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33 Cards in this Set
- Front
- Back
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Empiric treatment of CAP outpatient and uncomplicated
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a)azithromycin 500mg PO qd x3d or 2g PO x1
b)doxy 100mg PO BID x7-10d |
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Empiric treatment of CAP in adults outpatient and comorbidity (diabetes, COPD, CHF, etc.)
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Fluoroquinolone or ketolide
a)Telithromcyin 800mg qd PO x7-10d b)levofloxacin 750mg/d PO x5d |
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Empiric treatment of CAP in adults hospitalized patient
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1)Levo 750mg IV/PO q24hr x7-10d
2)Ceftriaxone 1gm IV q24hr AND azithro 500mg IV/PO qd x3days |
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Empiric therapy for HAP
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1)imipenem 500mg IV q6hr (if suspected legionella/ bioterrorism-AND FQ)
2)Zosyn 4.5gm IV q6hr OR cefepime AND tobramycin (ADD FQ if legionella/bioterror) |
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Duration of therapy for
a)CAP b)HAP |
a)7-14days (14 w/ anaerobes, atypicals)
b)7-14 (14-21 w/ pseudomonas) |
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Etiology of CAP
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a)strep pneumo
b)mora catt c)haem influ d)mycoplasma e)chlamydia species f)legionella g)staph aureus |
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Etiology of HAP
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a)strep pneumo
b)haem influ c)staph aureus d)gram - bacilli (e.coli, kleb, pseudo, enterobacter, prot, serr, acinetobacter) e)stenotrophomonas f)anaerobes |
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What constitutes a MDR causing HAP?
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1)antibiotic use in last 90days
2)current hospital stay >5days 3)immunosupp therapy/disease 4)area of resistance 5)risk factors for HAP a)NH b)chronic dial w/in 30days c)home wound care d)>2days in hospital in last 90days |
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Alcoholism
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a)strep pneumo
b)anaerobes |
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COPD/smoking
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a)strep pneumo
b)haemo influ c)morax catt d)legionella |
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poor dental hygience
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anaerobes
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HIV infection (early)
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a)strep pneumo
b)haem influ c)mycobacterium tb |
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suspected large volume aspiration
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anaerobes
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structural disease of lung (cystic fibrosis)
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a)pseudomonas
b)burkholderia c)staph aureus |
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injection drug use
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a)strep pneumo
b)staph aureus c)anaerobes d)mycobacterium tb |
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airway obstruction
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a)strep pneumo
b)staph aureus c)haem influ d)anaerobes |
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pneumococcus
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penicillin
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legionella
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azithromycin
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mycoplasma
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doxycycline
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haem influ
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cefuroxime
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chlamydia pneum
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doxycycline
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moraxella catar
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cefuroxime
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mouth flora
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unasyn or clindamycin
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psudomonas aeruginosa
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piper AND gent
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enterobacter
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piper +/- gent
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serratia
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piperacillin
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klebsiella
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piperacillin
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acinetobacter
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imipenem
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staph aureus
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oxacillin/nafcillin
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Aspiration pneumonia
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clindamycin 600mg IV q8hr + fluoroquinolone
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Influenza +/- superinfection
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ceftriaxone or cefotaxime +/-oseltamivir 75 mg bid x 5 d
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HAP empiric therapy low risk of MDR (4)
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a)ceftriaxone 2 gm/d IV
b)levofloxacin 750 mg c)Unasyn 2gm IV q6h d)ertapenem 1 gm IV qd |
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HAP empiric therapy high risk of MDR
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1)beta-lactam (antipseudomonal)AND
2) fluoroquinolone or aminoglycoside AND 3)vancomycin or linezolid 1)zosyn, imipenem, cefepime, ceftazidime 2)levo,cipro,gent,tobra, amikacin 3)vanco 15mg/kg IV q12hr or linezolid 600mg IV q12hr Follow-up at 48-72h (clinically improved): cx negative - consider stopping abx; if cx positive - de-escalate, treat for 7-8d. Follow-up at 48-72h (clinically unimproved): cx negative - look for alternative causes; cx positive - adjust abx. |
