Antiobiotic doses.txt

  1. Common Meds
    To Memorize!
  2. Adult Rx for Group A Strep
    Pen V 600mg PO BID x 10d
  3. If adult allergic to Pen?
    • Erythromycin 500mg PO BID x 10d
    • or 250mg PO QID x 10d
  4. 1st line Child Rx Group A Strep pharyngitis?
    • ≤ 27 kg: Pen V 40mg/kg/d PO divided BID x 10d
    • >27 kg: Adult dose
    • 2nd line: Amoxil 40mg/kg divided BID x 10d
  5. What is 2nd line after Pen and Amox for children with Strep throat?
    Erythromycin estolate - 40mg/kg/d divided BID

    • Rx if 22 yr old with sore throat?
    • 90% chance of Mono/EBV
    • 90%+ for heterophile Ab
    • False -ive 25% in 1st week on Monospot
  6. Rx Otitis Externa
    • Ciprodex (=cipro + dexa) 3 drops BID
    • or Buro-solution 3 drops TID (in guidelines, but rarely used)
  7. Rx Ear effusions
    Nothing! Not infection
  8. Otitis Media Rx (adult)
    Amoxicillin 500mg PO TID x 5 days
  9. Otitis Media Rx (older children)
    Amoxicillin 500mg PO TID x 5 days
  10. Otitis Media Rx - Amox resistant
    Clavulin 500mg PO TID
  11. OM Rx in kids 2+ yrs (if severe)
    Amoxicillin 90mg/kg/d divided BID x 5-7 days
  12. OM Rx in kids < 2 yrs
    Amoxicillin 90mg/kg/d divide BID x 10days
  13. OM Rx if pen allergic
    Use macrolide
  14. Sinusitis Rx
    • Want to see 1st viral infection then sudden 2nd worsening suggesting bacterial infection:
    • Amoxicillin 500mg PO TID x 10 days
  15. 2nd line Sinusitis Rx
    Clavulin, Cefprozil, Septra, Macrolide
  16. Bronchitis Rx
    • Nothing! Viral
    • No CXR as little utility in differing b/w mild pneumonia vs bronchitis
    • If decide to Rx: macrolide (ie if >14 d Sx, ill)
  17. 2 Rx of macrolides for bronchitis
    • Clarithromycin(Biaxin) 500mg BID x 7d
    • OR Azithromycin 500mg x 1d, then 250mg PO OD x 4d
  18. AECOPD (w simple COPD) 1st line drug choices
    Amoxil, Cefuroxime (Ceftin), Clarithro, Doxycycline, Septra, Azithro
  19. AECOPD simple Rx
    • Amoxicillin 500mg TID x 7d
    • Ceftin (cefuroxime) 500mg BID x 7d
    • Clarithro(Biaxin) 500mg BID x 7d
    • Azithro 500mg x 1d, then 250mg PO OD x 4d
  20. Pneumonia Rx (kids < 5yrs)
  21. Pneumonia Rx (kids > 4/5 yrs)
    Amoxil + Macrolide for atypical coverage
  22. Rx Pneumonia kids
    • Clarithro(Biaxin) 15mg/kg divided BID x 7-10d
    • Azithromycin 10mg/kg DIE x 1d, then 5mg/kg/d DIE x 4d
  23. CAP Rx for inpatient adults
    • 2nd generation cephalosporin + macrolide
    • or 2nd gen ceph + quinolone
  24. Cellulitis Rx 1st line
    • Keflex or Duracef
    • Keflex 500mg q6h x 7-10d
    • Duracef (cefadroxil) 500-1000mg PO BID
  25. 2nd line Cellulitis Rx
  26. UTI Rx - 1st line drugs
    Fluroquinolones or Sulphas - 3 days
  27. Other UTI drugs that take 7 days
    Nitrofurantoin, Clavulin, Cephadroxil
  28. Rx UTI uncomplicated
    • Cipro 250mg PO BID x 3 days OR
    • Septra DS 1 tab PO BID x 3 days (increasing R)
  29. Others
    • Levofloxacin 250mg PO OD x 3 days
    • Nitrofurantoin (Macrobid) 100mg PO q12h x 7d
    • Clavulin 250mg PO q8h x 7days or 500mg q12h x 7d
  30. Oral Rx acute pyelonephritis or complicated UTI
    • Cipro 500mg PO q12h x 14d (7d if young women without anatomic abN)
    • or Levofloxacin 500mg q24h x 14d (or 7d "")
  31. IV Rx for acute peel (ie vomiting, pregnant)
    • Ciprofloxacin 400mg IV BID x 14d
    • or Levofloxacin 500mg IV DIE x 14d
    • or Aminoglycoside + Ampicillin
  32. Rx C difficile
    • Metronidazole 500mg PO TID x 10d (skip this at JGH)
    • OR Vanco 125mg Po QID x 14d (can go up to 500mg QID)
  33. Sore Throat Score (McIsaac) - 5 criteria
    • 1 point for each:
    • Temp >38 C
    • Absence of cough
    • swollen, tender anterior cervical nodes
    • Tonsillar swelling or exudate
    • Age 3-14 (0 for 15-44, -1 for ≥45 yrs)
  34. At which sore throat scores do you not treat or do culture?
    1 or less - 10% chance
  35. At which sore throat scores do you culture first and only Rx if positive?
    Score of 2 or 3 = 11-35% chance - Culture or Rapid Ag test 1st
  36. At which sore throat score do you treat?
    4+ = 51-53% chance. start Rx. If you do culture and is -ive then stop Rx.
  37. When should the sore throat score not be used?
    • Test already positive in office - treat!
    • Epidemic or in populations with rheumatic fever still a problem (first nations) or ppl with Hx of Rheumatic fever, valvular heart disease
  38. When should you still culture despite a negative Rapid Strep antigen test?
    For children a Culture is still required. For adults, a negative antigen test is enough.
  39. What % of population is a carrier for Grp A Strep?
    • 20%. Culture then during an ASx period to determine their carrier status.
    • Only Rx then if outbreak in community/household
  40. What are some pharyngitis warning signs?
    Significant trouble swallowing, drooling, altered 'hot-potato' voice or stridor - epiglottitis, peritonsillar abscess or retropharyngeal abscess until proven otherwise!
Card Set
Antiobiotic doses.txt
Antiobiotics guidelines for infectious disease