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Infxs Disease Tx 1

Infectious Disease

Lyme dz tx adult: doxy; kids: ceftriaxone
Empiric treatment for bacterial meningitis begin Abx immediately (ceftriaxone or cefotaxime 2 g IV and vanc; add ampicillin for pts <3months & >55 and/or immunocomp
Meningitis: add to empiric therapy if HSV is suspected: acyclovir
Bacterial meningitis: give concurrently with empiric Abx: dexamethasone, continue for 4 days
supportive care for bacterial meningitis hydration, pain meds, anticonv, antiemetics
meningitis bugs: >50 yo / EtOH SP, listeria; tx = amp + rocephin + vanc + dex
meningitis tx: 1 - 3 mos Amp + (rocephin or cefotaxime) + Dex
meningitis tx: 3 mos - 50 yo (rocephin or cefotaxime) + vanc (if >1 mo. old) + Dex (add Amp for listeria)
Meningitis: EtOH / impaired immune Amp
post exposure prophylaxis for meningitis PEP = rifampin for household contacts/droplet exp only; alts = cipro or rocephin
meningitis tx: hosp-acquired (or post-neurosurg) or immunocompromised: amp + ceftazidime + vanc
brain abscess tx PCN +/- chloramphenicol +/- flagyl; if SA suspected, add nafcillin
Furuncle/carbuncle tx mild: oral dicloxacillin or ceph; severe: IV ceph
Mastitis: No MRSA Dicloxacillin or Keflex
Mastitis: MRSA possible TMP-SMX or clinda
Otitis externa drops (polymyxin B + neomycin + hydrocortisone) + Se sulfide shampoo
Otitis media Amox; if Abx in past month: Aug or cefdinir/cefpodoxime
Internal hordeolum Dicloxacillin; TMP-SMX-DS if MRSA-CA
Orbital cellulitis nafcillin 2 gm IV; if MRSA: vanco 1 gm IV + Rocephin 2 gm IV + Flagyl 1 gm IV
Advanced generation macrolide azithromycin or clarithromycin
Labs for hemochromatosis ferritin, iron sat, HFE gene
Malaria prophylaxis Chloroquine
1st gen Ceph Duracef, Keflex, cephalothin, cephazolin
2nd gen Ceph cefuroxime
3rd gen Ceph Omnicef, Suprax, Rocephin, fortaz, cefotaxime, cefpodoxime
4th gen Ceph Cefclidine, Cefepime (Maxipime), Cefrom
1st gen Ceph efficacy: GP: MSSA/MSS strep; not vs MRSA/strep; GN: PEcK (Prot, e coli, Klebs)
Cefuroxime efficacy: No GP; GN: HEN (H flu, Enterobacter aerogenes, some Neisseria )+ PEcK; >Gen1
Created by: Adam Barnard Adam Barnard