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What is meningitis?
- inflammation of the meninges identified by abnormal number of WBC in cerebrospinal fluid
- (Caused by gram(+) and (-) organisms)
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Whats the tx. for meningitis in newborn to 1month old?
what bugs?
- ampicillin and aminoglycoside, cefortaxime, or ceftriaxone
- bugs:gram(-)e.coli, group b strep, or listeria
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Whats the tx. for meningitis in 1month to 60 years old ?
what bugs?
- cefotaxime or ceftriaxone plus vancomycinbugs:haemophilus, neisseria, or streptoc. pneumoniae
- (30-60years old does not include haemophilus)
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Whats the tx. for meningitis adults >60 years old?
bugs?
- cefotaxime, ceftriaxone, or ampicillin
- and amnioglycoside-vancomycin
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What is endocarditis?
- infection of endocardium, membrane lining the heart chambers and valves
- most common bugs are streptococcus and staphylococcus
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Whats the drug tx. for endocarditis in pt. with penicillin susceptible streptococci?
- penicillin G alone (4weeks)
- penicillin G with gentamicin (2 weeks)
- ceftriaxone alone (4 weeks)
- vancomycin (if allergic to penc.) (4 weeks)
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Whats the drug tx. for endocarditis in pt. with streptococci relatively resistant to penicillin?
- penicillin G alone (4weeks)
- penicillin G with gentamicin (2 weeks)vancomycin (if allergic to penc.) (4 weeks)
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Whats the drug tx. for endocarditis in pt. with streptococcus without prosthetic material (methicillin sensitive)?
- nafcillin or oxacillin(3-5days of gentamycin may be added) (4-6weeks)
- cafazolin(with or without gentamicin) (4-6weeks)
- vancomycin(if allergic to penc) (4-6weeks)
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Whats the drug tx. for endocarditis in pt. with streptococcus without prosthetic material (methicillin resistant)?
vancomycin (4-6weeks)
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What are the causative agents of acute or chronic bronchitis?
mycoplasma, streptoc.pneumoniae, haemophilus,moraxella and chlamydia.
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Whats the tx. of acute bronchitis?
macrolides (erihromycin, clarihromycin, and azihromycin) for 7-10days
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Whats the tx. of chronic bronchitis?
amoxicillin, augmentin(amoxicillin and clavulanate), bactrim, macrolides, doxycycline, cefuroxime, cefaclor, or cefprozil
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Whats the tx. of adult community acquired pneumonia(inflammation of lungs)?
bugs?
- oral macrolide(azithromycin, clarithromycin, or erythromycin)
- or FQ (levofloxation, gatifloxacin, or moxifloxacin)
- bugs:streptoc.pneumoniae, haemophilus,klebsiella, m.pneumoniae
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Whats the tx. of adult community acquired pneumonia for a hospitalized pt.?
- cefotaxime or ceftriaxone with or without macrolide
- or FQ alone (levofloxacin, gatifloxacin,moxifloxacin)
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Whats the tx. of hospital acquired pneumonia?
bugs?
- aminoglycoside(tobramycin, amikacin, gentamicin) PLUS cefotaxime, ceftriaxone, cefepime, ticarcillin-clavulanic acid, piperacillin-tazobactam, meropenem or imipenem
- vanco may be added if staph.aureus suspected
- bugs:klebsiella,enterobacter,serratia,acinetobacter , staph.aureus
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Whats the tx. of tuberculosis (mostly caused by mycobacterium TB)?
- Latent: Isoniazid (9mo.)
- Latent isoniazid resistant: rifampin and pyrazinamide (2mo.)
- Active: Isoniazid and rifampin and pyrazinamide (2-4mo)
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What are the bugs that cause skin and soft tissue infections?
- streptococcus and staphylococcus
- possibly aerobic and anaerobic organisms
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What drugs are used to treat cellulitis?
- usually caused by staphyloc.aureus
- outpatient: dicloxacillin,cefadroxil,cephalexin,erythromycin
- in-pt:cefazolin, erythromycin
- severe case: vancomycin
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What is the tx. of diabetic foot infections?
- clindamycin or cephalexin
- severe cases:ticarcillin-clavulanic acid or other beta-lactamase inhibitor
- vanco may be added if MRSA suspected
- bugs:anaerobic streptoc.,e.coli,s.aurous,b.fragilis
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Whats the usual tx. for UTI?
bactrim or FQ for 3 days(acute infection)
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Whats the tx. for pyelonephritis?
- FQ for 14days or bactrim for 14days
- (if severe paranteral therapy with FQ and extended-spectrum penicillin plus aminoglycoside should be added)
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Whats the tx. for prostatitis?
- FQ for 4-6wks.
- or Bactrim for 4-6wks.
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