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47 Cards in this Set
- Front
- Back
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empiric therapy
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presumptive therapy
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approach of empiric therapy
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1-formulate a clinical diagnosis
2-obtain specimens for lab examination 3-formulate a microbiologic diagnosis 4-determine necessity for empiric therapy 5-institute treatment |
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acute otitis media or sinusitis
what pathogens |
S. pneumoniae
H. influenzae M. catarrhalis |
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first choice for acute OM or sinusitis?
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amoxicillin
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pneumonia in neonate
what pathogens? |
Group B strep
E. coli Listeria |
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pneumonia in infant
what pathogens? |
Pneumococcus
S. aureus H. influenzae |
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pneumonia in adult
what pathogens? |
pneumococcus
mycoplasma legionella C. pneumonia H. influenzae |
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first choice drugs for pneumonia?
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ampicillin+cephalosporin
Cefriaxone, Cefotaxime, Cefuroxime, Macrolide + cefotaxime or ampicillin |
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cellulitis is caused by what pathogens?
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S. aureus
Group A strep |
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first choice for cellulitis?
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first generation cephalosporin
nafcillin |
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septic arthritis -what pathogens?
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in child: H. flu, S aureus, streptococci, kingella
Adult: S. aureus, enterobactericae |
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first choice for septic arthritis?
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Cefriaxone
Cefaxolin |
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Sepsis - any pathogen
what drugs? |
vancoymycin+cephalosporin
piperacillin-tazobactam or meropenem |
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meningitis
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neonate: GBS, E.coli, listeria
child: H flu, penumococcus, meningococcus adult: pneumococcus |
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first choice for meningitis
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ampicillin + 3rd generation cephalosporin:
ceftriaxone, cefataxime |
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Bacterial endocarditis-pathogens
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acute-S. aureus
subacute: viridans streptococci, enterococci |
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first choice for bacterial endocarditis
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vancomycin+gentamicin
penicillin + gentamicin |
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host factors that influence drug of choice
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concomitant disease state
immunosuppressive medications prior adverse drug effects impaired elimination or detox of drug age of pt pregnancy epidemiologic exposure |
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pharmacologic factors
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kinetics of absorption, distribution, elimination
ability of drug to be delivered to site of infection potential toxicity of agent also: knowledge of susceptibility + cost of antimicrobial therapy |
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antibiotics that inhibit cell wall synthesis
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beta-lactams
vancomycin isoniazid ethambutol cycloserine ethionamide bacitracin polymyxin |
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antibiotics that inhibit DNA replication
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quinolones
metronidazole |
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antibiotics that inhibit RNA replication
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rifampin
rifabutin |
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antibiotics that are antimetabolites
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sulfonamides
dapsone trimethoprim Para-aminosalicylic acid |
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inhibit protein synthesis (30s)
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aminoglycosides
tetracyclines oxazolidinone |
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inhibit protein synthesis (50s)
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chloramphenicol
macrolides clindamycin streptogramins |
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what do you use w/ gram positive cocci normally?
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penicillin with maybe cephalosporin, clindamycin, or AG
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what do you use for S. aureus (sensitive)
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penicillinase-resistant penicillin, first generation cephalosporin
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what do you use for MRSA?
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clindamycin or vancomycin
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what do you use for listeria?
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ampicillin +/- aminoglycosides
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gram positive rods
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bacillus
listeria nocardia |
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nocardia species?
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TMP-SMZ
amikacin linezolide |
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gram negative cocci
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moraxella catarrhalis
neisseria gonorrhea neisseria meningitidis |
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moraxella catarrhalis
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TMP-SMZ
cephalosporin |
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neisseria gonorrhea
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Ceftriaxone
Cefixime Azythromycin |
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neisseria meningitidis
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Penicillin G
cefotaxime |
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Gram negative rods
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E. coli
Klebsiella enterobacter citrobacter serratia |
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E. coli/Klebsiella
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Cephalosporins or TMP-SMX
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enterobacter, citrobacter
serratia |
TMP-SMX
quinolones carbapenem |
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gram negative rods
non lactose fermenters |
salmonella
shigella proteus pseudomonas aeruginosa |
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salmonella
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quinolones
cefratiaxone |
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shigella
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quinolones
ampicillin azithromycin ceftriaxone |
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proteus
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cephalosporin
TMP-SMZ |
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pseudomonas
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antipsudomonal penicillin
AG 4th generation cephalosporin: carbapenems |
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MIC
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measure the concentration of drug required to inhibit growth of organisms
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MBC
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minimal bactericidal concentration
measure the concentration of drug required to kill organism |
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what antibiotics have renal toxicity?
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beta-lactams
trimethoprim aminoglycosides quinolones |
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what antibiotics have hepatic toxicity?
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metronidazole
clindamycin |
