Gram + Bacilli - Treatments

Question 1

What is the treatment for Bacillus cereus?

Answer 1

Nothing; it will pass in one to several days

Question 2

What is the treatment for Bacillus anthracis?

Answer 2

Penicillin (cutaneous), doxycycline, ciprofloxacin

Live cell vaccine, toxoid (military) vaccine, livestock vaccinations

Question 3

Treatment for Listeria monocytogenes?

Answer 3

Ampicillin is preferred

OR ampicillin + aminoglycoside, erythromycin

Question 4

Is there a vaccine for Corynebacterium diphtheriae?

Answer 4

Yes! Part of DTaP - formalin treated toxoid vaccine

- Booster before school and every 10 years

Question 5

Treatment for Corynebacterium diphtheriae?

Answer 5

Quarantine, equine anitoxin (large dose), penicillin/erythromycin (to keep bacteria # low; it is an intoxication, not an infection)

Question 6

Treatment for Clostridium botulinum?

Answer 6

Heptavalent antitoxin injection - order ASAP from CDC

Question 7

Treatment for Clostridium tetani?

Answer 7

TIG antitoxin only works if given prior to toxin binding receptors

• dark room, tracheostomy, muscle relaxants (MgSO4)
• metronidazole to reduce bacteria (but it’s an intoxication, not an infection)

Question 8

Vaccine for Clostridium tetani?

Answer 8

Yes - DTaP; booster every 10 years

Question 9

Treatment for Clostridium perfringens?

Answer 9

Surgical debridement / amputation, metronidazole / penicillin / clindamycin (to stop multiplication)

Question 10

Treatment for Clostridium difficile?

Answer 10

• Stop previous antibiotic and go on probiotic (replenish gut flora, if feasible)
• Fecal transplant
• To kill C. diff: vancomycin, metronidazole
• Fluid replacement
• If recurrent: Fidaxomycin