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37 Cards in this Set
- Front
- Back
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CAP symptoms
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Pleuritic chest pain, hemoptysis, sputum, fever, arthralgia, myalgia, confusion
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Single most sensitive sign of cap
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>30 breaths per minute
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CAP- Previously healthy and no abx in 3 mo
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Macrolide po (azithro, clarith, erythro) or doxy po
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CAP - comorbities
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DM, alcoholism, immunosuppressed (CORTICOsteroids, hiv, malignancies), chronic heart, lung or kidney dx
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CAP - tx w/ comorbidities outpatient
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Resp. Fluroquonolone(moxi, levo),
or HD amoxi/clav or amoxi/clav + macrolide po no erythro as mono |
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CAP - hospital ward pt
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Resp. Fluoroquinolones po/iv (pen allergy)
or B-lactam po/iv + macrolides po/iv |
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CAP - ICU admission indications
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Septic shock, acute resp failure req intubation
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CAP - ICU tx
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B-lactam iv + macrolide iv or respiratory FQ iv
Allergy: aztreonam + respiratory FQ |
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CAP - ICU pseudomonas
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Anti pnemucoccal/antipseudomonal B-lactam iv plus:
Cipro iv or AMG iv + macrolide IV or AMG iv + cipro iv |
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Anti pseudomonal B-lactams
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Ticarcillin, piperacillin, ceftazidime, cefepime, aztreonam, imipenem,meropenem
Add cipro or levo (gram -ve) |
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H. Flu coverage
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2nd or 3rd gen cephs, amoxi/clav, FQ, azithro, clarithro
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Legionella
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FQ, azithro, doxy(alt)
21 day tx |
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M.pneumo, Chlamydophila pneumo
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Macrolides, tetracyclines, FQ(alt)
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MSSA
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Cloxacillin, cefazolin, clinda
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Aspiration pneumo (poor dental hygene/putrid sputum/alcoholics)
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Metronidazole, clinda, amoxi/clav, pip/tazo, carbapenems, moxi
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Sinusitis - children - acute (<4 wk and < 3 ep/yr) organisms and tx
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S. Pneumo, M.Catarrhalis, H.flu, (maybe s aureus, s.pyogenes, anaerobes)
Std amoxil 10d or HD amoxil (daycare/abx use), TMP-SMX (ALLERGY) Azithro/clari only in allergy+abx/daycare |
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Sinusitis - child - first line failure (no improvement or worsen after 3 days or recurrence < 3 mo
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Patho same as acute
Amoxi/clav (7:1) 10d + amoxi or cefuroxime axetil 10d B-lactam allergy: azithro 3-5d, clarithro 10d Severe: iv cefuroxime 10d |
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Child chronic sinusitis (>12wks)
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Anaerobes, enterobacteria
Amoxi/clav 3wks or clinda 3wks |
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Adult sinusitis acute (<4wk and <3 ep/yr)
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Amoxil 10d
Allergy: doxy 10 days or SMX/TMP 10d |
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Adult sinusitis first line failure (deterioration in 72hr)
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Amoxi/clav 10d or cefuroxime axetil 10d
Allergy: azithro 3-5d, clarithro 10d, levo, moxi 5-10 d |
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Adult - chronic sinusitis (>12wk)
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Amoxi/clav 3wk
Allergy: clinda 3wk |
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Concentration dependent killing
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AMG, doxy, FQ
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AECOPD - signs for abx treatment
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Incr. dyspnea, incr. Sputum purulence, or incr. Sputum
Need at least 2 |
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AECOPD - risk factors that need more serious tx
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FEV <50 predicted, >4 exacerbations/yr, CVD, O2 use, oral CS use, abx <3 mo
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Chronic suppurative bronchitis
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AECOPD risk factors + constant purulent sputum, FEV <35?
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AECOPD - without risk factors abx tx
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2nd or 3rd gen ceph (cefprozil, cefutoxime axetil), amoxil, doxy, tmp/smx
Alt - FQ, amoxi/clav or telithro |
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AECOPD - with risk factors abx tx
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FQ or amoxi/clav
Alt - iv therapy |
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Diabetic Foot Infection (Osteomyelitis)
Mild/Moderate/Severe |
Mild: amox/clav, or cipro + clindamycin
Moderate: Carbapenem, amoxi/clav, pip/tazo or moxi +/- clinda or metro |
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Diabetic Foot Infection Duration of Therapy
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2 to 3 weeks if removed infected bone
4 to 6 weeks standard treatment 10 to 12 weeks if no debridement occurs |
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Osteomyelitis - MSSA IV/Oral abx
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IV: Cloxacillin, cefazolin, or clinda
Oral: Cloxacillin, cephalexin, clinda, amoxi/clav |
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Osteomyelitis - GAS IV/oral
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IV: Penicillin
Oral: Penicillin, Amoxicillin or clinda |
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Osteomyelitis - GBS, and Enteric gram -ve
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IV: Penicillin (GBS), Cefotaxime (gram -ve cocci)
Oral: not appropriate in babies |
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Osetomyeltitis - Pseudomonas IV/Oral abx
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IV: Ceftazidime + Gentamicin
Oral: ciproflox (only give to children after consideration) |
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Osteomyelitis MRSA abx
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Vanco
Oral: Only if CA-MRSA, possible for clindamycin, otherwise home iv |
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Osteomyelitis - Mixed aerobic/anaerobic
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IV: Carbapenem, moxi, amoxi/clav, pip/tazo
Oral: Cipro + Clinda or amoxi/clav |
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Cellulitis - Adult
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1: Cephalexin po
Cefazolin iv +\- clinda 2: Cloxacillin po clinda 3: macrolides (discharge from ER with cefazolin 2g IV w/ probenecid 1g po bid |
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Cellulitis - Child
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1:Cephalexin po
cefazolin +/- clinda 2: clinda po 3: macrolides |
