CAP
what are the 2 most common organisms causing CAP?
Strep.pneumo and H.influ
Define VAP
pneumonia occurring >48 hours after endotracheal intubation
which is more dangerous sub-acute infective endocarditis or acute infective endocarditis and why?
acute infective endocarditis; damage to cardiac structures very raid and has highly virulent organisms
what are the two criteria for community acquired IAI
- patient presents with infection to the hospital
- infection presents <48 hours following hospitalization
main organism causing fungal infection
Candida albicans
What is the main parthenogenesis mechanism of CAP
organisms expected for early onset HAP (2-5 days) give at least 2
S.pneumo, H.influ, S.aureus, G(-) bacilli
surgery options for infective endocarditis
valvectomy or valve replacement
most common pathogens causing IAI
E.coli
Bacterioides species
Coccidioidomycosis DOC?
Amp B
What PSI score indicats hospitalization of a patient
III: 71-90 (brief inpatient)
IV: 91-130 inpatient
V >130 Inpatient
duration of HAP and VAP therapy (generally)?
7 days for both
Synergy therapy for enterococcus caused endocarditis
Penicillin/ampcillin + gentamicin/streptomycin
First line Intra-abdominal candidiasis treatment
Fluconazole
signs and symptoms of pulmonary aspergillosis (main 3)
- pleuritic chest pain and friction rubs
- fever
- hemoptysis
what drug would you administer to a healthy adult without comorbidities or risk factors for antibiotic resistant pathogens?
or
- Doxycycline 100 mg BID
when is combination therapy indicated for HAP with (+) cultures for Pseudomonas
patients with septic shock/high risk of death with unknown susceptibilities
Oxacillin resistant native valve endocarditis treatment options?
daptomycin or Vancomycin
what C.diff infection indication includes potential surgical evaluation
Fulminant Colitis
oral pharyngeal candidiasis topical treatment options
clotrimazole or Nystatin
recommended therapy for severe CAP
Beta lactam + macrolide (strongest evidence)
Empiric antibiotic therapy for HAP with High mortality risk or receipt of IV antibiotics within 90 days
2 of the same broad spectrum agents + Vanc or linezolid
what are the HACEK organisms
H: haemophilus parainfluenza/aphrophilus
A: aggregatibacter spp
C: cardiobacterium hominis
E: eikenlla corrodens
K: kingella kingae
what infection do you avoid antibiotics in?why?
Shiga toxin producing E.coli, antibiotic administration can cause hemolytic uremic syndrome (antibiotics kill bacteria causing release of toxins)
AMbisome dose
3-5mg/kg/day