Which Drug...?

Front 1

bacterial pneumonia?

Back 1

penicillin if susceptible (MIC<0.1)

3G-ceph, high dose pen, fluoroquinolone (MIC between 0.1-1)

fluoroquinolone, vancomycin, linezolid (MIC>1.0)

**** NOT CIPROFLOXACIN***

Front 2

empyema?

Back 2

3GC + clindamycin, Pip-Tazo, or carbapenem

Front 3

Lung abscess?

Back 3

Pip-Tazo, Ceftriaxone + metronidazole

Front 4

Bordatella pertussis?

Back 4

Erythromycin drug of choice (macrolides)

vaccine = Tdap (adults), Dtap (kids)

Front 5

Legionnaire's Disease?

Back 5

Erythromycin drug of choice

other macrolides, TMP/SMZ, tetracycline, quinolones

14-21d

Front 6

Mycoplasma pneumonia?

Back 6

macrolides, quinolones (NOT CIPRO)

Front 7

Chlamydia psittaci?

Back 7

doxy, tetracycline, macrolides, quinolones for 2-3 weeks

Front 8

other atypical pneumonias? (Q fever, tularemia)

Back 8

tetracyclines, quinolones

Front 9

Pneumocystic jaroveci (AIDS patients)?

Back 9

TMP/SMZ prophylaxis & Rx

Front 10

ESBL-producing Enterobacteriaceae? (E. coli, Klebsiella, P. mirabilis)

Back 10

Carbapenems

Front 11

Rheumatic fever prophylaxis?

Back 11

Sulfas

Front 12

Nocardia infection

Back 12

Sulfas, minocycline

Front 13

Toxoplasmosis?

Back 13

TMP/SMX

Front 14

GI dysmotility disorders?

Back 14

Erythromycin

Front 15

C. difficile?

Back 15

Fidaxomycin

Front 16

Strep. pyogenes (GAS), S. pneumoniae, H. influenzae

Back 16

Clarithromycin and azithromycin (bactericidal)

Front 17

macrolides - Gm+ bacteria

Back 17

clarithromycin

Front 18

macrolides - Gm- bacteria

Back 18

azithromycin

Front 19

Chlamydia and gonorrhea

Back 19

Azithromycin (single-dose Rx)

Front 20

GI infections: H. pylori, C. jejuni, C. difficile

Back 20

Macrolides (fidaxo only for C. difficile)

Front 21

M. avium intracellulare, other NTM

Back 21

clarithromycin and azithromycin

Front 22

Rickettsial infections, Brucella, Lyme disease, Chlamydia, H. pylori, CA-MRSA (if S), acne

Back 22

tetracyclines

Front 23

Stenotrophomonas maltophilia

Back 23

minocycline, TMP/SMZ, Ticarcillin/clavulanate (Timentin)

Front 24

MSSA, MRSA, VISA, VRSA, MRSE, VRE, Pen-R Strep. pneumo (complicated skin/soft tissue, intra-abdominal infections, CA bacterial pneumonia)

Back 24

Tigecycline (avoid unless only choice)

Front 25

Gram + cocci, Gram - cocci (Neisseria meningitidis), anaerobes (severe Clostridia)

Back 25

Penicillin G

Front 26

Syphilis?

Back 26

Penicillin G

Front 27

Gram + cocci and bacilli except L. monocytogenes, Enterococcus, MRSA

Back 27

methicillin, nafcillin, oxacillin, cloxacillin, dicloxacillin

Front 28

severe penicillinase-producing S. aureus infections (not MRSA)?

Back 28

Nafcillin

Front 29

serious enterococcus and Listeria infections?

Back 29

Ampicillin IV (given in combo with aminoglycoside for synergistic killing)

Front 30

sinusitis, otitis, bronchitis, mild CA pneumonia?

Back 30

Amoxicillin PO

Front 31

serious gram negative infections

Bacteremia, pneumonia, endocarditis, osteomyelitis, UTI, pelvic & intra-abdominal infections

Back 31

Piperacillin

Front 32

skin & soft tissue infections, surgical prophylaxis (except bowel or appendix)

Back 32

Cefazolin (1st gen)

Front 33

CA-pneumonia (not nosocomial), epiglottitis, complicated sinusitis, bacteremia, soft-tissue infection, UTI

Back 33

Cefuroxime (2nd gen)

Front 34

minor respiratory tract infections

Back 34

Cefaclor (2GC)

Front 35

Gram negative gut anaerobes (Bacteroides fragilis) - intra-abdominal/pelvic, infected decubitus ulcers, mixed aerobic-anaerobic soft tissue infections, Pelvic infl. disease

colorectal surgery of appendectomy prophylaxis

Back 35

Cephamycin/cefoxitin (2GC)

Front 36

severe nosocomial infections caused by gram negative rods, bacterial meningitis, single IM injection for gonorrhea

Back 36

Ceftriaxone, IV (3GC)

Front 37

2nd line for UTIs, sinusitis, otitis

Back 37

Cefixime, PO (3GC)

Front 38

Serious Pseudomonas infections, empiric Rx of febrile neutropenic patients w/ incr. Pseudo risk

Back 38

Ceftazidime (3GC)

Front 39

nosocomial infections where increased frequency of gram neg. infections are anticipated

Back 39

Cefepime (4GC)

Front 40

MRSA! Gram negatives

CA-pneumonia and complicated skin and skin structure infections incl. MRSA

Back 40

Ceftaroline (5GC)

Front 41

Serious nosocomial gram-negative infections; not used alone empirically

Back 41

Aztreonam

Front 42

Febrile neutropenia, mixed infections (abd/pelvis) - not alone or for serious Pseudomonas

Back 42

Carbapenems

Front 43

polymicrobial infections, S. maltophilia, P. aeruginosa

Back 43

Ticarcillin/clavulanate (Timentin)

Front 44

otitis, sinusitis, lower resp. infections, UTI, skin/soft tissue

human & animal bites (S. aureus, beta-lactamase & oral anaerobes)

Back 44

Amoxicillin/clavulanate (Augmentin)

Front 45

polymicrobial infections (P. aeruginosa, S. maltophilia), some ESBLs

Back 45

Piperacillin/tazobactam (Zosyn)

Front 46

P. aeruginosa, most ESBL-producing Enterobacteriaceae

Back 46

Ceftolozane/tazobactam (Zerbaxa)

Front 47

most Enterobacteriaceae, P. aeruginosa

Back 47

Ceftazidime/avibactam (Avycaz)

Front 48

Gram+ in pt allergic to beta-lactams, Gram+ resistant to beta-lactams (MRSA, MRSE), Corynebacterium JK, severe C. difficile colitis

Back 48

Vancomycin

Front 49

VRSA

Back 49

linezolid, quinu-/dalfopristin

Front 50

skin, soft-tissue infections for resistant strains of staph, strep (not VRE), Clostridium, Peptococcus

Back 50

Telavancin

Front 51

skin, skin-structure infections with resistant strains

Back 51

Dalbavancin, Oritavancin

Front 52

Staph & Strep infections (not VRE)

Back 52

Quinupristin/dalfopristin (streptogramin)

Front 53

VRE, some MRSA infections, some rapid-growing NTM infections

Back 53

Linezolid (oxazolidinones)

Front 54

complicated skin/soft tissue infections, staphylococcal (MRSA) bacteremia

Back 54

daptomycin (cyclic lipopeptide)

Front 55

Aerobic Gm- infections: urinary tract, bacteremia/sepsis, intra-abdominal (+ anti-anaerobic agent), pneumonia, tularemia

Severe staph or strep infections in combo with pen or vanco

Back 55

Aminoglycosides (gentamicin, amikacin, streptomycin, tobramycin, neomycin)

Front 56

enterococcal endocarditis

Back 56

gentamicin or streptomycin + penicillin or vancomycin

Front 57

UTIs/prostatitis, GC, Chlamydia, chancroid, Traveler's diarrhea, Shigella, CA pneumonia, skin/soft tissue, bone/joint, acute otitis externa

*Pseudomonas aeruginosa, enterics, Neisseria, H. flu

Back 57

Fluoroquinolones (ciprofloxacin NOT for CA pneumonia)

Front 58

Gram-neg.: MDR P. aeruginosa, MDR Acinetobacter baumannii, MDR metallo-beta-lactamase producing Enterobacteriaceae

Back 58

Colistin (Polymyxin)

Front 59

Pseudomonas aeruginosa

Back 59

aminoglycosides, quinolones, ceftazidime, cefepime, cefoperazone, carboxypenicillins (carbenicillin and ticarcillin), and ureidopenicillins (mezlocillin,azlocillin, and piperacillin), carbapenems (meropenem, imipenem, doripenem, but not ertapenem), polymyxins, aztreonam

Front 60

TSS?

Back 60

Fluid replacement

Empiric: clindamycin + vanco AND carbapenem or pip/tazo

Specific: Clindamycin + nafcillin (MSSA); vanco or linezolid (MRSA); pen G (GpA strep, C. sordellii)

Front 61

CA-MRSA?

Back 61

Tetracycline, TMP/SMX, clindamycin

Front 62

Strep pneumo meningitis

Back 62

vancomycin, 3G cephalosporins

Front 63

Strep viridans

Back 63

beta-lactams, gentamicin for synergistic killing

alt: vancomycin, quinolones

Front 64

group A strep

Back 64

beta-lactams; penicillin

if pen allergy = erythromycin

Front 65

group B strep

Back 65

penicillin, ampicillin, cephalosporins, vancomycin

Front 66

Enterococcus species

Back 66

ampicillin & ureidopenicillins

ampicillin + aminoglycoside for serious infections (ex: endocarditis)

ampicillin alone for UTI

alt: quinolones, tetracyclines, imipenem, linezolid

Front 67

Diphtheria?

Back 67

administer antitoxin, erythromycin or penicillin

Vaccine (DPT, Td booster every 10 yr)

Front 68

Bacillus anthracis (Anthrax)?

Back 68

pencillin IV high doses

Doxy or ciprofloxacin for terrorism

Front 69

Listeria monocytogenes (Listeriosis)?

Back 69

IV ampicillin & gentamicin

alt: trim/sulfa

Front 70

Anaerobic infections

Back 70

Metronidazole, clindamycin, fidaxomicin, chloramphenicol

Front 71

bacterial vaginosis (Gardernella vaginalis)

Back 71

Metronidazole

Front 72

food-born botulism (C. botulinum)

Back 72

antitoxin & supportive care

Front 73

Clostridium tetani (tetanus)

Back 73

antitoxin, Pen G, wound care, support

tetanus toxoid vaccine

Front 74

Clostridium perfringens gas gengrene

Back 74

extensive surgery + Pen G

Front 75

anaerobic cocci infection

Back 75

penicillins, metronidazole, clindamycin

Front 76

Bacteroides fragilis

Back 76

metronidazole, beta-lactam/lactamase inhibitor combos, carbapenems

Front 77

Actinomyces

Back 77

high dose Pen G for long duration

Front 78

Enterohemorrhagic e. coli

Back 78

rehydration, NO antibiotics

Front 79

serious Salmonella infections

Back 79

cephalosporins, quinolones, aminoglycosides, TMP/SMZ

Front 80

Shigella treatment

Back 80

cephalosporins, aminoglycosides, quinolones

Front 81

Yersinia pestis

Back 81

gentamicin, streptomycin (glycopeptides)

tetracycline or chloramphenicol

vaccine - bubonic

Front 82

Yersinia enterocolitica

Back 82

quinolones, trim/sulfa

Front 83

Pseudomonas aeruginosa

Back 83

antipseudomonal beta-lactams (piperacillin), aminoglycosides, fluoroquinolones

Front 84

Haemophilus influenzae

Back 84

life-threatening: IV 3GC, ampicillin

other: amox/clavulanate, 2GC, quinolones, new macrolides, trim/sulfa

Front 85

Pasteurella infection

Back 85

penicillin or tetracycline

Front 86

Francisella tularensis

Back 86

streptomycin or gentamicin

alt: doxy, ciprofloxacin, chloramphenicol

Front 87

Brucella melitensis

Back 87

doxy + rifampin (or gentamicin)

Front 88

Legionella

Back 88

azithromycin, ciprofloxacin

Front 89

Vibrio cholerae

Back 89

rehydration & maintenance, tetracycline, doxy, quinolones, trim/sulfa

Front 90

C. jejuni

Back 90

rehydration, erythromycin, other macrolides, quinolones

Front 91

H. pylori

Back 91

PPI + amoxicillin + clarithromycin

PPI + bismuth salt + tetracycline + metronidazole