Pearls from the antibiotics review Flashcards
What bug tends to infect foreign bodies (prostheses, central lines)
CoNS
How do you treat an s. epidermidis infection?
Always assume this bug is resistant. Treat with vancomycin
What does adding a beta-lactamase inhibitor do?
Gives you anaerobic coverage.
Zosyn above diaphragm
Unasyn below diaphragm (amp+sulbactam…ampicillin alone only covers E Coli)
Aside from gram - coverage, what additional bug does ampicillin/amoxicillin cover?
listeria
What drug covers legionella?
azithromycin
Why wouldn’t you use ceftriaxone in ventilator acquired pneumonia?
It doesn’t cover the SPACEK organisms. (resistant GNR)
What is the BEST drug for SPACEK orgs?
Meropenem. Don’t use it until you have to! use zosyn and ceftazidine first. Or aztreonam
Why do you add ceftriaxone to azithromycin in cases of pneumonia in hospitalized pts?
It’s for resistant strep pneumo
Which drugs cover anaerobes?
clindamycin
metronidazole
beta lactam + beta lactamase inhibitor (unasyn=amoxicillin+sulbactam)
What is a reasonable treatment for a boil?
- Bactrim
- clindamycin
- macrolides
- tetracyclines
HOw might you treat a boil?
- Bactrim
- Clindamycin
- Macrolides
- Tetracycline
WHat’s different about encephalitis versus meningitis?
Usually LOSS OF ALERTNESS, with personality changes.
- -DO NOT have meningismis.
- -DO NOT have headache
How do you treat encephalitis empirically?
Acyclovir
What would make you think of a space occupying lesion (abscess?)
Focal neuro defect
- -may not have fever at all
- -Can be totally alert
