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Bugs & Antibiotics Flashcards

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1
Q

Causes of osteomyelitis

A 
Staph aureus 
Other staph spp
Strep 
Enterococci 
E coli 
Klebsiella 
Pseudomonas

Paed: kingella, HiB

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2
Q

Treatment of osteomyelitis

A

Flucloxacillin 50mg/kg IV to 2g Q6H

Add vancomycin 15-20 mg/kg IV IBW or paed 25-30 mg/kg IV

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3
Q

Causes of septic arthritis

A

Staphlococcus aureus
Streptococcus
Neisseria meningiditis (sexually active adults)

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4
Q

Treatment of septic arthritis

A

Flucloxacillin 50mg/kg IV Q6H

Add vancomycin 15-20 mg/kg (or 25-30mg/kg paeds) IV

If gram positive chain or gram negative - add ceftriaxonw 50mg/kg to 2g IV Daily

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5
Q

Treatment of diabetic foot infection

A

Moderate: Amoxycillin/clavulanic acid 1g/200mg IV Q8H
Severe: Piperacillin/Tazobactam 4.5g IV Q6H
- alt ciprofloxacin plus clindamycin

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6
Q

Causes of infective endocarditis

A

Native valve:

  • staph aureus
  • strep viridans
  • enterococci
  • HACEK: haemophilus, aggregatibacterium, cardiobacterium, eikenella, kingella

Prosthetic valve:

  • staph aureus
  • Corynebacterium
  • Strep
  • Enterococci
  • E coli
  • Pseudomonas
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7
Q

Treatment of infective endocarditis

A

Benzylpenicillin 50mg/kg to 1.8g Q4H
Flucloxacillin 50mg/kg to 2g IV Q4H
Gentamicin 5-7 mg/kg IV

If suspected MRSA, prosthetic valve or ICD or septic shock, replace benpen with Vancomycin 25-30 mg/kg

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8
Q

Causes of meningitis

A

> 2 months:

  • Strep penumonia
  • Neisseria meningiditis
  • > 50, immunocomp, alcoholic: listeria
  • Unvacc paed: HIB

< 2 months:

  • GBS (agalactiae)
  • E coli
  • Listeria
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9
Q

Treatment of meningitis

A

> 2 months: Ceftriaxone 50mg/kg to 2g IV BD plus dexamethasone 0.15mg/kg IV to 10 mg Q6H
- listeria: add benzylpenicillin 2.4g IV Q4H

< 2 months:

  • Benzylpenicillin 60mg/kg IV to 2.4g
  • Cefotaxime 50mg/kg IV
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10
Q

Treatment of encephalitis

A

Acyclovir 20mg/kg IV to 12 yrs, then 10mg/kg IV Q8H

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11
Q

Causes of encephalitis

A

Adult:

  • HSV
  • VZV
  • Enteroviruses
  • Listeria, toxoplasmosis

Paed:

  • Enteroviruses
  • HSV
  • Herpes viruses - EBV, CMV, VZV
  • Aboroviruses
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12
Q

Brain Abscess causes

A 
Polymicrobial 
- Streptococcus 
- anaerobes 
Surgical - staph aureus 
Ear - gram neg 
Immunocomp - Nocardia, toxo, cryptococcus, candida, aspergillosis
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13
Q

Treatment of brain abscesses

A

Ceftriaxone 2g IV BD

Metronidazole 12.5mg/kg to 500mg IV Q8H

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14
Q

Treatment of clamydia trachmatis

A

Doxycycline 100mg PO BD for 7 days

OR azithromycin 1g PO once

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15
Q

Treatment of neisseria gonorrhoea

A

Ceftriaxone 500mg IM/IV
PLUS
Azithromycin 1g PO

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16
Q

Sexually transmitted epididymoorchitis treatment

A

Ceftriaxone 500mg IM/IV

Doxycycline 100mg PO BD for 7 days (or azithromycin 1g PO and rpt 1 week)

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17
Q

Primary gential herpes infection treatment

A

Acyclovir 400mg PO Q8H for 10 days

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18
Q

Non-severe PID treatment

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A 
Ceftriaxone 500mg IV/IM 
PLUS 
Metronidazole 400mg PO BD for 14 days 
PLUS 
Doxycycline 100mg PO BD for 7 days (or azithromycin 1g PO rpt in 1 week)
19
Q

Severe PID treatment

Study These Flashcards
A

Ceftriaxone 2g IV daily
Azithromycin 500mg IV daily
Metronidazole 500mg IV BD

20
Q

Post-procedural Pelvic infection treatment

Study These Flashcards
A

Mild-Mod: Amoxycillin claviculanic acid 875/125 PO BD for 14 days

Severe:

  • Gentamicin 5-7 mg/kg IV TBW
  • Amoxycillin 2g IV Q6H
  • Metronidazole 500mg IV BD
21
Q

Treatment of prostatitis

Study These Flashcards
A

Trimethoprim 300mg PO daily for 2 weeks

If severe

  • Gentamicin 5-7 mg/kg IV
  • Ampicillin 2g IV Q6H
22
Q

Treatment of endopthalmitis or penetrating eye injury

Study These Flashcards
A

Intravitreal: ceftazidime and vancomycin

Exogenous - moxifloxacin 400mg or ciprofloxaacin 750 mg PO

If IV needed: IV ceftazidime and vancomycin

23
Q

Febrile neutropaenia treatment

Study These Flashcards
A

Piperacillin tazobactam 4.5g IV Q6H

If risk MRSA - add vancomycin
If septic shock - add gentamicin 5-7 mg/kg IV (to Pip taz)

24
Q

Initial antiretroviral treatment in adults

Study These Flashcards
A

Dolutegravir, abacavir and lamivudine

25
Treatment of acute cholangitis
Ampicillin 2 g Gentamicin 5-7 mg/kg IV metronidazole if chronic biliary obstruction
26
Treatment of acute appendicitis
Gentamicin 5-7 mg/kg IV Metronidazole 500mg IV BD Amoxycillin 2g IV Q6H Delayed hyersensitivity: cef & metro If immediate hypersensitivity to penicillin: gent and clinda
27
Treatment of spontaneous bacterial peritonitis
Ceftriaxone 2g IV Daily
28
Organisms involved with suspected peritonitis in peritoneal dialysis patient
``` Staph epidermidis Staph aureus Etnerobacteriae Streptococcus Enterococcus ```
29
Empirical therapy of peritonitis in peritoneal dialysis patient
Intermittent administration, intraperitoneal Gentamicin 0.6 mg/kg to 50mg in 1 bag of dialyis fluid per day Cefazolin 15 mg/kg in 1 bag of dialysis fluid per day If known to have MRSA, replace cefazolin with vancomycin If suspected bowel perf: add metronidazole 400mg PO BD
30
Contraindications to aminoglycosides
History of aminoglycoside vestibular / auditory toxicity History of severe hypersensitivity reaction to aminoglycoside Myasthenia Gravis Precaution / generally avoid if: - pre-existing significant hearing impairment - pre-existing vestibular condition - first degree relative with aminoglycoside induced auditory toxicity
31
Treatment of melioidosis
Meropenem 1g IV Q8H
32
Initial treatment of uncomplicated malaria
Quinine sulfate 600 mg PO Q8H PLUS Doxycycline 100mg PO BD (adult) or clindamycin PLUS single dose primaquine 15mg PO
33
Treatment of helmithic infection
Mebendazole 100 mg PO BD for 3 days (single dose for threadworm) Albendazole 400mg PO BD for 3 days (strongyloidiasis,
34
Post-exposure prophylaxis Hep B
Exposed person immune - nil further Exposed non-immune - source negative - HBV vaccination course ASAP < 24 hrs - Source positive / unknown -- test exposed at baseline and 6 months for HBsAg --start vaccination course < 24 hrs --HBV IgG within 72 hrs
35
HIV PEP required if
Source HIV positive / detectable viral load - Intercourse (anal/vaginal) - Non-occupational MM/not intact skin exposure - Occupational MM / broken skin / needle stick - Shared injecting equipment If HIV status unknown, PEP for sexual or injecting equipment not required, unless source MSM/high prevalence group (>1% country) If source is high risk & occupational exposure, consider 2 drug regimen
36
HIV PEP regimen
Lamivudine 300 mg PO daily for 4 weeks Tenofovir 300 mg PO daily for 4 weeks If 3 drug: Dolutegravir 50mg PO daily for 4 weeks
37
Standard short course therapy for TB
Isoniazid 300 mg PO Daily for 6 months Rifampicine 600 mg PO daily for 6 months Ethambutol 1200 mg PO daily for 2 months Pyrazinamide 2g daily for 2 months
38
Treatment of acute rheumatic fever
Benzathine benzylpenicillin IM 1.2 million units
39
Treatment of sepsis/septic shock, source not apparent in an adult
Flucloxacillin 2g IV Q4H Gentamicin 5-7mg/kg IV Meningitis suspected - ceftriaxone 2g IV MRSA suspected - vancomycin 25-30 mg/kg
40
Treatment of sepsis/septic shock in children
< 2 months: Benzylpenicillin 60mg/kg IV and cefotaxime 50mg/kg IV > 2 months: Ceftriaxone 100mg/kg (to 4g) IV Daily Flucloxacillin 50mg/kg (to 2g) IV Q6H
41
Causes of necrotising skin and soft tissue infections
``` Streptococci (pyogenes) Clostridium perfringes Staph aureus Vibrio spp E Coli Bacteroides fragilis ```
42
Empirical therapy for necrotising skin and soft tissue infections
Meropenem 20 mg/kg to 1g IV Q8H Vancomycin 25-30 mg/kg IV Clindamycin 15 mg/kg IV to 600 mg IV Q8H If water associated - add ciprofloxacin 400mg IV Q8H
43
When is tetanus vaccine indicated
If < 3 doses of vaccine recieved If > 3 doses of vaccine, but > 5 yrs (other wound) or > 10 yrs since last dose ** 9-13 year olds
44
When is tetanus immunoglobulin indicated
If < 3 doses of tetanus toxoid, and not clean minor wound If humoral immune deficiency or HIV if not clean minor wound

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