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28 Cards in this Set
- Front
- Back
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norm flora of the nasopharynx that can cause bac mening
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n meinigitidis
h influ b streptococcus pneumonia |
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maternal vag flora that can cause bac menin
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streptococcus agalactiae
e coli (if a mom gets frequent uti's . . . watch out w/ babies) |
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immunocompro and babies can get mening thru what pathogen
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listeria monocytogenes
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there's ---- protein, and --- glucose in bacterial mening
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elevated protein
low glucose |
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what are abx will penetrate meningeal inflammation: very good
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sulfonamides
trimethoprim chloramphenicol metronidazole rifampin other tb meds |
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adequate penetration w/ inflammed meningies
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pcns
cefuroxime 3GC cefepime aztreonam imipenem meropenem ciprofloxacin vanco |
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fair/poor penetrates of inflammed meninges
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1 GC
2 GC (except cefuroxime) aminoglycosides clindamycin macrolides |
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when should abx be given upon arrival to the hospital
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w/in 60 min
no later than 90-120 min |
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potential pathogens for neomates
tx |
group b strep
gram neg listeria ampicillin + 3rd GC (cefotaxime) |
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kids (1-23 mo) pathogens
tx |
group b strep
strep pneumo n meningitis h influ e coli 3rd GC (cefotaxime or ceftriaxone) and vanco |
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possible pathogens for kids > 2 yrs to adults < 50 yrs
tx |
strep pneumo
n meningitis 3rd GC (ceftriaxime or ceftriaxone) and vanco |
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possible pathogens for adults > 50 - 60 yrs
tx |
strep pneumo
n meningitis listeria 3rd GC (cefotaxime or ceftriaxone) and vanco and ampicillin |
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impaired immunity possible pathogens
tx |
strep pneumo
n meningitis listeria/gnrs vanco and (cefepime and meropenem) and ampicilin |
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status postneurosx or trauma possible pathogens
tx |
staph coagulase neg
staph aureus aerobic gram neg (ex pseudomonas) cefepime + vanco +/- rifampin |
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why is dexamethosone controversial w/ meningtis
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although reduces inflammation it can also reduce penetration of abx
recommendation: dextamethasone 10 g IV w/ first ax dose and q 6 hr for 4 days in adult patients |
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if strep pneumonia is sensitive what do you give
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pcn g
or ampicillin |
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if step pneumonia is intermediate what do you give
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ceftriaxone
cefotaxime |
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if strep penumonia is resistant what do you give
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vanco
+ ceftriaxone or ceftotaxime +/- rifampin 600 mg q day |
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how long do you tx strep pneumonia for
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10-14 days
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what do you use to tx n meningitis
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ceftriaxone 2 gm iv q 12hrs for 7 days
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what do you use for listeria
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ampicillin 2 gm iv q 4 hr
+/- gentamicin 2 mg/kg LD w/ 1.7 mg/kg q 8 hr tx for 14-21 days |
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what do you use to tx h influenzae
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b lactamase +: ceftriaxone 2 gms iv q 12 hrs
b lactamase -: ampicillin 2 gm 4 hrs for 7 days |
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t/f
ok to tx listeria w/ 3 gen cephalosporins |
f
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how's at high risk of meningitis
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household members
kissing daycare sharing utensils |
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chemoprohylaxis for n meningitis
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rifampin
cipro ceftriaxone kids: rifampin ceftriaxone |
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who should receive meningococcal vaccines
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kids: terminal complement deficiencies, asplenia, other high risk groups
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who whould get he penumococcal vaccine:
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chronic lung disease
dm chronic liver disease renal failure asplenia cochlear implants immunocompromised pts |
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who should received hib vaccine
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routine part of the child vaccin schedule
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