What are the 4 best treatment regimens for nosocomial (hospital-acquired) abscesses, ruptured bowel or cholangitis, and why is there a need to use these vs. comunity-acquired abscesses, ruptured bowel or cholangitis?
cefepime w/ metrodinazole
piperacillin/tazobactum
carbapenem
fluoroquinolones w/ metrodinazole
Expanded coverage for P. aeruginosa!
True or false. Acute cholecystitis is often an inflammatory condition, not an infectious one.
True
What is the suggested duration of therapy for intra-abdominal infections?
4-7 days; may d/c if there is a resolution of clinical signs/symptoms
What is the initial step in the treatment of infectious diarrhea?
rehydration
What is the best treatment option for infectious diarrhea caused by Salmonella? Duration of treatment?
Ciprofloxacin (FQ) although not routinely recommended for treatment; 5-7 days (longer for immunocompromised patients)
What is the best treatment option for infectious diarrhea caused by Shigella? Duration of treatment?
Ciprofloxacin (FQ); 3-5 days (longer for immunocompromised patients)
What is the best treatment option for infectious diarrhea caused by E. coli? Duration of treatment?
Ciprofloxacin (FQ); 3 days
What are the 2treatment options for infectious diarrhea caused by Aeromonas?
Bactrim (TMP/SMX)
Ciprofloxacin (FQ)
What is the best treatment option for infectious diarrhea caused by V. cholera? Duration of treatment?
Doxycycline (tetracycline); 3 days
What is the best treatment option for C. difficile diarrhea? Duration of treatment?
Metronidazole; 10-14 days
What is one of the side effects of nitazoxanide and which organism does it target in GI infections?
Diarrhea; Giardia
True or false. Ciprofloxacin can be used to treat Giardia GI infections.
False,fluoroquinolones are not effective.
What new drug was released in 2011 for the treatment of C. difficle diarrhea? What is its mechanism of action?
Fidaxomicin; inhibits RNA synthesis by inhibiting RNA polymerases
What is the best treatment option for HBV? What other types of meds are used?
IFN-alpha; HIV meds
What is the mechanism of action for IFN-alpha? and what 2 forms does it come in?
inhibition of viral protein synthesis, viral penetration (and/or uncoating) and boost of immune system; SubQ or IM
What is the most important psychological side effect of IFN-alpha?
Severe depression
What is the best combo treatment option for HCV? What is the mechanism of action? Most common side effects?
IFN-alpha w/ ribavirin; inhibition of viral RNA synthesis by mimicking guanine; hemolytic anemia and renal toxicity
What is the most recent addition to HCV therapy and what is its most common adverse drug effects?
protease inhibitors; avoid in liver failure (CYPA4/5 inhibitor and metabolite)