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Pediatric Empiric Antimicrobials > Pediatric Infections > Flashcards

Pediatric Infections Flashcards

(114 cards)

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1
Q

Sepsis (less than four weeks)

Most Likely Pathogens

A

Streptococcus agalactiae
Escherichia coli
Listeria monocytogenes
Herpes simplex virus

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2
Q

Sepsis (less than four weeks )

First choice antibiotics

A

Ampicillin plus gentamicin or cefotaxime

with or without Acyclovir

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3
Q

Sepsis (less than four weeks)

Penicillin allergy antibiotics

A

Vancomycin plus gentamicin or Cefotaxime

with or without acyclovir

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4
Q

Sepsis (greater than four weeks)

Most likely pathogens

A

Neisseria meningitidis
streptococcus pneumonia
Escherichia coli
staphylococcus aureus

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5
Q

Sepsis (greater than four weeks)

First choice antibiotics

A

Cefotaxime

With or without vancomycin

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6
Q

Sepsis (greater than four weeks)

Penicillin allergy antibiotics

A

Cefotaxime

with or without vancomycin

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7
Q

Meningitis (less than four weeks)

Most likely pathogens

A

Streptococcus agalactiae
Escherichia coli
Listeria monocytogenes
herpes simplex virus

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8
Q

Meningitis (less than four weeks)

first choice antibiotics

A

Ampicillin
plus Cefotaxime
plus acyclovir

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9
Q

Meningitis (less than four weeks)

Penicillin allergy antibiotics

A

Vancomycin
plus Cefotaxime
with or without Acyclovir

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10
Q

Meningitis (greater than four weeks)

most likely pathogens

A

Neisseria meningitidis
streptococcus pneumoniae
Haemophilus influenzae

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11
Q

Meningitis (greater than four weeks)

first choice antibiotics

A

Ampicillin
Plus vancomycin
With or without acyclovir

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12
Q

Meningitis (greater than four weeks)

Penicillin allergy antibiotics

A

Cefotaxime
Plus vancomycin
With or without acyclovir

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13
Q

Encephalitis

Most likely Pathogens

A

Herpes simplex virus

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14
Q

Encephalitis

First choice antibiotics

A

Acyclovir

Plus antibiotics as for meningitis

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15
Q

Encephalitis

penicillin allergy antibiotics

A

Acyclovir

Plus antibiotics as for “meningitis”

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16
Q

Cerebral abscess or subdural empyema

most likely Pathogens

A 
Streptococci species 
staphylococcus aureus 
anaerobic organisms 
gram-negative organisms 
streptococcus pneumonia 
Haemophilus influenza
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17
Q

Cerebral abscess or sub dural empyema

first choice antibiotics

A

Cefotaxime
Plus vancomycin
Plus metronidazole

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18
Q

Cerebral abscess or subdural empyema

penicillin allergy antibiotics

A

Cefotaxime
Plus vancomycin
Plus metronidazole

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19
Q

Streptococcal pharyngitis/tonsillitis

Most likely Pathogens

A

Streptococcus pyogenes (group A strep)

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20
Q

Streptococcal pharyngitis/tonsillitis

first choice antibiotics

A

Penicillin V PO
Or amoxicillin PO
Or penicillin G

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21
Q

Streptococcal pharyngitis/tonsillitis

penicillin allergy antibiotics

A

Cephalexin PO
Or clindamycin PO
Or clarithromycin PO
Or cefazolin

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22
Q

Bacterial acute otits media

most likely Pathogens

A

Haemophilus influenza
Streptococcus pneumoniae
Moraxella catarrhalis

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23
Q

Bacterial acute otitis media

first choice antibiotics

A

Amoxicillin PO

Or amoxicillin-clavulanate PO

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24
Q

Bacterial acute otitis media

penicillin allergy antibiotics

A

Cefprozil PO

Or clarithromycin PO

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25
Mastoiditis most likely Pathogens
``` Streptococcus pneumonia streptococcus pyogenes (group a strep) staphylococcus aureus ```
26
Mastoiditis | first choice antibiotics
Cefotaxime | With or without vancomycin
27
Mastoiditis | penicillin allergy antibiotics
Cefotaxime | With or without vancomycin
28
Sinusitis | most likely Pathogens
``` Haemophilus influenza streptococcus pneumonia Moraxella catarrhalis staphylococcus aureus streptococcus pyogenes (group a strep) Anaerobic organisms (in older children) ```
29
Sinusitis | first choice antibiotics
Amoxicillin PO Or amoxicillin-clavulanate PO If IV treatment required, treat as for mastoiditis
30
Sinusitis | penicillin allergy antibiotics
Cefprozil PO Or clarithromycin PO Or cefixime PO plus clindamycin PO If IV treatment required, treat as for mastoiditis
31
Cervical lymphadenitis | most likely Pathogens
``` Staphylococcus aureus streptococcus pyogenes (group a strep) ```
32
Cervical lymphadenitis | first choice antibiotics
Cephalexin PO Or clindamycin PO Or cefazolin
33
Cervical lymphadenitis | penicillin allergy antibiotics
Clindamycin PO | Or cefazolin
34
Preseptal cellulitis | most likely Pathogens
Streptococcus pneumonia | Staphylococcus aureus
35
Preseptal cellulitis | first choice antibiotics
Cephalexin PO Or clindamycin PO Or cefazolin Or vancomycin
36
Preseptal cellulitis | penicillin allergy antibiotics
Cefprozil PO Or clindamycin PO Or cefazolin Or vancomycin
37
Orbital cellulitis | most likely Pathogens
Staphylococcus aureus streptococcus pneumonia other Streptococcus species haemophilus influenza
38
Orbital cellulitis | first choice antibiotics
Cefotaxime | With or without vancomycin
39
Orbital cellulitis | penicillin allergy antibiotics
Cefotaxime | With or without vancomycin
40
Dental abscess with fever and/or extensive spread | most likely Pathogens
``` Viridans streptococci Peptostreptococcus species Prevotella species porphyromonas melaninogenicus fuslbacterium species usually polymicrobial ```
41
Dental abscess with fever and or extensive spread first choice antibiotics
Amoxicillin-clavulanate PO | Or penicillin G plus metronidazole PO
42
Dental abscess with fever and or extensive spread penicillin allergy antibiotics
Clindamycin PO/IV
43
Community acquired pneumonia (less than one month) | most likely Pathogens
Streptococcus agalactiae Eacherichia coli listeria monocytogenes
44
Community acquired pneumonia (less than one month) | first choice antibiotics
Ampicillin | Plus gentamicin or cefotaxime
45
Community acquired pneumonia (less than one month) | penicillin allergy antibiotics
Cefotaxime Plus gentamicin Plus vancomycin
46
Community acquired pneumonia (1 to 3 months) | most likely Pathogens
Streptococcus pneumonia Streptococcus agalactiae staphylococcus aureus Escherichia coli chlamydia trachomatis
47
Community acquired pneumonia (1 to 3 months) | first choice antibiotics
Cefotaxime With or without vancomycin With or without clarithromycin PO
48
Community acquired pneumonia (1 to 3 months) | penicillin allergy antibiotics
Cefotaxime With or without vancomycin With or without clarithromycin PO
49
Community acquired pneumonia (greater than three months) | most likely Pathogens
``` Respiratory viruses streptococcus pneumonia haemophilus influenzae staphylococcus aureus mycoplasma pneumonia chlamydia pneumonia ```
50
Community acquired pneumonia (greater than three months) mild first choice antibiotics
Amoxicillin PO
51
Community acquired pneumonia (greater than three months) mild penicillin allergy antibiotics
Cefprozil PO
52
Community acquired pneumonia (greater than three months) moderate most likely Pathogens
Ampicillin With or without clarithromycin PO With or without oseltamivir PO
53
Community acquired pneumonia (greater than three months) moderate penicillin allergy
Cefotaxime With or without clarithromycin PO With or without oseltamivir PO
54
Community acquired pneumonia (greater than three months) severe First choice antibiotics
Cefotaxime With or without vancomycin With or without clarithromycin PO With or without oseltamivir PO
55
Community acquired pneumonia (greater than three months) severe penicillin allergy antibiotics
Cefotaxime With vancomycin With or without clarithromycin PO With or without oseltamivir PO
56
Parapneumonic empyema | most likely Pathogens
Staphylococcus aureus streptococcus pneumonia Haemophilus influenza
57
Parapneumonic empyema | first choice antibiotics
Cefotaxime | With or without vancomycin
58
Parapneumonic empyema | penicillin allergy antibiotics
Cefotaxime | With or without vancomycin
59
Hospital acquired pneumonia | most likely Pathogens
Staphylococcus aureus Haemophilus influenza Enterobacter species Pseudomonas aeruginosa
60
Hospital acquired pneumonia | first choice antibiotics
Cefotaxime or piperacillin-tazobactam | With or without vancomycin
61
Hospital acquired pneumonia | penicillin allergy antibiotics
Cefotaxime With or without vancomycin With or without gentamicin
62
Aspiration pneumonia | most likely Pathogens
Staphylococcus aureus Haemophilus influenza Enterobacter species oral anaerobes (see “dental abscess”)
63
Aspiration pneumonia | first choice antibiotics
Amoxicillin-clavulanate PO Or cefuroxime PO Plus metronidazole or clindamycin IV/PO
64
Aspiration pneumonia | penicillin allergy antibiotics
Cefotaxime plus clindamycin IV/PO Or C PO Plus metronidazole or clindamycin IV/PO
65
Infective endocarditis | most likely Pathogens
Viridans streptococci | Staphylococcus aureus
66
Infective endocarditis | first choice antibiotics
As guided by blood culture results | consult ID and cardiology
67
Infective endocarditis | penicillin allergy antibiotics
As guided by blood culture results | consult IT and cardiology
68
Urinary tract infection (less than two months) | most likely Pathogens
``` Escherichia coli klebsiella species proteus species Enterobacter species enterococcus species ```
69
Urinary tract infection (less than two months) | first choice antibiotics
Ampicillin plus gentamicin | Imperative to check blood and CSF cultures. If positive, exit UTI pathway.
70
Urinary tract infection (less than two months) | penicillin allergy antibiotics
Cefotaxime or gentamicin | Imperative to check blood and CSF cultures. If positive, exit UTI pathway
71
Urinary tract infection mild (greater than two months) most likely Pathogens
``` Escherichia coli klebsiella species proteus species Enterobacter species enterococcus species staphylococcus saprophyticus (in adolescents) ```
72
Urinary tract infection mild (greater than two months) first choice antibiotics
Cephalexin PO
73
Urinary tract infection mild (greater than two months) penicillin allergy antibiotics
Cephalexin PO
74
Urinary tract infection severe (greater than two months) most likely Pathogens
Escherichia coli Klebsiella species Proteus species Enterobacter species
75
Urinary tract infection severe (greater than two months) first choice antibiotics
Cefotaxime or gentamicin
76
Urinary tract infection severe (greater than two months) penicillin allergy antibiotics
Cefotaxime or gentamicin
77
Pelvic inflammatory disease | most likely Pathogens
Neisseria gonorrhea chlamydia trichomonas anaerobic organisms
78
Pelvic inflammatory disease | first choice antibiotics
Cefixime PO or ceftriaxone IM Plus doxycycline PO With or without metronidazole PO
79
Pelvic inflammatory disease | penicillin allergy antibiotics
Cefixime PO or ceftriaxone IM Plus doxycycline PO With or without metronidazole PO
80
Bacterial gastroenteritis | most likely Pathogens
``` Salmonella species shigella species Campylobacter species Escherichia coli Plesiomonas shigelloides Aeromonas hydrophilic ```
81
Bacterial Gastroenteritis | first choice antibiotics
Treatment not routinely required. If severe, then treat according to susceptibilities of organism isolated.
82
Bacterial gastroenteritis | penicillin allergy antibiotics
Treatment not routinely required. If severe, then treat according to susceptibilities of organism isolated.
83
``` Secondary peritonitis (excluding peritoneal dialysis patients) Most likely Pathogens ```
``` Escherichia coli Klebsiella species Pseudomonas aeruginosa Enterococcus species bacteroides fragilis peptostreptococcus species ```
84
``` Secondary peritonitis (Excluding peritoneal dialysis patients) first choice antibiotics ```
Piperacillin-tazobactam Or Ampicillin plus gentamicin plus metronidazole
85
``` Secondary peritonitis (excluding peritoneal dialysis patients) penicillin allergy antibiotics ```
Cefotaxime plus metronidazole
86
Primary peritonitis | most likely Pathogens
Streptococcus pneumoniae | Escherichia coli
87
Primary peritonitis | first choice antibiotics
Cefotaxime
88
Primary peritonitis | penicillin allergy antibiotics
Cefotaxime
89
Ascending cholangitis | most likely Pathogens
``` Escherichia coli Klebsiella pneumoniae Enterobacter species Pseudomonas aeruginosa Enterococcus species Anaerobic organisms ```
90
Ascending cholangitis | First choice antibiotics
Ampicillin plus cefotaxime with or without Metronidazole Or piperacillin-tazobactam
91
Ascending cholangitis | Penicillin allergy antibiotics
Vancomycin with or without cefotaxime | With or without metronidazole
92
Antibiotic associated colitis (clostridium Difficile infection) First choice antibiotics
Metronidazole PO | Stop all other antibiotics if possible
93
Cellulitis Mild Most likely pathogens
``` Streptococcus pyogenes (group A strep) Staphylococcus aureus ```
94
Cellulitis Mild First choice antibiotics
Cephalexin PO | Or TMP-SMX PO
95
Cellulitis Mild Penicillin allergy antibiotics
Cephalexin PO | Or TMP-SMX PO
96
Cellulitis Severe Most likely pathogens
``` Streptococcus pyogenes (group A strep) Staphylococcus aureus ```
97
Cellulitis Severe First choice antibiotics
Cefazolin with or without clindamycin PO
98
Cellulitis Severe Penicillin allergy antibiotics
Cefazolin with or without clindamycin PO
99
Soft tissue injury Clean Most likely pathogens
Not infected
100
Soft tissue injury clean first choice antibiotics
Antibiotics not required
101
Dog/cat/human bites mild most likely Pathogens
``` Staphylococcus aureus streptococcus species Eikenella corrodens (human) pasteurella species (dog or cat) Capnocytophaga cynodegmi (dog or cat) anaerobic organisms usually polymicrobial ```
102
Dog/cat/human bites mild first choice antibiotics
Amoxicillin-clavulanate PO
103
Dog/cat/human bites mild penicillin allergy antibiotics
Clindamycin PO plus TMP-SMX PO
104
Dog/cat/human bites severe most likely Pathogens
``` Staphylococcus aureus Streptococcus species Eikenella corrodens (humans) Pasteurella species (dog or cat) Capnocytophaga cynodegmi (dog or cat) Anaerobic organisms Usually polymicrobial ```
105
Dog/cat/human bites Severe First choice antibiotics
Piperacillin-tazobactam
106
Dog/cat/human bites Severe Penicillin allergy antibiotics
Clindamycin | TMP-SMX
107
``` Necrotising fasciitis (unknown etiology) Most likely pathogens ```
Streptococcus pyogenes (group A strep) Staphylococcus aureus Aerobic and anaerobic organisms May be polymicrobial
108
``` Necrotising fasciitis (unknown etiology) First choice antibiotics ```
Piperacillin-tazobactam Plus vancomycin Plus clindamycin
109
``` Necrotising fasciitis (unknown etiology) Penicillin allergy antibiotics ```
Ciprofloxacin Plus vancomycin Plus clindamycin
110
Documented group A streptococcal necrotising fasciitis | First choice antibiotics
Penicillin plus clindamycin
111
Documented group A streptococcus necrotising fasciitis | Penicillin allergy antibiotics
Cefotaxime plus clindamycin
112
Osteomyelitis or septic arthritis (greater than 3 months) | Most likely pathogens
``` Staphylococcus aureus Streptococcus pyogenes (group A strep) Streptococcus pneumoniae Kingella Kingae Neisseria species Salmonella species ```
113
Osteomyelitis or septic arthritis (greater than 3 months) | First choice antibiotics
Cefazolin or vancomycin
114
Osteomyelitis or septic arthritis (greater than 3 months) | Penicillin allergy antibiotics
Cefazolin or vancomycin

Pediatric Empiric Antimicrobials (1 decks)

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