Infectious Diseases And Anti-Infectives Flashcards
(29 cards)
Tx for necrotising fasciitis (ALL)
M-eropenem
V-ancomycin
C-lindamycin
Strep pyogenes confirmed B-enzylpenicillin C-lindamycin PLUS normal immunoglobulin
Endocarditis Tx Native valve Empirical Tx Prostatic valve and MRSA Empirical Tx Hypersensitivity to penicillin Directed enterococcus Tx
Native Valve Empirical Tx
Gentamicin +
Benzylpenicillin +
Flucloxicillin
MRSA Empirical Tx & Prosthetic Valve Empirical Tx
Gentamicin +
Vancomycin +
Flucloxicillin
If immediate sensitivity to penicillins:
Gentamicin +
Vancomycin
Directed- enterococcal Gentamicin PLUS EITHER Benzylpenicillin OR Amoxicillin/ampicillin
What does TB Tx consist of?
Combination and prolonged therapy
TB Tx and duration
Isoniazid 6 months
Rifampicin 6 months
Ethambutol 2 months
Pyrazinamide 2 months
Bacterial gastroenteritis empirical Tx
Ciprofloxacin
OR
Norfloxicin 400mg 12-hourly 3 days
Campylobacter enteritis Tx
Azithromycin OR ciproflox OR norflox
Cholera tx
Azithromycin AS A SINGLE DOSE
OR
ciproflox AS A SINGLE DOSE
Salmonella Tx
If AB are required:
Azith
OR
ciproflox
Shigellosis Tx
Ciproflox OR Norflox OR Co-trimoxazole
Travellers diarrhoea Tx
Mild: no AB just rehydration, +/- anti motility drugs, usually self limiting Moderate or severe: rehydration 2-3L/day azithromycin OR norfloxacin
What are the two parasitic infections of the GIT?
Amoebiasis
Giardia
Ameobasis Tx
Tindazole OR 2. Metronidazole Then administration of a luminal agent to eradicate cysts and prevent relapse Paromomycin
Giardia Tx
Water borne
- Tindazole OR
- Metronidazole
Empirical Tx for bacterial meningitis
Hypersensitivity incl
Dexamethasone PLUS EITHER Ceftriaxone OR cefotaxime
If listeria is suspected or immunocompromised, pregnant, >50 years etc. ADD
Benzylpenicillin to the above regimen
Hypersensitive immediate
Vanc
PLUS
Ciproflox
OR
2. Moxiflox as monotherapy
Direct therapy neisseria minigitidis
Benzylpenicillin
Immediately hypersensivity
Ciproflox
Strep pneumoniae meningitis
Benzylpenicillin for strains susceptible to penicillin
OR
Ceftriaxone or cefotaxime for strains susceptible
Haemophilus influenzae type b (Hib)
Ceftriaxone or cefotaxime
Allergy: ciproflox
Listeria Tx
Benzylpenicillin
Allergy: co-trimoxazole
Tx of herpes simplex encaphalitis
Aciclovir
Mild early and erysipelas Cellulitis Tx empirical
Staph & strep: Difluclox 500mg orally 6-hourly for 5-10 days
Strep confirmed: phenoxy 500mg orally 6-hourly for 5-10 days OR procaine penicillin IM for 3 days
Allergy 2: Cefalexin 500mg 6-hourly 5-10 days
Allergy 1: clindamycin 450mg 8-hourly 5-10 days
Severe cellulitis Tx
Flucloxicillin IV
Allergy: cefazolin IV
Immediate allergy: 1. Vancomycin IV 2. Clindamycin IV
MIND ME- antimicrobial stewardship
Microbiology guides therapy wherever possible
Indications should be evidence based
Narrowest spectrum therapy required
Dosage individualised to the patient and appropriate to the site and type of infection
Minimise duration of therapy
Ensure oral therapy is used where clinically appropriate
Pyelonephritis Tx mild
Cefalexin 500mg orally 6-hourly OR amoxicillin/clav 875+125mg orally 12-hourly OR trimethoprim 300,g orally daily
10-14 Tx
Follow up urine culture 1-2 weeks after the conclusion of therapy.
Pyelonephritis Tx acute severe
Sepsis or vomiting Empirical IV amoxicillin/ampicillin PLUS IV gentamicin
THEN
Further Tx is guided by urine or blood MCS results and clinical response
Change to oral therapy as soon as patient is clinically well enough
IF SUSCEPTIBILITY RESULTS NOT AVAILABLE BY 72HRS SWITCH TO
IV Ceftriaxone or cefotaxime
Total 10-14 days Tx
Repeat urine culture 1-2 weeks after conclusion of therapy
