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32 Cards in this Set

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Rocky Mountain spotted fever
empiric therapy
Ceftriaxone 2g IV q12h
Doxycycline 100mg IV or PO q12h
Neisseria meningitidis septicemia (meningococcemia)
3rd gen cephalosporin (ceftriaxone 2g IV q12h
----------------------------
Chloramphenicol 100mg/kg/day IV divided q6h in beta-lactam allergic patient x 10-14d
RMSF
doxycycline 100mg q12h IV or PO x 7d
----------------------------
chloramphenicol
community-acquired sepsis
3rd gen cephalosporin
aminoglycoside
asplenic patients
risk for fulminant sepsis w/ encapsulated organisms such as strep pneumoniae, haemophilus influenzae, and N. meningitidis
----------------------------
Penicillin G 2 mill units IV q2-4h OR vancomycin 1g IV q12h
PLUS
3rd gen cephalosporin (ceftriaxone 2g IV q12h)
neutropenic hosts
pseudomonas aeruginosa sepsis may be likely
----------------------------
antipseudomonal beta-lactam PLUS
aminoglycoside
Erysipelas
GABHS
-------------------------
penicillin V 250-1000mg PO qid OR
procaine pencillin G 600,000 units IM bid OR
penicillin G 0.6-2 million units IV q6h
-----------------------------
erythromycin 500mg PO qid OR macrolides in penicillin allergic patients
Cellulitis
GABHS, S.aureus
-----------------------------
oxacillin 1-2g IV q4h OR
cefazolin 1-2g IV q8h OR
vancomycin 1g IV q12h
---------------------------
clindamycin OR macrolides for penicillin-allergic patients
Cellulitis in diabetic patients
beta-lactam/beta-lactamase inhibitor PLUS
3rd gen cephalosporin OR
carbapenem
Cellulits from water-borne pathogens
fresh water (Aeromonas hydrophila) or salt water (Vibrio vulnificus)
--------------------------
ceftazidime 2g IV q8h OR
cefepime 2g IV q8h OR
ciprofloxacin 400mg IV q8h or 750mg PO bid
Add doxycycline 100mg IV/PO q12 for Vibrio infections
Infected decubitus ulcers and limb-threatening diabetic foot ulcers
s.aureus, anaerobes, and enteric gram negative organisms
-----------------------------
clindamycin 450-900mg IV q8h PLUS
3rd gen cephalosporin OR ciprofloxacin 500-750mg PO bid
-----------------------------
OR beta-lactam/beta lactamase inhibitor combination
-----------------------------
OR imipenem-cilastatin 500mg IV q6h
------------------------------
less severe diabetic infections due to s.aureus w/ or w/o streptococcus--
cephalexin OR
dicloxacillin OR
clindamycin
Necrotizing fasciitis
mixed anaerobic (bacteroides, other anaerobes, aerobic gram negative organisms, and streptococcus species) or GABHS
----------------------------
penicillin G (or ampicillin) PLUS
clindamycin
PLUS
gentamicin or 3rd gen cephalosporin
-----------------------------
gram stain/culture show mixed infection--
imipenem or a beta-lactam/beta-lactamase inhibitor combination
------------------------------
if GABHS, penicillin or clinamycin should be continued
Anaerobic myconecrosis (gas gangrene)
Clostridium perfringens, Clostridium septicum, S.aureus, GABHS, or other anaerobes
-----------------------------
penicillin PLUS
clindamycin PLUS
gentamicin, ciprofloxacin, or 3rd gen cephalosporin until gram stain excludes gram-negative organism
Acute hematogenous osteomyelitis
s.aureus
----------------------------
osteomyelitis in the presence of orthopedic devices
s.aureus or coagulase-negative staphylococcus species
------------------------------
Rocky Mountain spotted fever
empiric therapy
Ceftriaxone 2g IV q12h
Doxycycline 100mg IV or PO q12h
Neisseria meningitidis septicemia (meningococcemia)
3rd gen cephalosporin (ceftriaxone 2g IV q12h
----------------------------
Chloramphenicol 100mg/kg/day IV divided q6h in beta-lactam allergic patient x 10-14d
RMSF
doxycycline 100mg q12h IV or PO x 7d
----------------------------
chloramphenicol
community-acquired sepsis
3rd gen cephalosporin
aminoglycoside
asplenic patients
risk for fulminant sepsis w/ encapsulated organisms such as strep pneumoniae, haemophilus influenzae, and N. meningitidis
----------------------------
Penicillin G 2 mill units IV q2-4h OR vancomycin 1g IV q12h
PLUS
3rd gen cephalosporin (ceftriaxone 2g IV q12h)
neutropenic hosts
pseudomonas aeruginosa sepsis may be likely
----------------------------
antipseudomonal beta-lactam PLUS
aminoglycoside
Erysipelas
GABHS
-------------------------
penicillin V 250-1000mg PO qid OR
procaine pencillin G 600,000 units IM bid OR
penicillin G 0.6-2 million units IV q6h
-----------------------------
erythromycin 500mg PO qid OR macrolides in penicillin allergic patients
Cellulitis
GABHS, S.aureus
-----------------------------
oxacillin 1-2g IV q4h OR
cefazolin 1-2g IV q8h OR
vancomycin 1g IV q12h
---------------------------
clindamycin OR macrolides for penicillin-allergic patients
Cellulitis in diabetic patients
beta-lactam/beta-lactamase inhibitor PLUS
3rd gen cephalosporin OR
carbapenem
Cellulits from water-borne pathogens
fresh water (Aeromonas hydrophila) or salt water (Vibrio vulnificus)
--------------------------
ceftazidime 2g IV q8h OR
cefepime 2g IV q8h OR
ciprofloxacin 400mg IV q8h or 750mg PO bid
Add doxycycline 100mg IV/PO q12 for Vibrio infections
Infected decubitus ulcers and limb-threatening diabetic foot ulcers
s.aureus, anaerobes, and enteric gram negative organisms
-----------------------------
clindamycin 450-900mg IV q8h PLUS
3rd gen cephalosporin OR ciprofloxacin 500-750mg PO bid
-----------------------------
OR beta-lactam/beta lactamase inhibitor combination
-----------------------------
OR imipenem-cilastatin 500mg IV q6h
------------------------------
less severe diabetic infections due to s.aureus w/ or w/o streptococcus--
cephalexin OR
dicloxacillin OR
clindamycin
Necrotizing fasciitis
mixed anaerobic (bacteroides, other anaerobes, aerobic gram negative organisms, and streptococcus species) or GABHS
----------------------------
penicillin G (or ampicillin) PLUS
clindamycin
PLUS
gentamicin or 3rd gen cephalosporin
-----------------------------
gram stain/culture show mixed infection--
imipenem or a beta-lactam/beta-lactamase inhibitor combination
------------------------------
if GABHS, penicillin or clinamycin should be continued
Anaerobic myconecrosis (gas gangrene)
Clostridium perfringens, Clostridium septicum, S.aureus, GABHS, or other anaerobes
-----------------------------
penicillin PLUS
clindamycin PLUS
gentamicin, ciprofloxacin, or 3rd gen cephalosporin until gram stain excludes gram-negative organism
Acute hematogenous osteomyelitis
s.aureus
----------------------------
osteomyelitis in the presence of orthopedic devices
s.aureus or coagulase-negative staphylococcus species
------------------------------
osteomyelitis associated w/ hemoglobinopathies
s.aureus or salmonella
------------------------------
salmonella may require surgical treatment and parenteral administration of high-dose ampicillin or chloramphenicol
osteomyelitis associated w/ vascular insufficiency
polymicrobial, including anaerobes