URIS Flashcards
URIs
-The most common illness seen in primary care
-Most common secondary infections seen with viral URIs are sinusitis (most common in adult) and otitis media (OM) in children
-sx: nasal congestion, rhinorrhea, malise, and scratchy throat
peak in 3-6 days
**Fever in adult/children suggest influenza or secondary infx
what cause URIs?
Rhinoviurs is the most common cause
Others: adenovirus, syncytial virus, parinfluenza virus, influenza viral strains, and human metapneumovirus
***Viral URIs are self-limiting
Goal: relieve nasal congestion
NO cough/cold med for children <4yo
children needs to encourage fluids/hydration
URIs meds
*Zinc lozenges showed to reduced sx
*echinacea safe for pregnancy/lactation, avoid if pt is allergic to daisies
What are symptoms with sinusitis?
Adults: purulent rhinorrhea, facial pain/pressure, and nasal obstructions
Children: frontal sinuses are not completely developed until 10 yo, children may VOMIT due to gagging on mucus
Pathophysiology of Sinusitis
Most common bacterial: S. penumoniae, Haemophilus influenzae, Moraxella catarrhalis
More rare: Staphylococcus, gram g
**anaerobic bacteria are more common in chronic sinusitis
Drug selection for Sinusitis
-Amoxicillin***1st line of tx, add clavulanate if sx fails to improve after a week, Augmentin is drug of choice for chronic sinusitis in children, adults can also tx with Levofloxacin
In patient at risk for resistance (<2yo or >65yo), high dose of amoxicillin-clavulanate (Augmentin 2g PO twice daily or 90mg/kg/d PO BID)
Otherwise
Adult: 500mg PO TID for 5-7 days
Children 45mg/kg/d BID/TID 10-14 days
IF pt is allergic to PCN,
-Doxycyline 100mg BID or 200mg daily
-levofloxacin 500mg daily/moxifloxacin 400mg/daily
Children with PCN allergy
Cefdinir 14mg/kg/d, cefuroxime 30mg/kg/d or cefpodoxime 10mg/kg/d
If sx not improving after 72 hours, bacterial resistance need to be considered
Take Tylenol or Ibuprofen for pain
