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GPC: Staphylococci and Streptococci
The Best intial Tx for G(+) orgs are:
- Oxacillin, cloxacillin, dicloxacillin, nafcillin
- 1st gen ceph: Cefazolin, cephalexin
- Fluoroquinolones
- Macrolides-- are 3rd line bc < efficacy than oxacillin or ceph...
- - Erythromycin is also > toxic
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Oxacillin (Methicillin)-Resistant Staphylococcus
best tx with:
- Vancomycin
- Linezolid: :( reversible BM-toxicity
- Daptomycin: :( elevated CPK
- Tigecycline
- Ceftaroline
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Minor MRSA skin infxn
Tx w:
- TMP/SMX
- Clindamycin
- Doxycycline
- Linezolid
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Anaerobes Tx w:
- Oral (above diaphragm)
- - PCN (G, VK, ampicillin, amoxicillin)
- - Clindamycin
- ABD/GI (below diaphragm)
- - Metronidazole, beta-lactam/lactamase combo
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GNB
(E. coli, Kleb, Proteus, Pseudomonas, Enterobacter, Citrobacter)
Infxn of bowel (peritonitis, diverticulitis); UTI (pyelonephritis); and liver (cholecystitis, cholangitis)
- Quinolones
- Aminoglycosides
- Carbapenems
- Piperacillin, ticarcillin
- Aztreonam
- Cephalosporins
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A man is admitted with E. coli bacteremia. What is the most appropriate therapy?
- choice of
- quinolones, aminoglycoside, carbapenem, piperacillin, ticarcillin, or aztreonam
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