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PHM 603 Infectious Disease > Exam 3 > Flashcards

Exam 3 Flashcards

(40 cards)

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1
Q

How to treat sinusitis (viral)?

A
  • Viral = Decongestants, irrigation, mucolytic
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2
Q

When to use antibiotics for sinusitis?

A
  • Persistent symptoms > 10 days without improvement
  • Severe symptoms > 3-4 days at beginning of illness (fever > 102 F, purulent nasal discharge, facial pain)
  • Worsening symptoms after typical viral upper respiratory infection (new onset of symptoms after 5 days of recovering from URI)
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3
Q

What antibiotic is used for sinusitis?

A

Amoxicillin/clavulanate
- Alternatives = fluoroquinolones, clindamycin + cefpodoxime or cefuroxime, doxycycline, TMP/SMX

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4
Q

How long should antibiotics be used for sinusitis?

A
  • Adults = 5-7 days
  • Kids = 10-14 days
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5
Q

Drug of choice for pharyngitis (and duration)

A

Penicillin VK or Amoxicillin for 10 days

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6
Q

What drugs can be used for penicillin allergic patients for pharyngitis?

A
  • Mild allergy (rash) = cephalexin for 10 days
  • Severe allergy (anaphylaxis) = clindamycin for 10 days or azithromycin for 5 days
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7
Q

What drugs can be used for patients who are unlikely to be adherent for pharyngitis?

A

Benzathine penicillin IM 1 shot

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8
Q

Pain management for otitis media

A

PO acetaminophen or ibuprofen PRN (typically needed for up to 1 week

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9
Q

Who should get antibiotic for otitis media?

A
  • 6 months - 12 years with mod-severe pain or temp > 102.2
  • 6-23 months with non severe bilateral acute otitis media
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10
Q

What antibiotics should be used for otitis media?

A

Amoxicillin or amoxicillin/clavulanate

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11
Q

CAP outpatient treatment for previously healthy and no risk factors for drug resistance

A
  • PO amoxicillin
  • PO doxycycline (alternative)
  • PO macrolide (azithro, clarithro)
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12
Q

CAP outpatient treatment for comorbidities

A
  • PO amoxicillin/clavulanate or cephalosporin (cefpodox, cefdinir, cefurox) + macrolide
  • PO respiratory quinolone
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13
Q

Inpatient CAP treatment non-severe

A
  • IV beta lactam (ampicillin/sulbactam, ceftriaxone) + macrolide
  • Respiratory fluoroquinolone
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14
Q

Inpatient CAP treatment severe

A
  • IV beta lactam + macrolide
  • IV beta lactam + respiratory fluoroquinolone
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15
Q

Duration of antibiotics for CAP

A

Minimum 5 days (generally 7 days)
- To stop, the patient should be afebrile for 48-72 hours

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16
Q

When should we consider antibiotic use for otitis media?

A

When symptoms are worsening for:
- 6-23 months with non severe unilateral otitis media
- 2-12 years with acute non severe acute otitis media

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17
Q

Empiric Antibiotics for HAP

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A
  • Ceftriaxone
  • Levofloxacin, moxifloxacin
  • Ampicillin/sulbactam
  • Ertapenem
18
Q

When to cover pseudomonas empirically for VAP/HAP?

Study These Flashcards
A
  • Prior IV antibiotic use within last 90 days
  • Severe presentation (septic shock, need for ventilator support)
  • Previous infection/colonization
  • Immunosuppression
19
Q

Antibiotics for covering pseudomonas in VAP/HAP

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A
  • Piperacillin/tazobactam
  • Cefepime
  • Ceftazidime
  • Imipenem, meropenem
  • Aztreonam
  • Ciprofloxacin
  • Levofloxacin
  • Aminoglycosides
  • Colistin, polymixin B
20
Q

Duration of antibiotic therapy for VAP/HAP

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A

7 days regardless of pathogen

21
Q

Cystitis Symptoms

Study These Flashcards
A
  • Dysuria
  • Frequency/urgency
  • Hematuria
22
Q

Pyelonephritis Symptoms

Study These Flashcards
A
  • Dysuria
  • Frequency/urgency
  • Hematuria
  • Costovertebral angle tenderness
  • Fever
  • Chills
  • N/V
23
Q

Therapy for women with acute, uncomplicated cystitis

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A
  • Nitrofurantoin monohydrate/macrocrystals 100 mg PO BID for 5 days
  • Bactrim PO BID for 3 days
  • Also = fosfomycin trometamol, quinolones, beta-lactams (not amoxicillin or ampicillin empirically)
24
Q

Outpatient treatment of acute pyelonephritis in women

Study These Flashcards
A
  • Bactrim BID for 14 days
  • Also = ciprofloxacin for 7 days (with or without initial IV dose), quinolone (ciprofloxacin 1000 mg, levofloxacin), oral beta-lactams with an initial IV dose for 10-14 days
25
Inpatient treatment of acute pyelonephritis in women
- Extended spectrum cephalosporin or penicillin +/- aminoglycoside (IV) - Also = quinolone IV, aminoglycoside +/- ampicillin, carbapenem All for 10-14 days
26
When do you treat asymptomatic bacteriuria?
- Pregnancy - Prior to invasive urinary tract procedures - Prior to renal transplantation
27
Treatment of Asymptomatic Bacteriuria in Pregnancy
- Amoxicillin/clavulanate for 7 days - Cephalexin for 3-7 days - Also = Nitrofurantoin for 7 days (not for close to delivery), amoxicillin for 7 days, Bactrim for 3 days (avoid in last trimester) - Quinolones and tetracyclines are contraindicated
28
Presentation of cystitis in men
- Elderly male with dysuria, frequency, fever, lower abdominal pain - Rare = dysuria and frequency in younger men
29
Acute bacterial therapy of prostatitis in men
Duration = 2-4 weeks - Bactrim PO BID - Also = quinolones, gentamicin/ampicillin if enterococcus
30
How to treat traveler's diarrhea?
Loperamide 2 mg PO PRN for loose bowel movement for 2 days
31
Mild Water Loss Classification
< 5% body weight lost - Alert, restless - Increased thirst - Moist to slightly dry mucus membranes - Normal/slightly decreased urinary output
32
Moderate Water Loss Classification
6 - 9% body weight loss - Lethargic, restless - Low volume (low BP, high HR) - Dry mucus membranes - Delayed cap refill - Dark urine
33
Severe Water Loss Classification
> 10% body weight loss - Drowsy, limp, LOC - Bradycardia - Cyanotic - Skin tenting - No urine production
34
Non-severe CDI Classification
Leukocytosis (WBC < 15k) and SCr < 1.5
35
Severe CDI Classification
Leukocytosis (WBC > 15k) or SCr > 1.5
36
Fulminant CDI Classification
- Hypotension or shock - Ileus - Megacolon
37
CDI diagnosis
> 3 unformed stools in 24 hours AND either - Stool test positive for c. diff or toxins - Pseudomembranous colitis diagnosed by colonoscopy
38
Initial non-severe CDI treatment
- Vancomycin 125 mg x 10 days - Fidaxomicin 200 mg x 10 days - Metronidazole 500 mg x 10 days
39
Initial severe CDI treatment
- Vancomycin 125 mg x 10 days - Fidaxomicin 200 mg x 10 days
40
Initial severe complicated CDI treatment
- Vancomycin 500 mg Add metronidazole IV if ileus present

PHM 603 Infectious Disease (3 decks)

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