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54 Cards in this Set
- Front
- Back
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Helicobacter pylori
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□ Triple Therapy:
PPI + Amoxicillin + Clarithromycin (Macrolide) 7-14 days □ Quadruple Therapy: (use this therapy if there are issues with macrolide allergies) PPI + bismuth + Metronidazole + Tetracycline (30S) 10-14 days □ Sequential Therapy: PPI + Amoxicillin: 5 days THEN… PPI + Clarithromycin: 5 days |
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Salmonella enterica
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§ Most cases untreated (self-limiting, but for those that do have to be treated…)
§ Salmonella, non-typhi (Salmonella enterica) □ 1st Line: w FQN (Ciprofloxacin or Levofloxacin); (route of administration: IV) ◊ Empiric antibiotic of choice for treatment of non-typhoidal Salmonella ◊ Use in children permissible over short course or w 3rd generation Cephalosporins (Ceftriaxone or Cefotaxime) ◊ Cheaper alternative to Quinolones ◊ Resistance developed easily w Resistance to these agents is common in Asia but not US or Patients have recently take the above medications ◊ Consider Carbapenems or Azithromycin |
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Salmonella typhi/paratyphi
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§ Former Approach
□ Aminopenicillins (Ampicillin) + Cholecystectomy (surgical removal of the gallbladder) § Current Approach □ Fluoroquinolones (Ciprofloxacin, Olfloxacin) +/- Cholecystectomy § C. OL. on + Cholecystectomy |
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Shigella
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§ Adults:
□ Oral w Ciprofloxacin w TMP/SMX w Azithromycin § Children: depends on local resistance patterns □ Oral w TMP/SMX and Ampicillin ◊ TMP: Dihydrofolate reductase ◊ SMX: Dihydropteroate Synthase w Azithromycin w Fluoroquinolones □ Parenteral w Ceftriaxone |
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Vibrio cholerae
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1) Oral rehydration
2) IV rehydration for patient who have lost >10% of body weight from dehydration (use Lactated Ringer's Solution) |
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Staphylococcus Aureus
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Replace fluids
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Haemophilus influenza type b
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§ Combo of:
□ 3rd generation cephalosporin (Ceftriaxone or Cefotaxime) + antibiotic active against MRSA (Vancomycin, Clindamycin, Oxacillin, Nafcillin, or Cefazolin) ○ Prevention: § Vaccine has greatly reduced incidence of epiglottitis and other dangerous H. influenzae type b diseases in children (e.g., meningitis, pneumonia) § Vaccine = purified capsular PRP (3 doses prior to age 6 months followed by later boosters) § Vaccine stimulates production of antibodies against PRP in capsule § Antibodies attach to capsule & render bacterial cells more susceptible to phagocytosis & digestion |
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Mumps Virus
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MMR vaccine
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Porphyrromonas, Prevotella, anaerobic streptococci, S. aureus, S. epidermidis
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§ ImmunoCOMPETENT hosts:
□ Ampicillin/Sulbactam ® Sulbactam: B-lactamase inhibitor (keeps the drug around longer) or □ Penicillin G + Metronidazole ® Metronidazole: Drug with the best activity against anaerobic bacteria or □ Clindamycin ® For B-lactam allergy § ImmunoCOMPROMISED hosts: □ Cefepime + ... ® Cefepime: 4th generation Cephalosporin □ Metronidazole or + □ Imipenem or + □ Meropenem or + □ Piperacillin/Tazobactam Extended spectrum penicillin/B-lactamase inhibitor |
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Clostridium difficile
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1st: metronidazole; 2nd: Vancomycin
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Vibrio parahaemolyticus
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Fluoroquinolones, Doxycycline, 3rd generation Cephalosporin
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Campylobacter jejuni
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Normally not indicated; Azithromycin
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Rotavirus
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Prevention: (vaccines)
1) Rotateq: proteins from several rota virus strains 2) RotaRix: attenuated strain of a single human rotavirus Administered in 3 doses (1 dose/2 months) staring at 2 months of age. |
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Norovirus
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rehydrate
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Giardia lamblia
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1st: Metronidazole or Tinidazole; 2nd: Nitazoxanide
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Enterobius vermicularis
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1st: Albendazole or Mebendazole; 2nd: Pyrantel pamoate
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Ascaris lumbricoides
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1st: benzimidazoles, Albendazole, Mebendazole
2nd: Ivermectin, Nitazoxanide, and Pyrantel pamoate (for pregnant women and children under 2) |
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Cryptosporidium parvum
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Immunocompromised patients: Nitazoxanide
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Entamoeba histolytica
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1st: Metronidazole
2nd: Tinidazole; Nitazoxanide Intraluminal: Paromomycin; Iodoquinol |
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Necator americanus
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1st: Mebendazole
2nd: Albendazole; Pyrantel pamoate Iron therapy to raise iron levels Severe anemia --> blood transfusion |
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HAV
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Prevention: Inactivated Virus Vaccine
Post-Exposure Prophylaxis: 1) 1-40 years old: single antigen HAV 2) > 40 years old: IG |
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HBV
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Nucleoside analogs
Lamivudine, Adefovir, Entecavir, Telbivudine, Tenofovir Prevention: Recombinant vaccine |
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HCV
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Ribavirin + Interferon treatment
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Onchocerca volvolus
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Ivermectin
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Chlamydia trachomatis
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Azithromycin
Tetracycline ointment |
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Streptococcus agalactiae (Group B Streptococcus)
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1. Empirical Therapy: Broad coverage antibiotics
a. Ampicillin, or Nafcillin, or Vancomycin + b. Gentamicin, or Cefotaxime 2. Definitive Therapy: Penicillin G |
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JC virus
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1) No Specific Therapy: Improve the Immune Status of the Patient
a. AIDS Patient: HAART |
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Toxoplasma gondii
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• Pyrimethamine: antimalarial drug which blocks Dihydrofolate reductase
and • Sulfadiazine: sulfonamide antibiotic which blocks folic acid synthesis ○ Sulfur containing drugs may result in allergic reactions (also see Penicillins and Cephalosporins) § In the case of a patient with sulfur allergies: □ Pyrimethamine + Clindamycin |
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Listeria monocytogenes
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1. Ampicillin and Penicillin G
a. Take too accumulate in the CNS b. For Meningitis: Gentamicin 2. Alternative: TMP/SMX |
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Candida
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1st line: Fluconazole
Esophageal Candidiasis: Fluconazole, Caspofungin, Amphotericin B If Fluconazole Resistance: Caspofungin |
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Strongyloides stercoralis
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1st line: Ivermectin alone
2nd line: Ivermectin plus Albendazole |
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Pneumocystis jiroveci
(aka Pneumocystis carinii |
Immuno-Competent:
1st line: TMP-SMX 2nd line: Atovaquone or Primaquine plus Clindamycin Immuno-Compromised: 1st line: TMP-SMX 2nd line: Atovaquone or Primaquine plus Clindamycin Alternative 2nd line: TMP-Dapsone |
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Anthrax
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Early infection: Ciprofloxacin and Doxycycline
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Variola Virus
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Vaccine
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Fransicella tularensis
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1st line: Streptomycin
2nd line: Gentamicin 2nd line: chloramphenicol + aminoglycoside |
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S. Pyogenes
(Necrotizing Fasciitis) |
Pen G +/- Clindamycin (Bad MC)
Prompt aggressive debridement of infected tissue |
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Clostridium Perfringens
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Pen G +/- Clindamycin (Bad MC)
2nd Line - ceftriaxone, Erythromycin Prompt aggressive debridement of infected tissue. Hyperbaric Oxygen |
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M. Tuberculosis
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RIPE, Streptomycin
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S. Aureus
(osteomyelitis) |
High, daily dose of IV antibiotic therapy for 4-6 weeks. Use antistaphylococcal penicillin (NOD), 1st generation cephalosporin -cefazolin,
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Chlamydia trachomatis
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AZ/DC?
Since it is due to the immune response… perhaps no treatment? |
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S. Epidermidis
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Removal of prosthetic joint
High doses of parenteral antibiotics for 4-6 weeks |
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S. Aureus
(SSSS, Bullous Impetigo) |
SSSS - NOD (MSSA) or Vancomycin (MRSA)
Bullous Impetigo - Mupirocin (Topical, PS Inhibitor), Dicloxacillin or Cephalexin (MSSA), TMP-SMX, or Clindamycin, or Minocycline (MRSA) |
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S. Pyogenes
(Cellulitis) |
Uncomplicated Cellulitis: IV - Pen G, Nafcillin, Oxacillin, Cefazolin.
Oral Dicloxacillin. If MRSA - Vancomycin, Daptomycin, Linezolid |
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M. Leprae
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Preferred: Dapsone, Rifampin.
Alternative - Ofloxacin, Levofloxacin, Minocycline, clarithromycin. "Dr. CLOM has Leprosy |
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Rickettsia Rickettsii
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Doxycycline - preferred
Chloramphenicol - Alternative "Ritzy Rickettsi likes to treat herself at DC. |
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Rickettsia Akari
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Self limiting
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Propionibacterium
P. acnes P. propionicum |
1. Topical Retinoids, Topical Antimicrobials - Benzoyl Peroxide, Erythromycin, Sulfacetamide, Dapsone, Clindamycin
(R Clinda'S BED) |
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N. Gonorrhoeae
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"Greek Cefs"
Ceftriaxone (IV or IM every 24 hrs) or Cefotaxime (IV every 8 hours) for 7-14 days |
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Rubeola (Measles) Virus
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Vaccine - MMR (Live attenuated)
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Streptococcus Pyogenes, Staphylococcus Aureus
(nonbullous impetigo) |
Mupirocin
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VZV
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Vaccine - Zostavax
Oral - Acyclovir, Valacyclovir, Famciclovir Topical- Acyclovir, penciclovir |
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Rubella
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MMR Vaccine (live attenuated)
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Tinea Infection
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Tinea Capitis - Griseofulvin superior to terbinafine, itraconazole, fluconazole
Tinea Pedis - terbinafine and Naftifine Tinea Corporis - Oral terbinafine, Itraconazole, fluconazole Tinea Cruris - Topical antifungal Oral Griseofulvin |
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Anaerobic Cocci/ Pepto-streptococcus
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Broad spectrum therapy
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