Respiratory (Module 2) - Bug Drugs Of Choice (Doc)

Front 1

CAP (outpatient)

Back 1

p.o. macrolide (azithro, erythro, clarithro),
or p.o. doxycycline +/- p.o. amoxicillin

Front 2

CAP outpatient with structural
lung disease (COPD, asthma)

Back 2

p.o. levofloxacin

Front 3

pneumonia (inpatient) (CAP that does not respond to outpatient tx with clari or doxy, or CAP in an untreated patient admitted to the hospital)

Back 3

i.v. ceftriaxone
or i.v. cefotaxime + i.v. or p.o azithromycin
or i.v. moxifloxacin
or levofloxacin

Front 4

hospital-acquired (nosocomial) pneumonia

Back 4

i.v. piperacillin - tazobactam,
or i.v. cefepime

Front 5

Strep pneumo (inpatient, identified by culture) e.g., meningitis, pneumonia

Back 5

i.v. pen G,
or i.v. cefotaxime,
or i.v. ceftriaxone;
--> send home on p.o. amoxicillin

Front 6

Pen G resistant strep pneumo (low level of PCN resistance)

Back 6

i.v. cefotaxime,
or i.v. ceftriaxone

Front 7

MDR strep pneumo (including high-level PCN-resistant)

Back 7

i.v. vancomycin
or i.v. moxifloxacin,
or high-dose i.v. levofloxacin

Front 8

Legionella

Back 8

i.v. azithromycin,
or Fluoroquinolone (FQ = cipro, levo, moxi)

Front 9

PCP

Back 9

trim-sulfa

Front 10

aspiration pneumonia

Back 10

clindamycin

Front 11

outpatient URI (Upper Respiratory Infection) in patient with PCN allergy

Back 11

p.o. clarithromycin,
or p.o. doxycycline

Front 12

beta-hemolytic strep:
inpatient -->
outpatient -->

Back 12

i.v. pen G (inpatient)
p.o. amoxicillin (outpatient)

Front 13

prophylaxis for beta-hemolytic strep

Back 13

i.m. procaine pen G,
or i.m. benzathine pen G

Front 14

infected diabetic foot ulcer

Back 14

i.v. ampicillin-sulbactam,
or i.v. piperacillin-tazobactam

Front 15

primary/secondary syphilis

Back 15

i.m. benzathine penicillin

Front 16

neurosyphilis

Back 16

i.v. penicillin G,
or i.v. or i.m. ceftriaxone

Front 17

gonorrhea

Back 17

p.o. cefixime
or i.v. or i.m. ceftriaxone

Front 18

bacterial meningitis (H. flu, strep pneumo or Neisseria spp. identified
by culture)

Back 18

i.v. cefotaxime
or i.v. ceftriaxone

Front 19

community-acquired meningitis (empiric therapy when the bug is unknown):
a) patient is one month - 50 y.o.

b) patient < one month or > 50 y.o

Back 19

a) i.v. ceftriaxone
or i.v. cefotaxime + i.v. vancomycin

b) add i.v. ampicillin to cover Listeria

Front 20

febrile neutropenia

Back 20

i.v. piperacillin - tazobactam,
or i.v. cefepime;
--> add i.v. vancomycin if you have evidence of gram(+) bugs

Front 21

cellulitis (MSSA) inpatient

Back 21

i.v. oxacillin or i.v. nafcillin

Front 22

cellulitis (MSSA) outpatient

Back 22

p.o. dicloxacillin, or p.o. cephalexin

Front 23

cellulitis (MSSA) outpatient with PCN allergy

Back 23

p.o. clindamycin, or p.o. doxycycline

Front 24

cellulitis (MRSA) outpatient

Back 24

p.o. clindamycin, or p.o. trim-sulfa, or p.o. doxycycline

Front 25

MRSA (hospital)

Back 25

i.v. vancomycin

Front 26

MRSA (hospital) in a patient who cannot tolerate vancomycin

Back 26

i.v. daptomycin or i.v. or p.o. linezolid

Front 27

MRSA pneumonia

Back 27

i.v. or p.o. linezolid

Front 28

otitis media

Back 28

p.o. amoxicillin, or p.o. amoxacillin +clavulanate, or p.o. cefdinir

Front 29

Pseudomonas

Back 29

i.v. piperacillin – tazobactam, or i.v. cefepime, or i.v. ceftazidime

Front 30

serious gram (-) infections (as empiric therapy)

Back 30

antipseudomonal beta-lactam + an aminoglycoside

Front 31

severe gram (-) infection in patients allergic to PCN’s

Back 31

aztreonam

Front 32

surgical prophylaxis (not intra-abdominal)

Back 32

i.v. cefazolin

Front 33

gut decontamination prior to G.I. surgery

Back 33

p.o. neomycin (not absorbed from GI tract)

Front 34

Perioperative prophylaxis for GI surgery

Back 34

i.v. cefoxitin, or i.v. cefotetan

Front 35

anaerobic infections (penetrating GI trauma,appendicitis, PID and lung abscess)

Back 35

i.v. piperacillin + tazobactam, or i.v. cefoxitin, or i.v. cefotetan

Front 36

anaerobic infections in PCN allergic patients

Back 36

i.v. metronidazole

Front 37

enterococcus

Back 37

i.v. ampicillin, if amp resistant use i.v. vancomycin if vanc resistant use i.v. or p.o. linezolid

Front 38

ampicillin-resistant enterococcus

Back 38

i.v. vancomycin

Front 39

VRE

Back 39

i.v. or p.o. linezolid

Front 40

gram (+) bacteremia

Back 40

i.v. vancomycin (empiric therapy which should be adjusted based on culture results)

Front 41

C. difficile (pseudomembranous colitis)

Back 41

p.o metronidazole,if disease is severe, give p.o. vancomycin

Front 42

Mycoplasma

Back 42

p.o. doxycycline, or a p.o. macrolide

Front 43

Chlamydia

Back 43

p.o. doxycycline, or a p.o. macrolide

Front 44

Rickettsia

Back 44

p.o. doxycycline

Front 45

Borrelia burgdorfi

Back 45

p.o. doxycycline

Front 46

Nocardia

Back 46

trim-sulfa

Front 47

diarrhea (Salmonella, Shigella, E. coli or campylobacter)

Back 47

p.o. FQ

Front 48

uncomplicated UTI

Back 48

p.o. trim-sulfa, or p.o. nitrofurantoin

Front 49

complicated UTI

Back 49

i.v. or p.o. ciprofloxacin or levofloxacin, or i.v. or p.o. 3rd generation cephalosporin (i.e. cefotaxime, ceftriaxone or cefpodoxime)

Front 50

pyelonephritis

Back 50

i.v. ceftriaxone or cefotaxime send home on p.o. cefpodoxime

Front 51

TB (sputum positive)

Back 51

p.o. rifampin +p.o. isoniazid +p.o. pyrazinamide +p.o. ethambutol

Front 52

TB (AIDS) (this is the answer for the Big June exam)

Back 52

p.o. rifabutin +p.o. isoniazid +p.o. pyrazinamide +p.o. ethambutol

Front 53

Treatment of latent TB infection in patient with positive PPD,but negative chest x-ray and sputum negative

Back 53

p.o.isoniazid, or p.o rifampin

Front 54

brucellosis

Back 54

p.o. doxycycline + i.v. gentamicin or doxycycline + p.o. rifampin

Front 55

Mycobacterium avium (AIDS patient)

Back 55

p.o. or i.v. macrolide + ethambutol

Front 56

acne

Back 56

p.o. minocycline, or topical clindamycin, or topical erythromycin

Front 57

leprosy (Mycobacterium leprae)

Back 57

dapsone