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ID Final Review
Rapid Review
| Question | Preferred Treatment | "Second-Line" Treatment |
|---|---|---|
| What is the treatment for gonorrhea if the patient is 90 kg? | Ceftriaxone 500 mg IM x 1 dose | |
| What is the treatment for primary syphilis? | Benzathine PCN G 2.4 million units IM x 1 dose | |
| What is the alternative for primary syphilis? | Doxycycline 100 mg PO BID x 14 days | |
| What is the treatment for late latent syphilis? | Benzathine PCN G 7.2 million units (divided into 3 doses of 2.4 million units) | |
| What is the alternative for late latent syphilis? | Doxycycline 100 mg PO BID x 28 days | |
| What is the treatment for gonorrhea and chlamydia coinfection if the patient is 90 kg? | Ceftriaxone 500 mg IM x 1 dose + Doxycycline 100 mg PO BID x 7 days | |
| What is the treatment for gonorrhea and chlamydia coinfection for a pregnant patient (90 kg)? | Ceftriaxone 500 mg IM x 1 dose + Azithromycin 1 gram PO x 1 | |
| What is the empiric treatment for acute bacterial meningitis? | Vancomycin + Ceftriaxone +/- Ampicillin +/- Dexamethasone | |
| What is the treatment for strep pneumoniae meningitis if PCN susceptible? | Penicillin or Ampicillin x 10-14 days + Dexamethasone x 4 days (adults only) | |
| What is the treatment for strep pneumoniae meningitis if PCN intermediate? | Ceftriaxone 2g IV x 10-14 days + Dexamethasone x 4 days (adults only) | |
| What is the treatment for strep pneumoniae meningitis if PCN resistant? | Ceftriaxone 2g IV x 10-14 days + Vancomycin + Dexamethasone x 4 days (adults only) | |
| What is the treatment for Neisseria meningitis if PCN < 0.06 mg/L? | PCN continuous infusion x 7 days | |
| What is the treatment for Neisseria meningitis if PCN > 0.05 mg/L? | Ceftriaxone 2 g IV x 7 days | |
| What is the treatment for H. influenzae meningitis if beta lactamase (+)? | Ceftriaxone 2 g IV x 7 days + Dexamethasone x 4 days (1 month - 13 years only) | |
| What is the treatment for H. influenzae meningitis if beta lactamase (-)? | Ampicillin x 7 days + Dexamethasone x 4 days (1 month - 13 years only) | |
| What is treatment for Listeria meninigitis? | Ampicillin x 21 days (at least) AND Gentamicin x 10 days | |
| What is the treatment for acute bacterial meningitis prophylaxis? | Rifampin 600 mg PO q 12 h x 2 days | |
| What is the treatment for acute bacterial influenzae meningitis prophylaxis (1 month - 12 years)? | Rifampin 20 mg/kg/day x 4 days | |
| What is the treatment for acute bacterial influenzae meningitis prophylaxis? | Rifampin 600 mg daily PO x 4 days | |
| What is the first-line treatment for cystitis UTI? | Bactrim 160/800 mg q 12 h x 3 days | |
| What is the first-line treatment for pyelonephritis UTI? | Ciprofloxacin 500 mg q 12 h x 7 days | Levofloxacin 750 mg PO x 5 days |
| What is the first-line treatment for pyelonephritis UTI if FQ resistance is < 10%? | Bactrim 160/800 mg q 12 h x 7 days | |
| What is the alternative treatment for cystitis UTI? | Augmentin 500/125 mg PO q 8 h x 5-7 days | |
| What is the alternative treatment for pyelonephritis UTI? | Augmentin 875/125 mg PO q 12 h x 7 days + Ceftriaxone 1g IM x 1 dose | |
| What is the first-line treatment for cystitis UTI if sulfonamide resistance is > 20%? | Macrobid 100 mg q 12 h x 5 days | |
| What is the first-line treatment for ESBL cystitis UTI? | Fosfomycin 3-gram packet x 1 dose | |
| What is the treatment for acute prostatitis? | Ciprofloxacin x 2-4 weeks | Bactrim DS x 2-4 weeks |
| What is the treatment for chronic prostatitis? | Levofloxacin x 6-12 weeks | |
| What is the treatment for chlamydia? | Doxycycline 100 mg PO BID x 7 days | Azithromycin 1 g x 1 dose preferred for pregnancy |
| What is the treatment for bacterial vaginosis? | Metronidazole 500 mg PO BID x 7 days | Clindamycin 2% cream x 7 days |
| What is the alternative treatment for bacterial vaginosis? | Clindamycin 300 mg PO BID x 7 days | Clindamycin ovules intravaginally nightly x 3 |
| What is first-line treatment for pharyngitis? | PCN VK x 10 days | Amoxicillin x 10 days |
| What is first-line treatment for pharyngitis if the patient has type I PCN allergy? | Azithromycin x 5 days | Clindamycin x 10 days (C.diff) |
| What is first-line treatment for pharyngitis if the patient has type IV PCN allergy? | Cephalexin x 10 days | |
| What is first-line treatment for acute otitis media? | Amoxicillin 90 mg/kg/day divided in 2 doses | Augmentin |
| What is the treatment for acute otitis media if not improved after 2-3 days (treatment failure)? | Augmentin (if not used) or Ceftriaxone 50 mg/kg IM x 3 days | |
| What is the treatment for acute otitis media if the patient has a mild PCN allergy? | Cefdinir 14 mg/kg | Ceftriaxone 50 mg/kg IM x 1-3 days |
| What is first-line treatment for acute otitis media if < 2 years? | Amoxicillin 90 mg/kg/day divided in 2 doses x 10 days | |
| What is first-line treatment for acute otitis media if 2-5 years? | Amoxicillin 90 mg/kg/day divided in 2 doses x 7 days | |
| What is first-line treatment for acute otitis media if > 6 years? | Amoxicillin 90 mg/kg/day divided in 2 doses x 5-7 days | |
| What is the treatment for acute rhinosinusitis if the patient has an PCN allergy? | Doxycycline x 5-7 days | |
| What is the first-line treatment for acute rhinosinusitis? | Amoxicillin x 5-7 days | |
| What is the pediatric (1-18 years) treatment for acute bronchitis? | Honey | |
| What is the treatment for infective endocarditis dental prophylaxis? | Amoxicillin 2 g PO 30-60 min before procedure | |
| What is the treatment for an initial episode of CDI? | Fidaxomicin 200 mg PO BID x 10 days | |
| What is the alternative treatment for an initial episode of CDI? | Vancomycin 125 mg PO QID x 10 days | |
| What is the alternative non-severe treatment for an initial episode of CDI? | Metronidazole 500 mg PO TID x 10-14 days | |
| What is the treatment for the first reoccurrence of CDI if metronidazole was used as the initial treatment? | Vancomycin 125 mg PO QID x 10 days | |
| What is the treatment for the reoccurrences of CDI? | Fidaxomicin 200 mg PO BID x 10 days | Vancomycin taper with pulse therapy |
| What is the treatment for fulminant CDI? | Vancomycin 500 mg PO QID | |
| What is the treatment for fulminant CDI if ileus present? | Vancomycin (rectal) + Metronidazole 500 mg IV q 8 h | |
| What is the preferred treatment for watery diarrhea (ETEC)? | Ciprofloxacin | |
| What is the preferred treatment for watery diarrhea (vibrio cholerae 01)? | Doxycycline | |
| What is the preferred treatment for dysenteric diarrhea (campylobacter)? | Azithromycin | |
| What is the preferred treatment for dysenteric diarrhea (shigella)? | Ciprofloxacin or Ceftriaxone | Amoxicillin |
| What is the preferred treatment for dysenteric diarrhea (salmonella)? | Ciprofloxacin or Ceftriaxone | Ampicillin |
| What is the preferred treatment for dysenteric diarrhea (yersenia)? | TMP/SMX (Bactrim) | |
| What is the alternative treatment for dysenteric diarrhea (shigella)? | Amoxicillin | |
| What is the alternative treatment for dysenteric diarrhea (salmonella)? | Ampicillin | |
| What is the treatment for a mild cellulitis non-purulent infection? | PCN VK or Cephalexin for at least 5 days | Dicloxacillin or Clindamycin |
| What is the treatment for a mild cellulitis non-purulent infection if the patient has a beta lactam allergy? | Clindamycin 300 mg PO QID | |
| What is the treatment for a mild abscess purulent infection? | Incision and drainage + TMP/SMX DS | Incision and drainage + doxycycline |
| What is the treatment for a severe purulent infection? | Vancomycin x 7-14 days | Daptomycin or Linezolid |
| What is the treatment for a severe non-purulent infection (necrotizing fasciitis)? | Vancomycin + Pip/Tazo + Clindamycin | Daptomycin + Meropenem + Clindamycin |
| What is the preferred treatment for MAC? | Clarithromycin x 1 year | Azithromycin + Ethambutol x 1 year |
| What is the preferred PO treatment for onychomycosis? | Terbinafine PO | Itraconazole PO or Fluconazole PO |
| What is the preferred treatment for Aspergillus? | Voriconazole | AmB, Posaconazole, Isaconazole |
| What is the preferred treatment for Cryptococcus? | AmB + 5-FC | |
| What is the treatment for infective endocarditis (Viridians)? | PCN or Ceftriaxone | |
| What is the treatment for infective endocarditis (MSSA)? | Nafcillin or Cefazolin | |
| What is the treatment for infective endocarditis (MRSA)? | Vancomycin | |
| What is the treatment for infective endocarditis (Enterococci)? | PCN or Ampicillin + Gentamicin | Ampicillin + high-dose Ceftriaxone |
| What is the treatment for infective endocarditis (Viridians) if the patient has a beta lactam allergy? | Vancomycin monotherapy | |
| What is the preferred treatment for Traveler's Diarrhea? | Azithromycin | |
| What is the prophylaxis treatment for MAC? | Azithromycin 1200 mg WEEKLY | |
| What is the treatment for pneumonia PJP/PCP? | TMP/SMX 15-20 mg/kg/day +/- prednisone x 21 days | +/- methylprednisolone |
| What is the treatment for toxoplasma encephalitis? | Pyrimethamine + Leucovorin + Sulfasalazine SZD x 6 weeks | |
| What is the prophylaxis treatment for toxoplasma encephalitis? | TMS/SMX 160/800 mg daily | |
| What is the prophylaxis treatment for PJP/PCP? | TMS/SMX DS daily | |
| What is the alternative prophylaxis treatment for MAC? | Azithromycin 600 mg 2x weekly | Clarithromycin 500 mg BID |
| What is the alternative prophylaxis treatment for PJP/PCP? | Dapsone | Atovaquone +/- Pyrimethamine + Leucovorin |
| What is the prophylaxis treatment for toxoplasma encephalitis? | Dapsone or Atovaquone | TMP/SMX DS 3x week or SS daily |
| What is the treatment for an uncomplicated yeast infection? | Fluconazole 150 mg x 1 dose | |
| What is the treatment for severe pyelonephritis? | Ceftriaxone x 5-7 days | |
| What is the treatment for a recurrent yeast infection? | Fluconazole 150 mg x 2-3 doses, then 100-200 mg PO x1 week | |
| What is the treatment for a complicated yeast infection? | Fluconazole 150 mg x 3 doses (Days 1,4,7) | |
| What is an OTC topical treatment option for yeast infections? | Monistat 1 Cure or Miconazole 1 Simple Therapy (Ticonazole) | |
| What is RX topical treatment option for yeast infections? | Butoconazole (Gynazole-1) | |
| What is an RX option for athlete's foot (tinea pedis)? | Naftifine cream/gel | Econazole cream/foam or Ketoconazole cream |
| What is an OTC option for athlete's foot (tinea pedis)? | Butenafine | Clotrimazole, Miconazole, Tolnaftate |
| What is the preferred topical treatment for onychomycosis? | Ciclopirox | Efinaconazole, Tavaborole |
| What is the preferred treatment for Histoplasma/Blastomyces? | Itraconazole or AmB | Fluconazole |
| What is the preferred treatment for Coccidiomycosis? | Fluconazole high dose | Itraconazole |
| What is the preferred treatment for Coccidiomycosis if the patient is critically ill? | Start with AmB, then step down to Fluconazole | |
| What is the preferred treatment for Mucormycosis? | Cut it out + LAmB, then step down to Posaconazole or Isavuconazole | |
| What is the preferred treatment for invasive CNS candidemia? | AmB or Fluconazole | |
| What is the preferred treatment for invasive candidemia? | Echinocandins x 5-7 days, then step down to Fluconazole PO | LAmB, Voriconazole, Fluconazole |
| What is the initial treatment for oral thrush? | Swish and swallow Nystatin x 7-14 days | |
| What is the severe treatment for oral thrush? | Fluconazole 100-200 mg PO x 7-14 days | |
| What is the fluconazole refractory treatment for oral thrush? | Voriconazole, Posaconazole, Itraconazole x 28 days | |
| What is the fluconazole refractory treatment for esophageal candida? | Voriconazole, Posaconazole, Itraconazole x 14 days | |
| What is the initial PO treatment for esophageal candida? | Fluconazole 200-400 mg PO x 14-21 days | |
| What is the initial IV treatment for esophageal candida? | Fluconazole 400 mg (6 mg/kg/day), then switch to PO | Echinocandins IV |
| What is the fluconazole recurrent treatment for esophageal candida? | Fluconazole 100-200 mg 3x weekly | |
| What is the empiric treatment for a patient with a post-op intra-abdominal infection from perforated diverticulitis? | Pip/Tazo OR cefepime + metronidazole OR meropenem OR imipenem cilastatin | |
| What is the empiric treatment for a patient with intra-abdominal infection most likely from a urinary tract infection (UA positive nitrites, LE, pyuria)? | Meropenem (for ESBL coverage) + tobramycin or levofloxacin | |
| What is the empiric treatment for a patient with intra-abdominal infection most likely from ventilator-associated pneumonia with bacteremia? | Vancomycin + Pip/Tazo or Cefepime + Tobramycin or Levofloxacin | |
| What is the treatment for active TB? | RIPE x 2 months Rif + INH x 4-7 months (6-9 months total) | |
| What is the gram (-) empiric treatment of bacteremia? | Amoxicillin +/- clavulanate, cephalexin, TMP/SMX, FQs x 7-14 days (switch to PO when stable) | |
| What is the treatment of s. pyogenes bacteremia? | IV PCN + IV clindamycin or linezolid x 7-10 days | |
| What is the s. pneumoniae treatment of bacteremia? | IV ceftriaxone |