EBM ABX Flashcards by Zach Ceez

Primaxin composition

“Gorillamycin”

AKA Imipenem an Cilastin

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Primaxin Dosage in patient with creatinine clearance = to or greater than 90 mL/min

500 mg IV over 20-30 min q 6h

1000mg IV over 40-60 min q 8h

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Does meropenem cover pseudomonas?

Yes!

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What is the dosage for meropenem in adults?

500 mg IV q8h for skin

1g q8h for complicated pseudomonal skin issues.

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What are the important drug interactions seen with Meropenem?

Probenecid: Can lead to increased meropenem levels.

Valproic Acid: Increases risk of seizures by deminishing valproic acid levels.

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What drug class does meropenem acts synergistic with to treat pseudomonas?

Aminoglycosides!

Especially against pseudomonas

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What is Invanz?

Whats it implicated in?

Ertpenem
Indicated for complicated skin infections AKA diabetic foot infections without osteomyelitis.

NOT Pseudomonas.

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What is the dosage of Invanz in adults older than 13?

1g given once a day.

Patients 3 mo - 12 years 15 mg/kg twice daily not to exceed 1g a day.

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Do aminoglycosides cover pseudomonas?

Yes!

And they are synergistic with carbapenems.

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What are the three big side effects of Aminoglycosides?

Ototoxicity
Phlebitis
Nephrotoxicity
Hypersensitivity.

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What are normal ESR levels?

0-22 mm/h

ESR > 60 mm likely osteo

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What are normal CRP levels?

3.0 mg/dL

> 3.2 mg/DL with ulcer >3 mm =OM

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What are normal CBC levels?

5-10 mm x10^8 cells/mmcubed

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What is timentin?

Ticarcillin + Clavulunic acid

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What is unasyn?

Ampicillin / Sulbactam
Given IV!

NO PSEUDOMONAS COVERAGE

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What is Zosyn?

Piperacillin + Tazobactam

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What is the indication and Penicillin G?

DOC for strep!

Doesn’t effect bacteroides

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What is the indication and dose for nafcillin?

How is it cleared?

MSSA
1g IV q 4-6 hours

Cleared hepatically with short half life.

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What are the semi-synthetic pencilins?

Cloxacillin

Dicloxacillin

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What is the dosage for cloxacillin and dicloxacillin?

250-500 mg no BID given orally.

These are the oral equivalent to nafcillin.

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What is Augmentin?

Amoxacillin and Clavulunic acid used as an oral emperic drug.

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What is the dosage for augmentin?

500-875 mg po q 12 hours

IMPORTANT FOR HUMAN BITES AND COVERS BACTEROIDES.

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What is the set ratio of clavulunic acid to amoxacillin?

125 mg clavulunic acid to 500-875 mg of amoxicillin.

Thus cannot give two 250 mg augmentins due to overdose leading to severe diahhrea.

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What is the dosage for unasyn?

1.5 - 3g IV q6

NO Pseudomonas coverage!!

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What is the dosage for zosyn?

Pipercyllin with tazobactam 3.7g IV q 6h or 4.5g IV q8' HAS PSEUDOMONAS COVERAGE

When comparing zosyn and unasyn, which covers pseudomonas?

Zosyn (pipercillyn and tazobactam) covers pseudomonas.

Dosage and indication of ticarcillin?

Pseudomonas coverage. 3g q 4h IV

Piperacillin dosage and indication

3-4g q4-6h For pseudomonas and streptococcus. For severe infections, combine with aminoglycosides.

Timentin dosage and indication

Ticarcillin and clavulunic acid Dosage: 3g ticarcillin + 100mg clavulunic acid. For MSSR and Streptococci.

Augmentin dosage

500-875 mg bid PO Is the oral DOC for emperic animal/human bites!!

Unasyn dosage?

Ampicillin and sulbactam 1.5g or 3g q6h IV or IM Great for mixed infections.

Zosyn dosage?

Piperacillin and tazobactam 4.5g q8h hits enteroccocus and mixed infections.

What is the drug combination to use against Vancomycin resistant enterococcus?

Daptomycin with linizolid.

Most common acute osteomyelitis agents in infants?

GBS S aureus E.coli

Most common acute osteo agents in children?

S aureus and epidermidis with sickle cell in those with salmonella.

Most common acute osteo agent in drug users?

PSeudomonas.

Most common agent in chronic osteomyelitis?

Staph aureus.

What imaging is available for osteomyelitis?

Tech 99 bone scan phase 3 CT scan Ceretec scan - Active infection.

What is the other name for Cefazolin?

Ancef

What is the indication and dosage for cefazolin?

Initial emperic treatment for community aquired infections. 1g q8h or IV for most infections. Renally cleared.

What is another name for cephalexin? | What is its indication and dosage?

Keflex Indicated for staphylococcus (penicillin cheaper) 250-500 mg bid-qid PO

What is the other name for Cefoxitin and what is its indication?

Mefoxin Used for gram negative organisms including bacteroides Dose: 2g q6-8h IV

What is the indication and dosage for cefotetan?

Anerobics similar to cefositin. Dose: 1-2g q12 h IV

What is cefuroxime indicated for and what are its dosages?

H. influenzae Best of any parenteral 2nd gen for staph. Dose: 750 mg q12h Rare in LE because H influ not found there often.

cephtriaxone alterative name?

Rocephin

Cephtriaxone cover pseudomonas?

Which cephaloasporin is DOC for septic arthritis?

Rocephin | esp for gonoccocal

Rocephin dose

1-2g q12-24h IV

Third gen cephalosporin that covers pseudomonas?

Cephtazidime | 1g q8h IV

What is omniceph/cefdinir the DOC for?

mixed skin infections!

4th gen ceph?

Cefepime | 1-2g q12h IV

What is the general abx coverage of fluoroquinolones?

Wide spectrum aerobic gram positive and gram negative organisms.

Does erythromycin cover MRSA?

No but it covers other staph! Careful for hepatotoxicity

What is the dosage for erythromycin?

250-500 mg four times a day PO or 1g q6h IV diluted in 100mL of solution.

macrolide for penicillin allergic pt with skin infection?

Azithromycin.

Clarithromycin dosage?

250-500mg four times a day PO

What are the best uses for minocycline and doxycycline?

Treatment of MRSA

Dosage for tetracycline?

250-500 mg four times a day PO

Dosage for minocycline and doxycycline?

100 mg q12h PO

Does clindamycin cover enteroccoi or MRSA?

No! | good for skin staph coverage in patients with penicillin allergies.

What is the dosage for clindamycin (cleocin)?

600-900 mg q8h IV or 150-300 mg two to three times a day PO for outpatient.

What is Flagyl?

Metronidazole

What is the dosage for metronidazole?

Good for protozoa 500mg three to four times a day PO Can treat C.diff

What is metronidazole used to treat?

Pseudomembranous colitis via cdiff and helps in combination therapy for diabetic foot infections.

How does MRI change in efficiency in diagnosing osteo?

Best for diagnosing neuropathic osteo Not great for diagnosing ischemic osteo.

Whats the non surgical drug cocktail for osteomyelitis?

Augmentin or Clindamycin with a quinolone. | Rifampin viable as well here.

What are two drugs of choice to treat patients with osteomyelitis, sickle cell anemia and resultant salmonella?

Cephtriaxone 1mg IV q 12h | Ciprofloxacin 200-400 mg IV q8h

What drugs should be used in children under 3 months of age with osteomyelitis due to GBS?

Vancomycin 1g q 12h IV with cephtriaxone 1g q 12h

Which antibitic should be used prophylactically for implant surgery?

Clindamycin 600-900 mg q 8h IV

what is the vancomycin dose for adults with contigous osteomyelitis?

15-20 mg/kg q 8-12h vancomycin oral dose

Whats the treatment for C.diff?

Flagyl 500 mg qid BO + vanco 125 mg PO qid.

EBM ABX Flashcards

(71 cards)