TREATMENT FOR CNS AND RESPIRATORY TRACT INFECTIONS - DR. POGUE)

What is the best therapy for the treatment of bacterial meningitis?

True or false. Beta-lactams are the mainstay agent for the treatment of bacterial meningitis.
True False

Which anitbiotics are the most sufficient at penetrating the blood-brain-barrier and blood-CSF-barrier?

A 3-day old infant has contracted bacterial meningitis. How should you treat this infant?

A. meropenem
B. amoxicillin/clavulanic acid
C. vancomycin + ceftriaxone
D. ampicillin + gentamycin

What are the 3 most common causative agents for bacterial meningitis in an infant that is less than 1 month old?

A 6-month old infant presents with a fever, irritability, poor feeding and a bulging fontanel. You suspect bacterial meningitis. What is your first-line of treatment?

A. oseltamivir (Tamiflu)
B. vancomycin + ceftriaxone
C. TMP/SMX
D. ampicillin + gentamycin

What are the 3 most common causative agents for bacterial meningitis in persons 1 to 23 months of age?

A 21-year old college student presents with a fever, stiff neck, mental status change and a petechial rash. He is later diagnosed with bacterial meningitis. What is the best drug treatment for this patient?

A. ciprofloxacin
B. clindamycin
C. ampicillin + cefotaxime
D. dexamethasone + vancomycin + ceftriaxone

What is the rationale behind giving a patient with bacterial meningitis a corticosteroid prior to the first antibiotic dose?

A 62-year old man has developed bacterial meningtitis. He has a fever, stiff neck, mental status change, but no rash, and he does not have a history of dementia or Alzheimer's disease. His wife tells you that he has a penicillin allergy. What is the best treatment for him?

A. Ampicillin + gentamycin
B. TMP/SMX
C. nothing, he will clear the infection on his own
D. vancomycin + cephalosporin

In what age group is a bacterial meningitis infection caused by Listeria monocytogenes the most likely? What is the drug of choice to fight this infection?

The use of _____ to treat bacterial meningitis in neonates should be avoided.

What is the best drug treatment for prophylaxis of bacterial meningitis that is caused by N. meningitidis?

A. ciprofloxacin in 1 dose
B. high dose of ceftriaxone
C. amphotericin B + flucytosine for 2 weeks then fluconazole for 8 weeks
D. high dose of ampicillin

An HIV-patient comes in your office and presents with a headache, fever, neck stiffness and photophobia. You suspect bacterial meningitis caused by Cryptococcus neoformans. How would you go about treating this patient?

A. ciprofloxacin in 1 dose
B. ceftriaxone IM
C. amphotericin B + flucytosine for 2 weeks then fluconazole for 8 weeks
D. high dose of fluconazole only

True or false. The vast majority of acute bronchitis infections are bacterial.
True False

What are the 3 best treatment options for Pertussis (Whooping cough)?

True or false. Influenza is easily treated with antivirals.
True False

What are the 5 most common pathogens associated with COPD exacerbation?

A 52-year old woman comes into your office presenting with a mild case of COPD exacerbation most likely caused by S. pneumoniae. How would you treat her?

A.  Tell her to go home, there's nothing you can do
B. amoxicillin
C. albuterol
D. tigecycline

A 16-year old boy comes into your office complaining of a high fever, purulent nasal discharge and facial pain that has persisted for more than 4 days. You suspect bacterial sinusitis. How would you treat him?

A. Tell him to toughen up and take it like a man!
B. oseltamivir (Tamiflu)
C. amoxicillin/clavulanic acid
D. ciprofloxacin
E. ampicillin

"The Big 6" pathogens that are most commonly involved in community-acquired bacterial pneumonia are:

How would you treat a community-acquired pneumonia out-patient who is previously healthy and has no risk for drug-resistance?

An immunosuppressed patient presents with community-acquired pneumonia that is caused by S. pneumoniae. They do not have any known drug allergies and are not resistant to any drugs. What is the best outpatient therapy for this patient?

A. metrodinazole
B. ceftriaxone + azithromycin
C. penicillin + azithromycin
D. vancomycin

How would you treat a community-acquired pneumonia in-patient who is in the ICU with a concern for MRSA?

How would you treat an outpatient with aspiration pneumonia?

How would you treat an inpateint with aspiration pneumonia?

_____ (2 words) and _____ (2 words) are the main pathogens of concern for HAP/HCPP/VAP respiratory tract infections.

Empiric therapy for HAP/HCPP/VAP respiratory tract infections is:

True or false. When treating HAP/HCPP/VAP respiratory tract infections, it is best to find the most narrow spectrum agent as possible.
True False

A patient in the hospital has contracted nosocomial pneumonia. The pathogen that is responsible is Stenotrophomonas maltophilia. What is the drug of choice to use in order to treat this patient?

Cystic fibrosis patients have an extremely _____  (2 words) rate for antimicrobials. Because of this, we generally consider the ______ dose possible for treatment.