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34 Cards in this Set
- Front
- Back
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What is the targeted bacteria in cystitis? |
E. Coli Others: S. saprophyticus and enterococcus |
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What is the treatment used for cystitis? |
1 day- Fosfomycin (3g) 3 days- TMP/SMX or FQ (Not Moxi) 5 days - Nitrofurantoin 7 days - B-lactams (S. saprophyticus needs 7 day course) |
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What is the MOA of Fosfomycin? |
Inhibits enolpyruvate transferase - inhibits cell wall synthesis Acts on: Urinary gram - (including drug resistant) |
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What are the benefits of using fosfomycin?
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Safe in pregnancy Can also be used in complicated UTI-- every 3 days |
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What are the different features that make a UTI complicated? |
Obstruction Renal transplant Male Immunocompromised Resistant organism Foreign body Recent urological procedure Pregnant Diabetes Health-care associated Pyelonephritis and CA-UTI |
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What are the targeted bacteria in pyelonephritis? |
E. coli and other gram negatives |
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What are the oral options to treat pyelonephritis? What is the duration? |
FQ 3rd gen cephalosporins TMP/SMX (Nitrofurantoin & fosfomycin NOT APPROPRIATE) 7-14 days |
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What are the IV options to treat CA-pyelonephritis? |
FQ Aminoglycosides 3rd gen cephalosprins ESBL carbapenems (not empiric) |
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What main pathogens need to be covered in healthcare associated UTI? |
P. aeruginosa and other Gram - |
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What are the main treatments for Healthcare associated UTI? |
Cefepime or ceftazadime Piperacillin/Tazobactam Ciprofloxacin/Levofloxacin Meropenem, Imipenem, Doripenem Aminoglycosides Mistake: Sometimes give Vanco.. but don't need to cover MRSA in this case |
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Under what conditions is asymptomatic bacteriuria treated?
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Pregnancy Urinary tract instrumentation/surgery/obstruction Maybe: Neonates Renal transplant |
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What is the treatment for candiduria? |
Don't need treatment Discontinue foley and unnecessary antibiotics |
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What causes chancroids? |
Haemophilus ducreyi Possible co-infection with HSV, syphilis |
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What is the treatment for chancroids? |
Azithromycin (1g PO x 1 dose) Ceftriaxone (IM) Ciprofloxacin (500mg BID x 3 days) Topical erythromycin (TID x 7 days) |
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Under what situations would a partner of someone with chancroids be treated?
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Treat partner symptoms or not if they had sexual contact within 10 days of partners symptoms |
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What is used as treatment for the first clinical expisode of genital herpes? |
Acyclovir (7-10 days) Alternative: Valacyclovir/Famcyclovir (twice daily dosing) |
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What is used as treatment for recurrent genital herpes infections? |
Suppressive therapy Valacyclovir once daily Acyclovir/famciclovir twice daily Episodic regimen: 5 day course of acyclovir |
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What is the treatment for severe genital herpes disease? |
IV acyclovir (2-7 days) Oral therapy (10 day course) |
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What is the preferred agent for all stages of syphilis? |
Benzathine penicillin |
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What is the alternative for penicillin for treatment of syphilis? |
Doxycycline (14 days) Ceftriaxone (10-14 days) Azithromycin (1 dose) Desensitization |
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What is the treatment for latent syphilis and tertiary syphilis? |
Same as Primary/Secondary but if late latent then 3 doses at 1-week intervals |
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What is the treatment for neurosyphilis? |
Penicillin for 10-14 days |
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What is a common side effect seen after syphilis treatment? Why does it occur? |
Jarisch-Herxheimer -- 1-2 hours after Headache, myalgia, fever, tachycardia Release of pyogen from spirochetes (Lasts 1-2 days) Treated with anti-inflammatory agents |
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What are the common treatments of C. trachomitis? |
Azithromycin 1g PO x 1 dose Doxycycline 100mg Po x 7 days (or Erythro, FQ) Abstain until treatment completed |
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What are the most common cause of NGU? How can you suspect one or the other? |
Most likely = C. trachomitis If not responding to Doxy, then probably Mycoplasma genitalium (Treat with azithromycin or moxifloxacin) |
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What is the treatment for uncomplicated Neisseria gonorrhea? |
Ceftriaxone and Azithromycin Altern: Cefixime + Azithromycin Allergies: Cephalosporins = use gentamycin Azithro = doxycycline |
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What are the major symptoms of uncomplicated GC? What are the major symptoms of disseminated GC? |
Uncomplicated: cervicitis, urethritis Disseminated: Septic arthritis, endocarditis, meningitis |
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What is the treatment of disseminated gonococcal infection (DGI)? |
3rd gen cephalosporins (ceftriaxone + Azithro) Always treat for chlamydia unless ruled out |
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What are the three main categories of vaginal infections? |
Bacterial- anaerobic (g. vaginalis) Trichominiasis Candidiasis - c. albicans |
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What is the main treatment for vaginosis? |
Bacterial- metronidazole x 7 days Trichomonas- Mitronidazole/tinidazole 2gx 1 dose OR metronidazole 500bid x 7 days Fungal- fluconazole x 1 dose |
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What are the causative organisms of Pelvic Inflammatory disease?
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N. gonorrhea, C. trachomitis, some gram -, anaerobes |
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What are the recommended treatments for PID? |
Cefoxitin + doxycycline Allergy: Clindamycin + gentamicin |
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What are the major causative organisms for epididymitis? |
C. trachomitis N. gonorrhea Anal intercourse: E. coli, P. aeruginosa |
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What are the main treatments for epididymitis? |
Ceftriaxone + Doxycycline If enteric are a concern: FQ If both: Ceftriaxone + FQ Treat sex parteners if suspect chlamydia or gonorrhea. |
