Flashcards in Infectious Disease Deck (48)
MSSA IV and oral treatment
IV: oxacillin/nafcillin; cefazolin
Oral: dicloxacillin; cephalexin
Severe MRSA treatment
Vancomycin, daptomycin, ceftaroline, tigecycline, linezolid, telavancin
SE of linezolid
SE of daptomycin
Myopathy and elevated CPK
Minor MRSA treatment
TMP/SMX, clindamycin, doxycyline
If a patient presents with infection best treated with penicillin but allergy includes rash is it safe to use cephalosporins?
In patients with anaphylactic penicillin allergies what are appropriate options for treatment?
Macrolides (azithromycin, clarithromycin)
MOA of TMP/SMX
What are three specific medications used to treat Streptococcus but not Staphylococcus? (Hint: all from same family)
Penicillin, Amoxicillin, Ampicillin
What class of antibiotics are great at treating pneumococcus?
SE of imipneme
What cephalosporins offer good gram negative rod coverage?
What is the best antibx for abdominal anaerobes?
What are the only cephalosporins which cover anaerobes?
What antibx is the best for respiratory anaerobes?
Best therapy for CMV retinitis
SE of foscarnet
SE of valganciclovir and ganciclovir
Neutropenia and BM suppression
What are simeprevir, boceprevir, sofosbuvir, and ledipasvir used for?
Chronic hepatitis C
What medication is used in combination with IFN to treat HCV?
SE of ribavirin
What are lamivudine, IFN, adefovir, tenofovir, entecavir, and telbivudine used to treat?
Chronic hepatitis B
What can be used to Candidiasis, Cryptococcus, and as an alternative to oral and vaginal candidiasis?
What medication is best for coverage against Aspergillus?
SE of voriconazole
What class of medication (and list examples) are great for neutropenic fever patients?
Echinocandins (inhibit 1,3 glucan synthesis step of fungi)
E.g. caspofungin, micafungin, and anidulafungin
How do -azole antifungals work?
Inhibit step turning lanosterol to ergosterol which leads to more permeable fungal cell membrane
Amphotericin is effective against a wide variety of fungi but due to significant toxicity it has only two main uses currently, what are they?
SE of amphotericin
Renal toxicity (directly toxic to distal tubules leading to distal RTA causing K and Mg loss which leads to H+ retention)
Best initial test for osteomyelitis
Most accurate test
Initial: X-ray (2nd is MRI)
Accurate: bone bx and culture
What is the earliest finding of osteomyelitis on X-ray?
Patient with osteomyelitis come in and you decide to culture the visible sinus tract and ulcer. Good idea?
No! You should never culture the ulcer or sinus tract
What should you be trending as you treat osteomyelitis to know response to therapy?
ESR; if still elevated then continue treating since majority of patients won't be febrile or have elevated WBC
Otitis externa is best treated how?
What adjunctive medications can assist?
Topical antibx (ofloxacin, ciprofloxacin, or polymyxin/neomycin)
Topical hydrocortisone: reduces swelling and itching
Acetic acid and water solution reacidifies ear to eliminate infection
How is malignant otitis externa different than simple otitis externa?
Very different. Malignant is basicallt osteomyelitis of skull often occurring in diabetics and caused by Pseudomonas
Tx of malignant otitis externa
Surgical debridement and antibix against Pseudomonas
Best initial test for sinusitis
Most accurate test for sinusitis
Sinus aspirate for culture
Tx of Strep pharyngitis
Penicillin or amoxicillin
(If allergic then azithromycin or clarithromycin)
If dx of influenza is unclear what test can you do?
Viral rapid antigen detection
Which influenza treatment works for both strains A and B?
Oseltamivir and Zanamivir (if symptoms started with last 48 hrs)
When is the inactivated influenza vaccine indicated?
>50 years old and with illness
Topical mupirocin or retapamulin
Severe disease: oral dicloxacillin or cephalexin
What presents with skin infection where the skin becomes red and hot and often occurs on the face?
Oral dicloxacillin or cephalexin
What are sequela of erysipelas or pharyngitis caused by Strep?
Erysipelas: Strep glomerulonephritis
Pharyngitis: Strep glomerulonephritis and/or Rheumatic fever
When considering LE cellulitis what else should you order?
Dopplers to rule out DVT
How is cellulitis treated?
Minor: dicloxacillin or cephalexin orally
Severe: oxacillin, nafcillin, or cefazolin