Bugs & Drugs
Three agents that cover pseudomonas
What is
-Pip/tazo
-cefepime, ceftaz, ceftaz/avibactam, ceftolozane/tazobactam
-carbapenems (except Erta)
-cipro, levo
-aztreonam
-AGs
-colistimethate, polymyxin B
The identifying risk factors for MRSA or MDR pathogens
what is positive MRSA nasal swab, high prevalence of resistant pathogen noted in hospital unit, IV antibiotic use within past 90 days
The symptoms of pyelonephritis
What is flank pain, abdominal pain, n/v, fever and malaise
What 4 drugs are preferred to treat the intensive phase regimen in Active Tb?
R-rifampin
I-isoniazid
P-pyrazinamide
E-ethambutol
The most common side effect of Flagyl
What is metallic taste
What is azithromycin, doxycycline, quinolones
also: clarithromycin, minocycline
The respiratory fluoroquinolones
What is moxifloxacin, gemifloxacin, levofloxacin
The drugs of choice for acute uncomplicated cystitis (NKA)
what is
nitrofurantoin (Macrobid) 100 mg po BID x 5 days (C/I if CrCl <60 mL/min)
or
SMX/TMP DS 1 tablet po BID x 3 days (not w/ sulfa allergy or >/= 20% E. coli resistance)
or
fosfomycin 3 g x 1 dose
The preliminary gram stain comes back as gram positive cocci in chains. What potential organisms could be present
What is
-strep pneumoniae
-streptococcus spp.
-enterococcus spp.
The populations to avoid doxycycline in
What is
children <8 yrs, pregnancy, and breastfeeding (suppresses bone growth, skeletal development, and permanently discolors teeth)
Ertapenem does not cover
The outpatient CAP treatment for a patient with no comorbidities
What is
amoxicillin high-dose (1 g TID) or
doxycycline or
macrolide (azithromycin or clarithromycin) if local pneumococcal resistance is <25%
The fluoroquinolones that should be avoided for UTIs and why
what is moxifloxacin (does not reach high levels in the urine) or gemifloxacin (limited activity against normal UTI pathogens)
The presenting features of lyme disease
what is
bullseye rash (round, red), achy joints, fever
bonus: treatment is doxycycline 10 mg BID (PO/IV)
The cephalosporin that can cause disulfiram reactions with alcohol ingestion
What is cefotetan (side chain)
Aztreonam does not cover
what is gram positive bacteria or anaerobes
The outpatient CAP treatment for a patient with comorbidities
What is
Beta-lactam + macrolide or doxycycline
-Augmentin or cephalosporin + macrolide or doxy
or
respiratory FQN monotherapy
The drugs of choice in a patient who has bacteriuria (asymptomatic) and pregnant
What is amoxicillin +/- clavulanate
or
po cephalosporin
if allergy to beta lactams:
Bactrim (avoid in 1st trimester)
nitrofurantoin (avoid in 3rd trimester)
The treatment of choice for a patient that just got back from an international trip who presents with sudden onset of loose stools, abdominal cramps/pain, dysentery (bloody diarrhea).
what is azithromycin 1g po x 1 dose or 500 mg po daily x 1-3 days
The cephalosporin to avoid in neonates
What is ceftriaxone
The only beta-lactam that is active against MRSA
The empiric regimen for patient with HAP, MRSA nasal swab positive, but low risk for MDR pathogens
What is cefepime + Vanco
(choose 2 abx, 1 for MRSA, 1 for pseudomonas)
The class of drugs used to treat UTIs that should be avoided in pregnancy and why
What is quinolones, cartilage toxicity and arthropathies
The patient is a pregnant female with syphilis and a PCN allergy. What are the 3 steps to follow per the CDC.
what is
per the CDC:
1. confirm allergic reaction with a skin test
2. desensitize pt with an approved desensitization protocol
3. treat with IM penicillin G benzathine (Bicillin L-A)
The number one drug interaction to be aware of in carbapenems and why
What is valproic acid. Can cause decrease in serum concentrations of valproic acid, leading to loss of seizure control