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Comprehensive Bacteria - Treatment (Chad's Charts)
Creighton University School of Medicine
86
Medical
Professional
08/18/2013

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Term
S. aureus
Definition
-Penicillin G if no resistance
-Oxacillin or nafcillin if MSSA
-Vanco if MRSA
-linezolid or quin/dalfo if VRSA
Term
Staph. epidermidis
Definition
vancomycin
Term
Staph. saprophyticus
Definition
TMP-SMX
Term
Strep. pneumoniae
Definition
-PENICILLIN DOC
-Cephalosporins if R
-Vancomycin in meningitis
Term
Vididians Group (Strep. Sanguis, S. anginosus, S. mutans, S. bovis)
Definition
Penicillin + aminoglycoside
Term
Strep. pyogenes
Definition
- penicillin
- Penicillinase-res. Penicillins (PRPs) when ou cannot diff. bwn staph or strep
Term
Strep. agalactiae
Definition
PROPHYLAXIS: ampicillin

POST-PARTUM: penicillin
Term
Enterococcus faecalis, E. faecium
Definition
Ampicillin + AMG for UTI

VRE: linezolid or dapto
Term
Cornyebacterium diptheriae
Definition
antitoxin ASAP + erythromycin or penicillin + Dtap boose
Term
Listeria monocytogenes
Definition
Ampicillin + gentamyciin

TMP-SMX alternative

Tx for meningitis 3-6 weeks
Term
Bacillus anthracis
Definition
Cipro or doxy for 60-100d -> IV for first few weeks then switch to PO

*no P2P spread
Term
Bacillus cereus
Definition
self-limited

DO NOT TREAT (DNT) bc enterotoxin
Term
Clostridium botulinum
Definition
adults: antitoxin with supportive care

infants: self-limited
Term
Clostridium tetani
Definition
- TETANUS: antitoxin + penG, diazepam (muscle relaxant) + vaccine

- environmental exposure does not confer imunity
Term
Clostridium difficile
Definition
- metronidazole x2

- vanco or fidaxomicin if resistant

-rifampin or fecal transplant if refractory
Term
Clostridium perfringens
Definition
- FOOD POISONING: self-limited

- GAS GANGRENE: debridement + penG
Term
Actinobacterium israeli
Definition
Pen G
Term
Nocardia asteroides
Definition
TMP-SMX
Term
T. whipplei (actinobacetria)
Definition
Pen for 1-2 years + sulfonamides for neuro symptoms
Term
Neisseria meningitidis
Definition
Penicilin, ceftriaxone

Rifampin for prophylaxis
Term
Neisseria gonorrhea
Definition
ceftriaxone once IM or cefixamine once PO
Term
Moraxella catarrhalis
Definition
amoxicillin-clavulanate = augmentin
Term
Enterobacteriaceae (general characteristics)
Definition
Tx: C.A.T.
-Cephalosporin
-Aminoglycosides
-TMP-SMX
Term
ETEC
Definition
no antibiotics, rehydration
Term
EPEC
Definition
no antibiotics, rehydration
Term
EHEC
Definition
no antibiotics, rehydration
Term
EIEC
Definition
no antibiotics, rehydration
Term
Salmonella typhi
Definition
- GASTROENTERITIS: self-limited: Tx can prolong the carrier state
-Can use ceftriaxone, cipro, ampicillin in other conditions
-cholecystectomy for carriers
Term
Shigella (S. sonnei, S. flexneri, S. dysenteriae)
Definition
-Rehydration
-Maybe:
--azithro
--FQs
--TMP-SMX
Term
Klebsiella pneumonia
Definition
3rd Gen. cephs
Term
Proteus mirabilus
Definition
*most antibiotics okay but R to tetracyclines
Term
Vibrio cholera
Definition
Tx: rehydration + TMP-SMX, tetracycline, or doxy
Term
Vibrio parahaemolyticus
Definition
self-limited
Term
Vibrio fulnificus
Definition
rehydration + TMP-SMX or tetracycline
Term
Campylocater jejuni
Definition
rehydration + erythromycin or FQs (if given early)
Term
Bacteroides fragillis
Definition
metronidazole
Term
H. pylori
Definition
Polytherapy: PPI or H2 blocker + bismuth + 2 antibiotics (metronidazole, clarithromycin or amoxicillin)
Term
Y. pestis
Definition
Tx: aminoglycosides or FQs

doxycycline in bioterrorism
Term
Y. enterocolitica
Definition
TMP-SMX, FQs
Term
Pseudomonas aeruginosa
Definition
TX EXAMPLES: piperacillin, azteronam, imipenem, or cefazidime

+ aminoglycosides for serious infections
Term
Burkholderia cepacia
Definition
TMP-SMX
Term
H. influenzae
Definition
Tx: ceftriaxone for meningitis

rifampin for contacts or type b

amoxicillin
Term
H. ducreyi
Definition
erythromycin
Term
Pasturella multicida
Definition
amoxicillin, penicillin, tetracycline

amoxicillin-clavulanate
Term
Brucella spp.
Definition
doxycycline + gentamicin
Term
Francisella tularensis
Definition
streptomycin or gentamicin

tetracycline

FQs
Term
HACEK's group
Definition
penicillins

cephalosporins

FQs for actinomyces
Term
B. pertussis
Definition
erythromycin during catarrhal stage
Term
Legionella pneumophilia
Definition
erythromycin, tetracyclines, or FQs (all accumulate intracellularly, thus effective)
Term
C. psittaci
Definition
doxycycline
Term
C. pneumoniae
Definition
doxycycline
Term
C. trachomatis
Definition
doxycycline, azithromycin, FQs (all accumulate intracellularly, thus effective)
Term
M. pneumonia
Definition
erythromycin
Term
M. tuberculosis
Definition
LATENT: isoniazid for 9mo -> check LFTs if pt has HIV, pregnant or liver disease (think sex and booze)

ACTIVE: rifampin, INH, pyrazinamine, ehtambutol: QD x2 weeks, 2x weekly for 6 wks; INH + rif for 2x/wk for 18 weeks
Term
M. leprae
Definition
One of the following for 2 years:
1.) dapsone + rifampin
2.) dapson + clofazimine
Term
M. avium intracellulare (MAI or MAC)
Definition
azithro and clarithromycin

use multiple drugs: macrolides + TB drugs
Term
M. kansasii
Definition
isoniazid + rifampin + ethambutol for 18mo
Term
N. gonorrhea
Definition
ceftriaxone 1 dose IM, cefixime 1 dose PO

*treat for concomitant chlamydia

*if pregnant use azithromycin
Term
C. trachomatis
Definition
AZITHRO PO single dose; DOXY x14 days if complicated

DOXY + CEFTRIAXONE for concurrent gonorrhea

ERYTHROMYCIN (ORAL) for neotates -> stomach acid can cause pyloric stenosis; OINTMENT FOR EYES
Term
T. pallidum
Definition
PRIMARY, SECONDARY, AND EARLY LATENT: benzathine penG IM 1 dose

LATE LATENT OR LATE: benzathine penG IM 1/wk x3 weeks

NEUROSYPHILIS: penG IV Q4hrs x10-14 days

Watch for Jarish-Herxheimer Rxn

can also use doxycycline or erythromycin
Term
Herpes simplex
Definition
valacyclovir BID for 7-10 days for primary infection

prophylaxis will decrease reoccurrence by 75%; re-eval in one year
Term
Human papilloma virus
Definition
cryotherapy or surgery

vaccine
Term
Trichomonas vaginalis
Definition
metronidazole BID/7d
Term
Gardnerella Vaginalis
Definition
metronidazole BID/7d
Term
R. rickettsii
Definition
doxycycline
Term
R. akari
Definition
doxycycline
Term
R. prowaszekii
Definition
doxycycline
Term
R. typhi
Definition
doxycycline
Term
Ehrlinchia chaffeesis
Definition
doxycycline
Term
Bartonella bacilliformis
Definition
doxycycline
Term
Bartonella henselae
Definition
doxycycline
Term
Bartonella quintana
Definition
doxycycline
Term
Coxiella burnetti
Definition
doxycycline
Term
Babesiosis microti
Definition
clindamycin
Term
Leptospira interrogans
Definition
doxycycline
Term
Borrelia recurrentis
Definition
doxycycline
Term
Borrelia burgdorferi
Definition
EARLY: doxycycline
LATE: IV penG or ceftriaxone
PREVENTION: DEET or permethrin (for clothes)
Term
Associated with all Spirochetes spp.
Definition
penicillin and oral hygeine
Term
Flavivirus
Definition
prevent with insect repellant and permethrin on clothing
Term
Arenavirus
Definition
n/a
Term
Bunyavirus
Definition
n/a
Term
Filovirus
Definition
none developed
Term
Fish (scombroid poisoning)
Definition
self-limited
Term
Eikenella corrodens
Definition
augmentin
Term
Coronavirus
Definition
n/a
Term
L. donovanni
Definition
CUTANEOUS: meglumine antimoniate or sodium stibogluconate
VISCERAL: amphotericin B
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