PNA Tx Word Scramble
|
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
Question | Answer |
CAP Outpatient tx IF healthy pt & no prior abx for 3 months: | Macrolide or Doxy |
CAP Outpatient tx IF comorbids / recent abx: | Moxi/Lev OR Amox/Aug |
CAP Outpatient tx IF comorbids (chronic htn, lung, liver, renal dz), DM, EtOH, Ca, asplenia, immunosuppression, or abx in past 3 months: | Resp FQ (moxi or Lev 750) OR beta-lactam [(Amox 1g TID or Aug 2g BID); Alt: cefpod, rocephin, or ceftin] PLUS macrolide |
CAP Inpatient (non-ICU) tx (briefly): | Moxi/Lev OR Amox/Aug + Azithro |
CAP Inpatient (non-ICU) tx: | Resp FQ (moxi or Lev 750) OR beta-lactam plus macrolide |
CAP Inpatient (ICU) tx (briefly): | Rocephin/Unasyn + Azithro or Levaquin |
CAP Inpatient (ICU) tx: | Beta-lactam (cefotaxime/Claforan, Rocephin, or Unasyn) PLUS (Azithromycin OR resp FQ) [IF low pseudomonas risk] |
Most common CAP Outpatient organisms: | S pneumo, Mycoplasma pneumoniae, H flu, Chlamydophila, resp viruses |
Most common CAP Inpatient (non-ICU) organisms: | S pneumo, Mycoplasma pneumoniae, Chlamydophila, H flu, Legionella, aspiration, resp viruses |
Most common CAP Inpatient (ICU) organisms: | S pneumo, Staph aureus, Legionella, GN bacilli, H flu |
Atypical pna organisms are so called bc: | Not detectable on Gram stain or culturable on standard cx media |
Atypical pna organisms = | Mycoplasma pneumoniae, Chlamydophila, Legionella, resp viruses |
CAP: likely GPC orgs | S pneumo |
CAP: likely GN orgs | M Cat, H flu, Klebsiella, Chlamy, mycoplasma |
CAP: GNDC = | M cat |
CAP: GNCB = | H flu |
CAP: M cat abx | 1stline: rocephin, FQs. Alt: bactrim, augmentin, azithro |
CAP: GNR orgs | Klebsiella, Chlamydophila |
CAP: Klebsiella abx | 1stline: rocephin (+gent if severe). Alt: zosyn, unasyn, FQ, aztreonam |
CAP bugs: COPD | H flu, Pseudomonas, Legionella (also S pneumo, M cat, Chlamy) |
CAP bugs: Legionella seen in which populations? | Elderly, smokers, immunosuppressed |
CAP bugs: GNRs / Klebsiella seen in which populations? | EtOH, other aspirators |
CAP bugs: S. aureus seen when? | Post-viral infxn |
CAP bugs: in young, healthy pts = | Mycoplasma, Chlamydophila, viral |
CAP bugs: viral | Influenza A & B |
Inpatient tx of PNA: CAP (non-ICU): IF necrosis/empyema: | Regular abx + cover MRSA |
Extended spectrum (ES) (antipseudomonal) PCNs = | Amox, Ampicillin, Zosyn, Timentin |
CAP: If Pseudomonas is a concern, firstline tx: | Antipneumoccal / antipseudomonal beta-lactam (Zosyn, cefepime, ceftazidime, aztreonam, imipenem, meropenem) PLUS (Cipro or Lev) |
CAP: If Pseudomonas is a concern, secondline tx: | Beta-lactam (Zosyn, cefepime, imipenem, meropenem) PLUS (AG: Gent AND Azithro) |
CAP: If Pseudomonas is a concern, thirdline tx: | Beta-lactam (Zosyn, cefepime, imipenem, meropenem) PLUS AG (Gent) AND antipneumoccal FQ |
CAP: If MRSA is a concern, add: | Vanco or linezolid |
CAP: firstline abx for S pneumo | Pen G or amoxicillin |
CAP: likely abx for S pneumo if PCN allergy: | Cefotaxime (Claforan) or Rocephin or resp FQ |
CAP: firstline abx for H flu (NON-beta-lactamase producing): | Amoxicillin |
CAP: firstline abx for H flu (beta-lactamase producing): | 3G ceph (eg, Rocephin) or Augmentin |
CAP: firstline abx for Myco pneumoniae and C. pneumoniae: | Macrolide or tetracycline (doxy) |
CAP: alternate abx for H flu | FQ, Doxy, Azithro |
CAP: alternate abx for Myco pneumoniae and C. pneumoniae: | FQ |
CAP: firstline abx for Legionella | FQ or Azithro |
CAP: alternate abx for Legionella | Doxycycline |
CAP: firstline abx for MSSA | AntiStaph PCN (Nafcillin or Oxacillin) |
CAP: secondline abx for MSSA | Cefazolin or Clindamycin |
CAP: firstline abx for MRSA | Vancomycin or linezolid |
CAP: secondline abx for MRSA | Bactrim |
Aspiration pna: MOA | Chemical pneumonitis 2/2 aspiration of gastric contents. Bac PNA 24-72 hrs later 2/2 aspiration of oropharyngeal microbes |
Aspiration pna: bugs (outpatient) | Typical oral bugs: Strep, S aureus, oral anaerobes. GN enteric pathogens |
Aspiration pna: bugs (inpatient or chronically ill) | GNR (enteric pathogens) and S aureus |
Aspiration pna abx: | (3G ceph OR FQ) +/- (Clinda OR Flagyl, for anaerobes) |
HCAP: GPC orgs | MSSA, MRSA |
HCAP: GNR orgs | E coli, Legionella, Pseudo |
HCAP: Legionella abx | Abx combo for HAP with MDR RFs, EXCEPT use Azithro OR (Lev or cipro) instead of AG (gent) |
HCAP: PCP abx | 1stline: bactrim; Pentamidine isethionate plus prednisone. Alt: Dapsone + bactrim OR Clinda + primaquine |
PNA: bugs in immunosuppressed pts | CAP/HAP bugs, PCP, fungi, Nocardia, atypical Mycobacteria, CMV, HSV |
PNA abx in immunocompromised pt: | HCAP abx + bactrim +/- steroids (for PCP) |
HAP (hosp acquired pna) bugs: GNR | Pseudomonas, Klebs, E coli, Enterobacter, Serratia, Acinetobacter |
HAP: this may increase risk of acquiring pna in hosp: | Acid suppressant meds |
HAP/VAP in pt with NO MDR risk factors: potential pathogens include: | S pneumo, H flu, MSSA, abx-sensitive GNRs (E coli, Klebs, Enterbacter spp, Proteus spp, Serratia marcescens) |
Initial empiric abx tx for HAP/VAP in pt with NO MDR risks factors: | Ceftriaxone OR (Lev, moxi, or Cipro) OR Unasyn OR Ertapenem |
HAP/VAP in pt WITH MDR risks factors: likely pathogens include: | Pseudomonas, Klebsiella (ESBL), Acinetobacter spp (plus non-MDR pathogens) |
Initial empiric abx tx for HAP/VAP in pt with MDR risks factors (or late-onset dz): | [Antipseudomonal: (cefepime or ceftazidime) OR (imipenem or meropenem) OR Zosyn] PLUS [Antipseudo FQ (Lev or Cipro) OR (AG: amikacin or Gent)] PLUS [vanc or linezolid] |
Transition from IV to PO abx - if on beta-lactam (eg rocephin) + azithro, switch to: | Ceftin + azithro |
Respiratory quinolone | Moxifloxacin, gatifloxacin, levofloxacin, or gemifloxacin |
Outpatient therapy for pneumonia in otherwise healthy patients | Advanced generation macrolide (azithro or biaxin); doxycycline if allergic |
Outpatient therapy for pneumonia in otherwise healthy patients | azithromycin or clarithromycin |
Outpatient therapy for pneumonia in otherwise healthy patients if patient is allergic to macrolides | doxycycline |
Outpatient therapy for pneumonia in patients with cardiopulmonary disease and/or other modifying factors | Anti-pneumococcal FQ. Macrolide PLUS b-Lactam (oral cefpod, Ceftin, high-dose amoxicillin, Aug; or parenteral CTX then PO cefpodoxime) |
Outpatient therapy for pneumonia in patients with cardiopulmonary disease and/or other modifying factors | macrolide PLUS b-Lactam (oral cefpodoxime, cefuroxime, high-dose amoxicillin, amox/clavulanate; or parenteral ceftriaxone followed by oral cefpodoxime |
MAC tx | Clarithromycin plus (ethambutol or rifabutin) |
Created by:
Abarnard
Popular Medical sets