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FNP~EENT 2

Empiric ABX therarpy...AOM, ABRS

QuestionAnswer
S. pneumoniae is the most common bacterial pathogen in ... ABRS, AOM, CAP...it is the treatment target in AOM...Rare )~10% spontaneous resolution in AOM
H. influenzae is a common pathogen in... ABRS, AOM, CAP, particularly with recurrent infection, tobacco users; 50% spontaneous resolution in AOM
N, catarrhalis is less common pathogen and rare in ... ABRS, AOM...CAP; 90% spontaneous resolution in AOM
Adults with mild disease and no prior antimicrobial use in the past 4-6 weeks should be given 1st line treatment of... Amoxicillin (1.5-4g/d)~~or~~Augementin (1.75-4g/250mg/d)
Adults with mild disease and no prior antimicrobial use in the past 4-6 weeks should be given 2nd line treatment of_________if NO improvement after 72 hours Augmentin 4g/d~~or~~Respiratory fluroquinolone such as Levaquin or Avelox
Adults with mild disease and b~lactam allegy and NO prior antimicrobiial use in the past 4-6 wks should be given 1st line of... Bactrim (DRSP, H. influenzae tx failure risk)~~or~~Doxycycline (DRSP tx failure risk)~~or~~Zitrhomax, Biaxin, Macrolides (**2nd line only if allergy)
Adults with mild disease and a hx of prior antimicrobial use in the past 4-6wks~~or~~adults with moderate dz with or without prior antimicrobial use Levofloxacin or moxifloxacin~~or~~ HD Augmentin ~~or~~ Rocephin ~~or~~ Clindamycin w/ Rifampin
Mild ABRS, (-) allergies, no recent Abx use should be given... Amoxicillin (kills Strep Pneumoniae)
Mild ABRS, allergic to PCN should be given... Bactrim, Doxy or Zithromax
Mild ABRS + recent Abx use or Mod ABRS should be given... Levaqui or Augmentin
Mild ABRS + recent antibx use + PCN allergy should be given... Levaquin
Definition of a "substrate"... The surface or material on or from which an organism lives, grows, or obtains its nourishment.
Definition of an "inhibitor"... blocks the activity of an isoenzyme, limiting substrate secretion (increase of med in system)
Definition of an "inducer"... accelerates the activity of the isoenzyme so that substrate is pushed out (reduction of med in system)
Clinical example of "substrate"... CYP 450...Viagra, Effexor, Xanax
Clinical example of "inhibitor"... CYP 450..Erythro~, Clarithro~
Clinical example of "inducer"... CYP 450...St. John's wort
Created by: KimmiNP
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