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28 Cards in this Set

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  • Back
Post-op surgical site infection occur at which sites?
• superficial (skin and soft tissue)
• deep (fascia & muscle)
• organs
Clean post-op wounds are usually contain which bacteria?
• strep epidermis
• diptheroides
What are different wound types?
• clean (non-traumatic)
• clean (contaminated): GI/Resp tract entered w/o much spillage
• contaminated: w/ significant spillage
• dirty wounds
Why is delayed primary closure at 5 days the optimum time to approximate a wound?
• maximum phagocyte proliferation at 5 days
• minimal chances for infection
If surgery is expected to enter the colon, distal ileum, or appendectomy, what species should you provide prophylactic antibiotic coverage for?
• Bacteroides
• cover with Cefotetan (or Cefoxitin as an alternative)
If anaerobic flora are not expected to be encountered, what is the prophylactic drug of choice?
Cefazolin (Ancef)
What is the prophylactic drug of choice for patients with allergies to cephalosporins?
clindamycin
When do you stop antibiotics in the hospital setting?
• pt is afebrile
• no WBC count
What is the definition of a surgical fever?
> 101.2
Superficial absecess on the trunk, head, and neck are usually caused by what bacteria?
• staph
• strep
What is the organism that causes nectrotizing fascitis?
• Clostridial myonecrosis (aka Gas gangrene)
• can layer between the sub-q fascia and muscle layers
What is the most common cause of necrotizing fascitis, when non-clostridial fasciitis is reported?
B-hemolytic strep pyogenes
What is the DOC for necrotizing fasciitis?
Clinadmycin + PEN G
What is the MCC of fever in a 1st day post-op patient?
atelectasis
What are the 2 infectious causes of fever in the first 36 hours post-op?
• anastamotic leak
• wound infection (caused by B-hemolytic strep or Clostridial species)
What is treatment of C. Difficle?
• Metrodinazole (1st Line)
• Vancomycin (2nd line, reserved for severe resistant cases)
What is the most common nosocomial infection in surgical patient?
UTI
What is the treatment of MRSA?
• Vanomycin
• Zyvox (Linezolid)
• Synercid (quinupristin/dalfopristin)
Where are Entercocci infections usually seen?
urinary & biliary tract
What is the treatment for enterococci?
gentamycin with (vanco or Ampicillin)
Which aerobic and facultative gram-negative rods are especially sensitive to 2nd generation cephalosporins?
• E. Coli
• Klebsiella
• Proteus
Which aerobic gram-negative rods require 3rd generation cephalosporins?
• enterobacter
• serratia
What are treatment for pseudomonas or acenitobacter?
• ceftazidime
• aztreonam
• imipenem
• cipro
• aminoglycoside
What is the most common anaerobic bacteria in the GI and mouth?
B. fragilis
What are the most effective antibiotics to anaerobic bacteria (like B. frag)?
• metronidazole
• imimpenum
• clindamycin
• PCN/B-lactamase inhibitor (Timentin, Unasyn, Zosyn)
What virus is of concern when treating transplant patients?
CMV
Aztreonam has excellent coverage against what bacteria?
gram-negative bacteria, including Pseudomonas and Serratia
Carbapenems cover which bacteria?
extremely broad spectrum
• gram-positive, gram-negative, aerobic, anaerobic