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PHRM 865: Theraputics V > Lecture 18.2: Intraabdominal Infections > Flashcards

Lecture 18.2: Intraabdominal Infections Flashcards

1
Q

What is Intra-abdominal infections?

A
  • Infections within the peritoneal cavity or retroperitoneal space

Peritoneal: stomach, small/large bowel, lover, gall bladder spleen
Retroperitonal: Kidneys, pancreas, adrenal glands, aorta, vena cava.

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1
Q

What are the four types of Intra-abdominal Infections?

A
  • Uncomplicated
  • Complicated
  • Community- acquired
  • Healthcare-acquired
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2
Q

What is Uncomplicated Intra-abdominal Infections?

A
  • IN vicersal structures [liver, gall bladder, spleen, pancreas, kindey…] and NOT into peritoneum
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3
Q

What is Complicated in Intra-abdominal Infections?

A
  • INTO the peritoneal space possibly making abscess
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4
Q

What is Community-Acquired Intra-abdominal Infections?

A
  • < 48 hours within a Hospital

Like CAP

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5
Q

What is Healthcare-Aquired Intra-abdominal Infections?

A
  • > 48 hours in a hospital

Like HAP/VAP

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6
Q

What are the 2 general types of Intra-abdominal Infections>

A
  • Peritonitis: Inflammation of Peritoneal lining [Primary, Secondary, Tertiary]
  • Abscess: Purulent collection of fluid [immune system trys to put it in one spot]
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7
Q

What is Secondary Peritonitis in Intra-abdominal Infections?

A
  • Bacteria in Peritoneum affecting GI tract; by diseases, injuires, trauma, obstruction…
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8
Q

What are some of the most common caustive pathogens in Secondary Peritonitis?

A
  • Gram (-): E. Coli
  • Gram (+): Strep
  • Anaero: B. Fragilis
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9
Q

What is the pathogensis or pathphysiology of Secondary Peritonitis in Intra-abdominal Infections?

What are the 5?

A
  • Inoculum overpowered Host; Foreign Body, Large Bacterial Inoculum, Constant Contamination, Contamination with mix organisms, Impaired Defenses
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10
Q

What is the systemic responses that may happen during Secondary Peritonitis in Intra-abdominal Infections?

A
  • GI: Increased fluid = distention
  • Cardio: Fluid shifts = decreased cardiac output, hypotension, venous return
  • Respiratory: Fast Shallow breathes
  • Renal: Failure
  • Metabolic: wieght loss
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11
Q

What are the symptoms of Secondary Peritonitis in Intra-abdominal Infections?

A
  • Abdominal Pain
  • Anrexia
  • N/V
  • Fever +/- Chills
  • Thristy
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12
Q

What are some of the Physical Finding for Secondary Peritonitis in Intra-abdominal Infections?

A
  • Lie VERY still in bed
  • Rapid Breathes
  • Fever
  • Voluntary Guarding
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13
Q

What are some of the test results for Secondary Peritonitis in Intra-abdominal Infections?

A
  • Leukocytosis with LEFT SHIFT
  • High BUN
  • X-Ray or CT scan
  • Blood Cultures
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14
Q

What is important to know about Surgery in the treatmet of Secondary Peritonitis in Intra-abdominal Infections?

A
  • Source Control: repairing skin damage; removing fluids = decreases infection risks
  • COLLECT this fore susceptibilty testing
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15
Q

What is the Single Agent Treament for Mild-to-Mod Secondary Peritonitis in Intra-abdominal Infections?

A
  • Cefoxitin
  • Ertapenem
  • Moxifloxacin??
  • Tigecycline or Eracycline [Alternatives]
16
Q

What is the Single Agent Treament for High Risk or Severe Secondary Peritonitis in Intra-abdominal Infections?

A
  • Imipenem/Cilastatin
  • Meropenem
  • Doripenem
  • Pip/Tazo

Pseudo Coverage

KPC = Mero/Vabor; Imi/Cila/Rele

17
Q

What is the Combination Therapy Treament for Mild-to-Mod Secondary Peritonitis in Intra-abdominal Infections?

A
  • [Cefazolin, Cefuroxime, Ceftriaxone, Cefotaxime, Cirpo or Levo] + Metro
18
Q

What is the Combination Therapy Treament for High Risk or Severe Secondary Peritonitis in Intra-abdominal Infections?

A
  • [Cefepime, Ceftazidime, Cefiderocol, Ceftazidime/avibactam, ceftolozane/taxobactam, Cipro or Levo] + Metro

Pseudo Coverage

KPC: Ceftazidime/avibactam or Cefiderocol + Metro

19
Q

What are some of anitbiotic treatments that shuoldnt be used in Secondary Peritonitis Intra-abdominal Infections/

A
  • Amp/Sulbactam: high resistance to E. Coli
  • Cefotetan or Clinda: high resistance to B. Fragilis
20
Q

What is the empiric therapy for Healthcare-aquired intra-abdominal infections?

A
  • Mero, Dori, Imi/cila, Pip/Tazo, Ceftazidime + Metro, Cefepime + Metro
21
Q

What is the duration of therapy for Secondary Peritonitis Intra-abdominal infections?

A
  • 4 Days
22
Q

What is main causes of Primary Peritonitis in Intra-abdominal Infections?

A
  • Uncommon
  • Adults: hepatic failure or ascites & Kids: cirrhosis
23
Q

What are some of the bacterial that can cause Primary Peritonitis Intra-abdominal Infections?

A
  • SINGLE PATHOGEN
  • Kids: S. Pneumoniae
  • Adults: E. Coli [alcoholic cirrhosis

PHRM 865: Theraputics V (42 decks)

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