URTI Flashcards
What is the bacteria commonly associated with pharyngitis?
S. pyogenes
what are the complications commonly associated with bacterial pharyngitis?
acute rheumatic fever
acute glomerulonephritis
which age group is the most susceptible to bacterial pharyngitis?
3-14 yo
Supportive care for viral and bacterial pharyngitis:
- analgesic/antipyretic
- topical analgesic lozenges/sprays
- saltwater gargle
- adequate fluid and rest
antibiotics that can be used for bacterial pharyngitis (only need S. pyogenes coverage)
- penicillin VK
- amoxicillin
- cephalexin
- clindamycin
- clarithromycin
major symptoms of sinusitis:
purulent anterior nasal discharge purulent/discolored posterior nasal discharge nasal congestion/obstruction facial congestion/fullness facial pain/ pressure hyposmia/anosmia fever
minor symptoms of sinusitis:
HA ear pain pressure fullness halitosis dental pain cough fatigue
what is the criteria of diagnosing sinusitis
≥2 major symptoms/1 major + ≥2 minor symptoms
+ any one of below:
persistence of symptoms >10 days not improving
severe symptoms at onside – purulent nasal discharge 3-4 days/ high fever >39 deg
double sickening – worsening symptoms after 5-6 days after initial improvement
treatment period for bacterial pharyngitis:
10 days
most common bacteria involved in sinusitis:
strep pneumoniae/H. influenzae
what is thing to take note of during the use of amoxicillin in sinusitis and AOM?
use high dose for coverage of S. pneumoniae
supportive care for sinusitis:
analgesic/antipyretic nasal steroid spray saline irrigation expectorant nasal/systemic decongestants/antihistmines
Abx treatment for sinusitis:
amox/augmentin
levo/moxifloxacin
cotrimoxazole
cefuroxime
why are macrolides and tetracyclines not used for sinusitis?
local s. pneumonias has increased resistance to macrolides and tetracyclines
treatment period for sinusitis
adults 5-10 days
pediatrics 10-14 days
clinical presentation of acute otitis media:
ear pain ear discharge ear popping ear fullness hearing impairment dizziness fever non-specific in young infants
Risk factors for AOM
siblings attending day care supine position during feeding exposure to tobacco smoke at home pacifier use winter season
prevention of AOM
avoid exposure to tobacco smoke
exclusive breast feeding for 1st 6 months
pacifier use
vaccinations (HiB, PCV, influenza)
common causative bacteria for AOM
S. pneumoniae, H. influenzae, moraxella catarrhalis
support care for AOM:
analgesic/antipyretic
decongestants and antihistamines not shown to be beneficial
Treatment duration for AOM
< 2yo: 10 days
severe symptoms in last 48 hr: 10 days
2-5 yo, non severe: 7 days
≥ 6 yo, non severe: 5-7 days
common treatments for AOM:
amoxicillin 80-90mg/kg/day divided BD
augmentin 80-90 mg/kg/day divided BD
Cefuroxime 30mg/kg/day divided BD
Common treatments for bacterial sinusitis:
amox 1g PO TDS/augmentin 625mg tds
Levofloxacin 500mg PO OD
Chemoprophylaxis for influenza:
oseltamivir 75mg PO OD 7D
treatment for influenza
oseltamivir 75mg PO OD 5D
Groups in need of preexposure chemoprophylaxis:
institutional outbreaks
individuals >3mths who cannot receive vaccination
Groups in need of postexposure chemopropylaxis
all high risk individuals >3mo
unvaccinated individuals > 3mth + household contacts of high risk individuals
high risk for influenza related complications:
Children < 5yo
Elderly >65 yo
pregnant women /2wks post partum
residents of nursing homes/ long term care facilities
obese individuals BMI > 40
individuals with chronic medical conditions
common treatment for bacterial pharyngitis:
penicillin VK 250mg PO qds amox 1g PO OD cephalexin 250mg PO qds clindamycin 300mg PO TDS clarithromycin 250mg BD
