Id Rotation - Common Antibiotic Therapies

Front 1

CAP: non-severe

Back 1

S. pneumonia, H. influenzae, Mycoplasma or Chlamydia

Hint 1

Levoquin or Zithromax/Rocephin

Front 2

CAP: severe

Back 2

Gram negative rods PLUS S. pneumoniae, H. influenzae, mycoplasma or chlamydia

Hint 2

Levoquin OR Zithromax and Zosyn OR Cefepime

Front 3

Suspected aspiration pneumonia

Back 3

Anaerobes

Hint 3

Clindamycin/Zosyn

Front 4

Hospital Acquired Pneumonia

Back 4

Gram negatives, E. coli, Enterobacter, Pseudomonas, Klebsiella

Hint 4

Pseudomonas, Gram negatives: Zosyn OR Cefepime OR Cipro +/- tobramycin
MRSA: Zyvox

Front 5

HAP: Staph aureus

Back 5

Nafcillin

Front 6

Blastomycosis

Back 6

Itraconazole (Amphotericin B for life-threatening infection)

Front 7

Histoplasmosis

Back 7

Itraconazole (Amphotericin B for meningeal infections)

Front 8

Cryptococcus

Back 8

Amphotericin B +/- 5-flucytosine

Front 9

Chronic suppression of cryptococcus in HIV patients

Back 9

Fluconazole

Front 10

Candida albicans (superficial)

Back 10

PO: Fluconazole
Topical: miconazole, nystatin, clotrimazole, ketoconazole

Front 11

Candida esophagitis

Back 11

Fluconazole

Front 12

Candida albicans - deep seated infection

Back 12

Amphotericin B

Front 13

Cholecystitis

Back 13

Coliforms and enterococci

Hint 13

Cefoxitin OR Zosyn

Front 14

Cholangitis

Back 14

Enterics, enterococci, anaerobes

Hint 14

Cefoxitin OR Zosyn

Front 15

Diverticulitis

Back 15

Enterics, anaerobes

Hint 15

Cefoxitin OR clindamycin OR zosyn or flagyl + tobramycin

Front 16

Intra-abdominal infection

Back 16

Enterics, anaerobes, enterococci

Hint 16

Zosyn OR Clindamycin OR Flagyl + Tobramycin/Ancef

Front 17

Cystitis

Back 17

E. coli, Staph saprophyticus

Hint 17

Bactrim, Cefadroxil, Nitrofurantoin, Fosfomycin, Quinolone (Cipro)

Front 18

Pyelonephritis (community)

Back 18

E. coli, Proteus

Hint 18

Bactrim OR Tobramycin OR Cipro/Levoquin

Front 19

Pyelonephritis - nosocomial (underlying GU disease)

Back 19

Gram negatives including E. coli, Pseudomonas, Enterococcus

Hint 19

Ampicillin + tobramycin OR Ancef + ampicillin

Front 20

Prostatitis: acute

Back 20

Under 35 years old: Neisseria gonorrhoeae or Chlamydia
Over 35 years old: Enterobacteriaceae

Hint 20

Under 35 years old: Ceftriaxone OR Cipro + Doxycycline
Over 35 years old: Bactrim OR Cipro

Front 21

Prostatitis: chronic

Back 21

Enterobacteriaceae, Enterococcus

Hint 21

Bactrim OR Cipro

Front 22

Cellulitis (non-diabetic)

Back 22

Streptococcus or Staphylococcus

Hint 22

Nafcillin (oral dicloxacillin), Clindamycin or Cefazolin in non-anaphylactic PCN allergy
Suspect MRSA - Vancomycin

Front 23

Decubitus ulcer/diabetic ulcer

Back 23

Staphylococcus, Streptococcus, Gram negatives, anaerobes

Hint 23

PO: Augmentin
IV: Zosyn OR Clindamycin OR Flagyl + Tobramycin

Front 24

Necrotizing fasciitis

Back 24

Streptococcus, Staphylococcus, Gram negative aerobes, anaerobes

Hint 24

PCN + Clindamycin + Tobramycin (or Cipro) OR Zosyn OR Merapenam

Front 25

Human/animal bites

Back 25

Pasteurella multocida, Streptococcus, Staphylococcus

Hint 25

IV: Cefuroxime
PO: Augmentin

Front 26

Osteomyelitis: acute (hematogenous)

Back 26

Staph aureus (common)
Gram negatives (less common)

Hint 26

S. aureus: nafcillin + rifampin OR nafcillin + tobramycin
Gram negatives: ciprofloxacin or ceftriaxone

Front 27

Diabetic foot or contiguous ulcer

Back 27

Gram negatives
Gram positives
Anaerobes

Hint 27

Zosyn +/- tobramycin

Front 28

Septic arthritis: sexually active young adult

Back 28

Neisseria gonorrhoeae, gonococcus

Hint 28

Ceftriaxone OR Ciprofloxacin + doxycycline

Front 29

Septic arthritis: adult

Back 29

Staph aureus
Group A streptococcus
Gram negative aerobes

Hint 29

Nafcillin +/- tobramycin +/- rifampin OR ceftriaxone +/- rifampin

Front 30

Septic arthritis: with prosthesis

Back 30

Staph epidermidis
Staph aureus
Gram negatives

Hint 30

Vancomycin OR ceftriaxone (+ rifampin if S. aureus)

Front 31

Meningitis: ages 18-50 (community)

Back 31

S. pneumoniae
N. meningitis
H. influenzae

Hint 31

Ceftriaxone + vancomycin + ampicillin (+ dexamethasone)

Front 32

Meningitis (immunosuppressed)

Back 32

Community acquired pathogens
Listeria monocytogenes
Fungal
Mycobacterial

Hint 32

Ampicillin +ceftriaxone + vancomycin

Front 33

Viral encephalitis/meningoencephalitis

Back 33

Herpes simplex

Hint 33

Acyclovir

Front 34

Acute sinusitis

Back 34

S. pneumoniae
H. influenzae
M. catarrhalis

Hint 34

Amoxicillin OR cefuroxime OR Augmentin

Front 35

Chronic sinusitis

Back 35

S. pneumonia
H. influenzae
M. catarrhalis
+ S. aureus

Hint 35

Augmentin or Clindamycin

Front 36

Hospital acquired sinusitis

Back 36

Gram negative aerobes
S. aureus
Anaerobes

Hint 36

Levoquin OR Azithromycin + Zosyn OR cefepime

Front 37

Exudative pharyngitis

Back 37

Group A strep

Hint 37

Penicillin *watch for mono!*

Front 38

Vesicular/ulcerative pharyngitis

Back 38

Coxsackie or Herpes simplex virus

Hint 38

Acyclovir

Front 39

Epiglottitis

Back 39

Group A strep OR H. influenzae

Hint 39

Cefuroxime OR ceftriaxone

Front 40

Periorbital/Orbital cellulitis

Back 40

Strep species
Staph species
H. influenzae
Anaerobes

Hint 40

Cefuroxime OR ceftriaxone (consider fungal etiology if immunosuppressed)

Front 41

Otitis media

Back 41

S. pneumoniae
H. influenzae
M. catarrhalis

Hint 41

Amoxicillin OR Augmentin OR cefuroxime

Front 42

Acute mastoiditis

Back 42

S. pneumoniae
S. pyogenes
S. aureus

Hint 42

Cefuroxime

Front 43

Chronic mastoiditis

Back 43

Polymicrobial: pseudomonas, S. aureus, anaerobes

Hint 43

Tobramycin + Zosyn (requires surgery)

Front 44

Urethritis/Cervicitis/Prostatitis

Back 44

N. gonorrhoeae
Chlamydia

Hint 44

Ceftriaxone OR Ciprofloxacin + doxycycline OR Zithromax

Front 45

PID

Back 45

N. gonorrhoeae
Chlamydia
Bacteroides
Enteric gram negatives

Hint 45

Outpatient: Ceftriaxone + doxycycline
Inpatient: Cefotetan +doxycycline

Front 46

Herpes simplex

Back 46

HSV

Hint 46

Acyclovir, valcyclovir

Front 47

Chancroid

Back 47

Haemophilus ducreyi

Hint 47

Ceftriaxone OR erythromycin OR azithromycin

Front 48

Syphillis

Back 48

Treponema pallidum

Hint 48

Benzathine PCN

Front 49

Neurosyphillis

Back 49

T. pallidum

Hint 49

Penicillin G