UTI to end of ID drugs Flashcards
what are the urinary tract only drugs and ROA
nitrofurantoin (po)
fosfomycin (po)
MOA of nitrofurantoin
inhibition of bacterial enzymes
adverse effects of nitrofurantoin
pulmonary toxicity with prolonged use
anemia
activity of nitrofurantoin
s. saprophyitcus
E. colu
Enterococcus
Some VRE
citrobacter
klebsiella
NO anaerobic activity
how to enhance absorption of nitrofurantoin
eat
minimum CrCl of nitrofurantoin
package insert says 60
notes say 30?
mechanism of fosfomycin
inhibition of bacterial cell wall synthesis
Indication of fosomycin
UTI
fosfomycin is approved for use with which organisms
enterrococcus faecalis
E. coli
Maybe VRE ESBL
no anaerobic activity
common organisms of the skin
diphtheroids (corynebacterium)
propionibacteriaceae
bacillus
staphylococci (coagulase negative)
streptococci
common organisms of the GI tract
bacteroides
clostridium
enterobacteriaceae (E. coli, klebsiella)
streptococci (anaerobic)
enterococcus
fusobacterium
common organisms of the upper respiratory tract
bacteroides
haemophilus
neisseria
anaerobic streptococci
common organisms of the genitourinary tract
lactobacillus
corynebacterium
enterobacteriaceae (E. coli)
staph (saprophyticus)
strep
normal flora can become pathogenic when translocated to what areas
sterile areas
i.e bloodstream, pleural fluid, peritoneal fluid, pericardial fluid, synovial fluid, bone, urine
patients can have their normal flora replaced by pathogenic gram negative “hospital bugs” when hospitalized for more than
48 hours
localized clinical signs of infection
pain
inflammation
swelling
erythema
purulent or abnormal discharge
sputum production
systemic clinical signs of infection
chills
rigors
tachycardia
tachypnea
malaise
hypotension
mental status change
fever
laboratory signs of infection
WBC > 10,000 (presence of left shift)
positive gram stain and culture
elevated ESR
elevated CRP
positive antigen or antibody liters
causative pathogens of skin and soft tissue uncomplicated
staph aureus
strep pyogenes (group A)
strep agalactiae (group B)
causative pathogens of complicated skin and soft tissue infections
polymicrobial and gram negative bacilli
e coli
pseudomonas aeruginosa
meningitis causative pathogens
strep pneumo
n meningitidis
CAP causative pathogens
s pneumo
mycoplasma pneumoniae
chlamydiphila pneumoniae
legionella
HAP/VAP causative pathogens
pseudomonas aeruginosa
klevsiella
E. coli
enterobacter spp
serratia spp
acinetobacter spp
causative pathogens of uncomplicated UTI’s
E. coli
staph saprophyticus
klebsiella pneumonia
proteus
gram negative rods and enterococci
causative pathogens of bone and joint infections
staph aureus
causative agents of lyme disease
borrelia burgdorferi
causative agents of syphilis
treponema pallidum
causative agents of anthrax
bacillus anthracis
causative agents of whooping cough
bordetella pertussis
causative agents of whooping cough
bordetella pertussis
which cultures aren’t helpful
wound/skin cultures, sputum (just difficult),
MIC 50
concentration needed to inhibit 50% growth
MIC 90
concentration needed to inhibit 90% growth
empiric therapy
antibiotics are chosen that have activity against the predicted or most likely pathogen causing the patient’s specific infection
this is wide spectrum to cover a wide variety until definitive culture
directed or targeted therapy
antibiotics are used to treat an established infection
narrower spectrum directed toward the infecting pathogen
prophylactic therapy
given to prevent infection for a short time
combination therapy
may be needed when one antibiotic does not cover all of the pathogens identified by culture
take advantage of synergistic effects
agents that inhibit the growth of the organism and rely on the hosts defenses to help kill the bacteria and eradicate the infection
bacteriostatic
agents that kill the organism without needing help from the host defences
bactericidal
GOLDEN RULE of infectious disease treatment
always remove source of infection if you can
