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17 Cards in this Set

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intitial phase of therapy in TB
1. INH (300 mg/day) for 8 wks
2. Rifampin (600 mg/day)8 wks
3. Pyrazinamide (PZA) (25 mg/kg/day up to 2 g/day) 8 wks
4. Ethambutol (15 mg/kg/day) 8 wks
5. pyridoxine (10-25 mg/day)
-if isolate reported susceptible to INH and Rifampin, stop PZA and ethambutol.
Continuation Phase of therapy in TB (No pulmonary cavities and smear negative after 2 months of therapy)
1. INH for 26 wks
2. Rifampin for 26 wks
3. Pyridoxine 26 wks
therapy for TB with cavities present or cultures positive after 2 months
1. INH for 9-12 months
2. Rifampin for 9 months
3. Pyrazinamide for first 2 months
4. ethambutol for 2 months
5. pyridoxine for 9 months
*therapy is same for disseminated TB, TB meningitis, osteomyelitis, or TB in children
Therapy for INH resistant TB
1. Rifampin + ethambutol + PZA + Gatifloxacin or Levofloxacin for 6-9 months
2. pts who cannot take PZA (liver disease or hyperuricemia) take Rifampin + ethambutol for 12 months; streptomycin is alternative for ethambutol
Therapy for INH and rifampin resistant TB
use at least 4 active drugs--
for 18-24 months or 12-18 months after last positive culture
intitial phase of therapy in TB
1. INH (300 mg/day) for 8 wks
2. Rifampin (600 mg/day)8 wks
3. Pyrazinamide (PZA) (25 mg/kg/day up to 2 g/day) 8 wks
4. Ethambutol (15 mg/kg/day) 8 wks
5. pyridoxine (10-25 mg/day)
-if isolate reported susceptible to INH and Rifampin, stop PZA and ethambutol.
Continuation Phase of therapy in TB (No pulmonary cavities and smear negative after 2 months of therapy)
1. INH for 26 wks
2. Rifampin for 26 wks
3. Pyridoxine 26 wks
therapy for TB with cavities present or cultures positive after 2 months
1. INH for 9-12 months
2. Rifampin for 9 months
3. Pyrazinamide for first 2 months
4. ethambutol for 2 months
5. pyridoxine for 9 months
*therapy is same for disseminated TB, TB meningitis, osteomyelitis, or TB in children
Therapy for INH resistant TB
1. Rifampin + ethambutol + PZA + Gatifloxacin or Levofloxacin for 6-9 months
2. pts who cannot take PZA (liver disease or hyperuricemia) take Rifampin + ethambutol for 12 months; streptomycin is alternative for ethambutol
Therapy for INH and rifampin resistant TB
use at least 4 active drugs--
for 18-24 months or 12-18 months after last positive culture
TB in pregnancy
INH + Rifampin + ethambutol for 9 months. all cross placenta and appear not to be teratogenic. DO NOT USE PZA.
treatment of minimal TB
IHN susceptible:
1. INH for 9 months; if abnormal xray, treat 12 months
DOT
For INH resistant:
1. Rifampin for 4 months; DO NOT use rifampin + PZA for treatment of minimal disease due to cases of lethal hepatotoxicity
TB prophylaxis
Multidrug resistant TB:
PZA + Ethambutol + Levofloxacin + an Aminoglycoside for 18-24 months
treatment of listeria monocytogenes
Penicillin or ampicllin alone or in combo with gentamycin
Early antibiotic treatment of infected pregnant women can increase chances of having healthy child.
No vaccine.
Pasteurella treatment
penicillin
treat septic arthritis with joint drainage and antimicrobials.
treatment of brucella
Spontaneous resolution: CMI important for clearance—activated macrophages required; Brucella replicates within normal macrophages.
-control of disease in livestock with vaccine (none against suis or canis)
-avoidance of unpasteurized dairy products
-doxycycline combined with rifampin for at least 6 wks
-TMP-SMX + rifampin for pregnant women or children under 8 yrs
-No human vaccine available
tularemia treatment
Streptomycin drug of choice, but toxicity issues may exist.
Gentamycin – acceptable alternative.