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Infxs Disease Tx 2

Infectious Disease

3rd gen Ceph efficacy: GN: Broad spectrum, esp hosp acquired; meningitis (pneumococci, meningococci, H flu, some E coli/Klebs); ceftriaxone / cefixime for NG
4th gen Ceph efficacy: GP: MSSA/MSS strep; not vs MRSA/strep; GN: exp beta-lactamase, meningitis, pseudomonas
5th gen Ceph (Ceftobiprole, Ceftaroline) efficacy: Antipseudomonal
Cryptococcus tx HIV: PO fluconazole x10 wks, OR Ampho B x 2ks & fluconazole lifelong; non-HIV: ampho B (higher mortality)
Pneumocystis (PCJ) tx TMP-SMX (alt: dapsone, pentamidine); steroids if PaO2 <70 mmHg
Ppx for Pneumocystis is recommended for: pts with CD4 <200; TMP-SMX
tetanus tx IM IG; post recovery, full tetanus toxoid; PCN; DTaP/TDaP booster q 10 yrs
Tetanus IG: give if: pt has dirty wound & imms hx unknown, OR not fully immunized (ie, received <3 doses)
Tetanus toxid: give if: 1) pt’s tetanus imms hx unknown or got <3 doses; 2) wound is >24 hrs old; 3) pt’s last booster was >5 yrs (if dirty wound) or >10 yrs (if clean wound)
Diphtheria tx serum antitoxin; airway (poss membrane removal via laryngoscopy); PCN or erythro/zithro; test of cure
HSV tx antivirals (acyclovir, valcyclovir); trifluridine for HSV keratitis; Foscarnet for immunocompromised pts
CMV tx ganciclovir, valganciclovir, foscarnet, cidofovir
Histoplasmosis tx Itraconazole (wks to mos); ampho B if cannot tolerate or meningitis
RMSF tx doxycycline or chloramphenicol hastens recovery; poorer outcomes in older pts (usu 2/2 pneumonitis or resp failure)
Severe Rhinosinusitis tx Augmentin; macro or ceph
Monobactams w/antipseudomonal action = Imipenem & meropenem
PCNs MOA: inhibit peptidoglycan cross linking
Aminoglycoside MOA prevent mRNA translation into proteins
Glycopeptides (vancomycin, daptomycin) MOA inhibit peptidoglycan cross linking (Gram pos orgs only)
FQs MOA inhibit bacterial DNA gyrase
macrolides MOA bind to 50S ribosome (interfere w/protein synthesis)
Oxazolidinones MOA inhibit protein synthesis at 50S ribosomal subunit
macrolides: effective against: GPC, some anaerobes (NOT Bacteroides), mycoplasma, chlamydia
Flagyl MOA accepts electrons under anaerobic conditions => metabolite toxic to bac DNA
tetracyclines MOA locking tRNA to septal site of mRNA (thus interfere w/pro synthesis)
SMX-TMP MOA inhibit synthesis of tetrahydrofolate
MRSA (cellulitis) tx Vanco +/- rifampin, gentamicin, linezolid
Non-gono arthritis: gram neg: tx ceftazidime or genta; IV 2wks & po 4 wks
Created by: Adam Barnard Adam Barnard