CLINICAL USE OF ANTIMICROBIALS Flashcards Preview

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Flashcards in CLINICAL USE OF ANTIMICROBIALS Deck (56):
1

DRUGS FOR STRICTLY AEROBIC BACTERIA

1) AZTREONAM

2) AMINOGLYCOSIDES

2

DRUGS FOR STRICTLY ANAEROBIC BACTERIA

METRONIDAZOLE

CLINDAMYCIN

3

BACTERICIDAL DRUGS

"VB-FAMS"

VANCOMYCIN

B-LACTAMS

FLUOROQUINOLONES

AMINOGLYCOSIDES

METRONIDAZOLE

STREPTOGRAMINS 

4

BACTERIOSTATIC

MC's TTS --> STATIC b/c you want them to stay there

MACROLIDES (b/c big tits)

CLINDAMYCIN

TRIMETHOPRIM

TETRACYCLINES

SULFONAMIDES 

5

ANTIMICROBIAL ELIMINATION

RENAL OR HEPATIC? 

HEPATIC: Chlorine Cleans Everyting Naf Car

1) CHLROAMPHENICOL

2) CLINDAMYCIN

3) ERYTHROMYCIN

4) NAFCILLIN

5) CLARITHROMYCIN 

Everything else = RENAL (note the only C for renal is cephalosporin)

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ANTIMICROBIAL EFFECTS ON FETUS + NEONATE: 

AMINOGLYCOSIDES

Possible damage to the 8th crnail nerve of the fetus

7

ANTIMICROBIAL EFFECTS ON FETUS + NEONATE: 

TETRACYLINES, GLYCYLCLINES

Tooth enamel dysplaisa, inhibitiong of bone growth 

8

ANTIMICROBIAL EFFECTS ON FETUS + NEONATE: 

SULFONAMIDES

KERNICTERUS (displacement of bilribuin from serum albumin)

9

ANTIMICROBIAL EFFECTS ON FETUS + NEONATE: 

CHLORAMPHENICOL

GRAY BABY SYNDROME

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ANTIMICROBIAL EFFECTS ON FETUS + NEONATE: 

FLUOROQUINOLONES

TENDON RUPTURE/DAMAGE

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ANTIMICROBIAL EFFECTS ON FETUS + NEONATE: 

NITROFURANTOIN

HEMOLYTIC ANEMIA 

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ANTIMICROBIAL EFFECTS ON FETUS + NEONATE: 

TRIMETHOPRIM

FOLATE DEFICIENCY

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ANTIMICROBIAL EFFECTS ON FETUS + NEONATE: 

METRONIDAZOLE

UNKNOWN SAFETY (just like going on the metro) 

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SURGICAL ANTIMICROBIAL PROPHYLAXIS

1) CARDIOTHORACIC

2) COLORECTAL

3) GENERAL SURGERY

4) NEUROSURGICAL

5) ORTHOPEDICS

6) VASCULAR SURGERY

FOR EACH DO ANTIMICROBAL + IF PATIENT ALLERGIC TO PENICILLIN

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ANTIBIOTICS THAT FREQUENTLY CAUSE C. DIFF

1) CLINDAMYCIN

2) AMPICILLIN

3) AMOXICILLIN

4) CEPHALOSPORINS

5) FLUOROQUINOLONES

 

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TREATMENT OF C DIFF

1) METRONIDAZOLE

2) VANCOMYCIN

3) FIDAXOMICIN

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BACTERIAL MENINGITIS 

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BACTERIAL MENINGITIS PROPHYLAXIS!

1) RIFAMPIN

2) CIPROFLOXACIN

3) CEFTRIAXONE

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COMMUNITY-ACQUIRED PNEUMONIA - EMPIRICAL TREATMENT

OUTPATIENTS

OUTPATIENTS

PREVIOUSLY HEALTHY + NO USE OF ANTIMICROBIALS WITHIN PREVIOUS 3 MONTHS: 

1) MACROLIDE or 

2) DOXYCYCLINE

 

PRESENCE OF COMORBIDITIES; immunosuppressing conditions or use of immunosuppressing drugs; or use of antimicrobials within previous 3 months 

1) RESPIRATORY FLUOROQUINOLONE

2) B-LACTAM + MACROLIDE 

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COMMUNITY-ACQUIRED PNEUMONIA - EMPIRICAL TREATMENT

INPATIENTS

NON-ICU:  respiratory fluoroquinolone OR B-lactam + macrolide

 

ICU: BLACTAM + either

  • azithromycin or a
  • respiratory fluoroquinolone

For PENICILLIN-ALLERGIC PATIENTS, a

  • 1) respiratory fluoroquinolone
  • 2) + AZTREONAM 

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ANAEROBE (ASPIRATION) TX

DRUGS OF FIRST CHOICE =

1) B-LACTAM

2) B-LACTAMASE INHIBITOR

3) CLINDAMYCIN

 

NO ALTERNATIVE DRUGS

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BACTEROIDES

DRUGS OF FIRST CHOICE = 

1) METRONIDAZOLE

 

ALTERNATIVE DRUGS: 

1) CLINDAMYCIN,

2) CARBAPENEMS,

3) PENICILLINS + B-LACTAMASE INHIBITOR,

4) CHLORAMPHENICOL

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BORDETELLA PERTUSSIS

DRUGS OF FIRST CHOICE = MACROLIDE

 

ALTERNATIVE: 

TMP-SMX 

24

BRUCELLA

DRUGS OF FIRST CHOICE =

1) DOXYCYCLINE + MACROLIDE 

25

CAMPYLOBACTER JEJUNI

DRUGS OF FIRST CHOICE =

1) AZITHROMYCIN

 

ALTERNATIVE DRUGS

1) ERYTHROMYCIN

2) CIPROFLOXACIN 

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CHANCROID

DRUGS OF FIRST CHOICE =

1) AZITHROMYCIN, ERYTHROMYCIN, CEFTRIAXONE, CIPROFLOXACIN

 

ALTERNATIVE = none

27

C. TRACHOMATIS

DRUGS OF FIRST CHOICE =

1) AZITHROMYCIN (or other macrolide)

2) DOXYCYCLINE 

Alternative drugs: 

1) FLUOROQUINOLONE

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C. DIFFICILE

DRUGS OF FIRST CHOICE =

1) METRONIDAZOLE

 

ALTERNATIVE

1) VANCOMYCIN, FIDAXOMICIN

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C. PERFRINGENS

DRUGS OF FIRST CHOICE =

1) IV PENICILLIN G+/- CLINDAMYCIN

 

Alternative drugs: 

1) CEPHALOSPORINS, DOXYCYCLINE

 

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ENTEROBACTER SPP

DRUGS OF FIRST CHOICE =

1) CARBAPENEM

2) CEFEPIME

Alternative drugs:

1) AMINOGLYCOSIDE

2) TMP-SMX, 

3) FLUOROQUINOLONE

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ENTEROCOCUS SPP

DRUGS OF FIRST CHOICE =

1 ) AMPICILLIN +/- GENTAMICIN

2) VANCOMYCIN +/- GENTAMICIN 

 

ALTERNATIVE:

1 )LINEZOLID

2) DAPTOMYCIN

3) STREPTOGRAMINS 

 

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E. COLI

 

DRUGS OF FIRST CHOICE =

1) CEPHALOSPORINS

2) FLUOROQUINOLONES

 

Alternative drugs: 

-many penicillins +/- 

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G. VAGINALIS

DRUGS OF FIRST CHOICE =

1) METRONIDAZOLE

 

ALTERNATIVE TREATMENT: 

1 )CLINDAMYCIN

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H. INFLUENZAE (otitis, sinusitis, etc...)

DRUGS OF FIRST CHOICE =

1) CEFTRIAXONE

2) CEFOTAXIME

Alternative drugs: 

1 )AMPICILLIN-SULBACTAM

2) MEROPENEM

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KLEBSIELLA PNEUMONIAE

DRUGS OF FIRST CHOICE =

1) CEFTRIAXONE

2) CEFOTAXIME

Alterative drugs:

1) FLUOROQUINOLONE

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LEGIONELLA SP.

DRUGS OF FIRST CHOICE =

1) FLUOROQUINOLONE OR

2) MACROLIDE

 

ALTERNATIVE DRUGS:

1 )TMP-SMX

2) DOXYCYCLINE

37

LISTERIA MONOCYTOGENES

DRUGS OF FIRST CHOICE =

1) AMPICILLIN +/- GENTAMICIN

 

Alterative Treatment:

1) TMP-SMX

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M. CATARRHALIS

DRUGS OF FIRST CHOICE =

1) AMOXACILLIN-CLAVULANIC ACID

2) 2nd/3rd generation CEPHALOSPORINS

3) TMP-SMX

Alterative drugs: 

1) AZITHROMYCIN

2) CLARITHROMYCIN 

39

MYCOPLASMA PNEUMONIAE

DRUGS OF FIRST CHOICE =

1) MACROLIDE or

2) TETRACYCLINE

Alterative drugs: 

1) RESPITARORY FLUOROQUINOLONES

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N. GONORRHOAE

DRUGS OF FIRST CHOICE =

1) CEFTRIAXONE AND

2) AZITHROMYCIN/DOXYCYLIN

Alterative drugs: 

1) AZITHROMYCIN/DOXYCYCLINE

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N. MENINGITIDIS

 

DRUGS OF FIRST CHOICE =

1) 3RD GENERATION CEPHALOSPORIN (usually CEFTRIAXONE)

Alternative drugs: 

1) PENICILLIN G

2) CHLORAMPHENICOL

3) FLUOROQUINOLONE

 

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P. MIRABILIS

 

DRUGS OF FIRST CHOICE =

1) AMPICILLIN (sketchy says sulfonamide... eggs on ground)

Alternative drugs: 

1) CEPHALOSPORINS

2) PENICILLINS + B-LACATMASE INHIBITORS

3) AMINOGLYCOSIDES

4) TMP-SMX

5) FLUOROQUINOLONES

43

PSEUDOMONAS AERUGINOSA

DRUGS OF FIRST CHOICE =

1) ANTIPSEUDOMONAL B-LACTAM + CIPROFLOXACIN

Alternative drugs: 

1) LEVOFLOXACIN

2) AMINOGLYCOSIDE

44

RICKETTSIA

DRUGS OF FIRST CHOICE =

1) DOXYCYCLINE

Alterative drugs:

1) CHLORAMPHENICOL

2) FLUOROQUINOLONES

45

SALMONELLA TYPHI

 

DRUGS OF FIRST CHOICE =

1) CEFTRIAXONE OR

2) FLUOROQUINOLONE (ciprofloxacin) 

Alterative drugs: 

1) Chloramphenicol

2) TMP-SMX

3) Ampicillin

46

SERRATIA SPP.

 

DRUGS OF FIRST CHOICE =

1) AMINOGLYCOSIDE + ANTI-PSEUDOMONAL B-LACTAM

Alterative drugs: 

1) FLUOROQUINOLONE

47

SHIGELLA

DRUGS OF FIRST CHOICE =

1) AMPICILLIN

2) TMP-SMX

Alterative drugs: 

1) FLUOROQUINOLONE

2) CEFTRIAXONE

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S. AUREUS OR EPIDERMIS

(METHICILLIN-SUSCEPTIBLE)

DRUGS OF FIRST CHOICE =

1) NAFCILLIN, OXACILLIN, DICLOXACILLIN = ANTISTAPHYLOCOCCAL PENICILLINS

Alterative drugs: 

1) CEPHALOSPORIN

2) CLINDAMYCIN

3) FLUOROQUINOLONE

4) IMIPENEM

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S. AUREUS OR EPIDERMIS

(METHICILLIN RESISTANT)

Drug of first choice:

1) VANCOMYCIN

2) LINEZOLID

Alternatives:

1) Daptomycin

2) Doxycycline

3) Fluoroquinolone

4) Streptogramins

50

STREP PNEUMONIAE

(PENICILLIN-SUSCEPTIBLE)

 

DRUGS OF FIRST CHOICE: 

1) PENICILLIN G

2) AMOXICILLIN

ALTERNATIVE DRUGS: 

1) CEPHALOSPORIN

2) CLINDAMYCIN

3) FLUOROQUINOLONE

4) MACROLIDE

5) TMP-SMX

51

STREP PNEUMONIAE

(PENICILLIN RESISTANT)

 

DRUGS OF FIRST CHOICE: 

1) 3RD GENERATION CEPHALOSPORIN (CEFTRIAXONE) 

2) FLUOROQUINOLONE

ALTERNATIVE DRUGS: 

1) VANCOMYCIN

2) LINEZOLID

3) STREPTOGRAMINS

52

TREPONEMA PALLIDUM

DRUGS OF FIRST CHOICE: 

1) BENZATHINE PENICILLIN G

ALTERNATIVE DRUGS: 

1) DOXYCYCLINE (penicillin allergic patients) 

53

TRICHOMONIASIS

 

DRUGS OF FIRST CHOICE: 

1) METRONIDAZOLE

ALTERNATIVE DRUGS: 

NONE

54

TULAREMIA (FRANCISELLA TULARENSIS)

DRUGS OF FIRST CHOICE: 

1) STREPTOMYCIN

ALTERNATIVE DRUGS: 

2) GENTAMICIN/CHLORAMPHENICOL

 

55

YERSINIA PESTIS

 

DRUGS OF FIRST CHOICE: 

1) STREPTOMYCIN

ALTERNATIVE DRUGS: 

2) DOXYCYCLINE

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