10. Antimicrobial Prophylaxis Flashcards
Secondary risks associated with infective endocarditis (4)
- Prosthetic cardiac value or valve repair
- Previous IE
- Congenital heart disease
- Cardiac transplant patients w/ cardiac valve disease
Systemic lupus
- 25% manifest what?
- 50% develop what?
- You should do what to determine valvular status?
- Valve abnormality on echocardiogram
- Libman-Sack endocarditis (non-bacterial verrucous endocarditis)
- Med consult indicated
Normal ANC?
Causes of neutropenia (6)
Absolute Neutrophil Count - 1,500-8,000/mm3
- Aplastic anemia
- Medication
- Cancer
- Chemotherapy
- Radiation
- Autoimmune neutropenia
Uncontrolled/poorly controlled diabetes - Increased risk for bacteremia-induced infections why? (2)
- Reduced phagocytic activity
2. Impaired wound healing
Controlled diabetes glucose (fasting and postprandial) and A1C levels?
- Fasting: 70-130 mg/dl
- Postprandial: <180 mg/dl
- <7% A1C
Uncontrolled diabetes glucose (postprandial) and A1C?
- Postprandial: >200 mg/dl postprandial
2. >9%
Splenectomy - antimicrobial prophylaxis not normally recommended, except when? (3)
- Children <5 y/o
- Splenectomy w/in past year
- Underlying immunodeficiency
Which of the three treatments for end stage renal disease is microbial prophylaxis indicated?
- Chronic ambulatory peritoneal dialysis
- Hemodialysis
- Kidney transplant
- Not recommended
- Significant risk of endarteritis at fistula site
- Due to increased drug induced immunosuppression, it is recommended
What is AHA standard regiment recommendation? What if allergic?
- Amox 2 grams orally one hour before tx
- Clindamycin 600 mg PO 1 hour before
- Cephalxin/cephadroxil 2 gram po 1 hour before
- Azitromycin 500 mg PO 1 hour before
If unable to take oral meds, what is dosage IM or IV for Amox or for Clinda/cefazolin?
Amox 2 grams IM/IV within 30 minutes before
Clindamycin 600 mg or cefazolin 1 gram im/iv within 30 minutes before
