Q

macrolides spectrum

(erythromycin, clarithromycin, azithromycin)

A

resp gram positive

gram nega

intracellular atypicals (mycoplasma, chalmydia, legionella)

26
Q

pneumonia with exposure to birds

A

chlaymdophila pistacci (parrots)

avian influenza (poultry)

28
Q

best antipseudomonal FQ

A

ciprofloxacin

(also levofloxacin)

29
Q

late HIV infection Pneumonia (CD4

A

Pneuocystis jirovecii

Non=tuberculous myubacteria

Histoplasma

30
Q

Empiric Abs for HCAP without multidrug resistant risk factors

A

ceftriaxone

amp/sulbactam

ertapenemm

Flouroquinolone

32
Q

CAP if MRSA suspected

A

Add vancomycin or linezolid

33
Q

hemoptysis + weight loss + homelessness =

A

tuberculosis

34
Q

empiric antibioitic for HCAP with multidrug resistant risk factors

A

Anti-psuedomonal beta-lactam

PLUS
antipseudomondal fluroquinolone OR aminoglycoside
PLUS
Vanco or Linezolid if MRSA suspected

35
Q

DOCs for invasive MSSA infections

drugs NOT indicated

A

(Nafcillin) Oxacillin, Cefalozin

NOT Quinolones (moxifloxacin,ciprofloxacin)

36
Q

beta lactam categories

A

**penicillins **- cillin

cephalosporins - cef or ceph

carabpenems - ertapenenm, meropenem, imipenem

monobactams - aztreonam

**beta-lactamase inhibitors - **calvuloanic acid, sulbactam

38
Q

DOC peusdomonas aeruginosa

A

piperacillin+Tazobactam

Ceftazadime

Cefepime

Meropenen..Imipenem

Aztreonam (mono bactam(

39
Q

risk factors penicillin reisstant strep pneumo

A

>65

Beta lactam in last 3 months

alcoholism

comorbidities

exposreu to child in day care

40
Q

most common inpatient, ICU CA pneumonia

A

S pneumonia

staph areus

legionalla

gram negative bacilli

H influenzae

41
Q

risk factors for HCAP

A

hospitalization >5 days

acute care >2 days in past 90 days

nursing home/long term care facility

IV abxs, chemo, or wound care in past 30 days

chronic dialysis within 30 days

family member with multidrug resistant pathogen

42
Q

do not treat abnormal x-rays with antibiotics if patient does not have evidence of

A

systemic inflammation (fever, WBC, sputum production)

43
Q

most common inpatient, non-ICU CA pneumonia bacteria

A

Strep pneumonia

Mycoplasma pneunmonia

chlamydophila pneumonia

H influenze,
Legionalla
aspiration
Resp viruses (Flu A+B, adenovirus, RSV, parainfluenza

44
Q

for multi drug resistant strep pneumo

A

Vanco and rifampin

clinadmucin, levofloxacin/moxfloxacin

linezolid

45
Q

pneumonia with travel to SW US most likely

A

cocciciodes

Hanta virus (four corners, acute pulmonary syndrome)

Renal/Resp (43 decks)

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