Term
| C. diff: Non antibiotic treatments? |
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Definition
-Stop the abx that cused C. Diff (if you can)
-Fluids and electrolytes
-NO ANTIMOTILITY agents
-Anion exchange resin (colestipol, cholestyramine)
-Probiotics (but dont use in immunocomp, elderly, children, premature babies, if have cardiac valve dz (will worsen), central catheter, impaired intestinal barrier fx, pancreatitis |
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Term
| C. Diff: Oral antibiotic regimens (Mild-Mod and Severe) |
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Definition
Mild-Mod: Metronodazole 500mg PO TID x 10-14 days
Severe: Vanco 125mg PO QID x 10-14 days
Severe is when WBC are elevated and serum creatinine has changed |
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Term
| C. Diff: IV antibiotic regimen (Mild-mod and Severe) |
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Definition
Mild-mod: Metronidzole IV
Severe: Metronidazole IV AND Vanco rectally |
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Term
| C diff: Alternative options for abx? |
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Definition
Fidaxomicin, Rifaximin, and Nitazoxanide.
Fidaxomicin: very expensive.
Rifaximin: use as a chaser for 2 weeks after took metronidazole for 2 weeks
Nitazoxanide: if allergic to vanco and metronidzole |
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Term
| C diff: when not to use probiotics? |
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Definition
| Dont use in immunocomp, elderly, children, premature babies, if have cardiac valve dz (will worsen), central catheter, impaired intestinal barrier fx, pancreatitis |
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Term
| Vibrio Cholerae: antibiotic options? |
|
Definition
-Doxycycline 300mg single dose
-Tetracycline 12.5mg/kg qid x 3 days
-Erythromycin 12.5mg/kg qid x 3 days (children) |
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Term
| Enterotoxigenic E. Coli (ETEC): antibiotic options? |
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Definition
Usually no big deal. bismuth.
UNLESS: lasts >48hrs
GIVE: Norflox, Ofloxacin, or Ciprofloxacin |
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Term
| Enterohemorrhagic e.coli: antibiotics? |
|
Definition
NONE
-lysis of bacteria will release toxin, no abx used.
So just supportive care |
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Term
|
Definition
Enterocolitis:
-fluid/electrolytes
-in healthy adults, NO abx,
treat: <6 months, immunocomp, fever/bloody diarrhea, post-op splenectomy:
Enterocolitis: FQ, 3rd ceph
Bacteremia: nontyphoid infx: 3rd ceph (ceftriaxone, cipro)
Enteric fever: FQ, uncomplicated 3-5 days
Chronic carriers: (shedding in stool) norfloxacin 400mg BID x 28 days |
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Term
|
Definition
NONE usually. bc is self limited, with 4-7 days recovery.
So just give oral hydration.
UNLESS: Immunocomp, children, malnourished, healthcare worker,
GIVE: Bactrim |
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Term
| Campylobacter jejuni: antibiotics? |
|
Definition
NONE usually. Is self limited.
So just Fluid/electrolytes.
UNLESS: high fever, severe bloody diarrhea, lasts >1 week, pregnancy, immunocomp
GIVE: Macrolides: azithro/clarithro (within 4 days of sx!!!!!) |
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Term
| Yersinia Enterocolitica: antibiotics? |
|
Definition
Usually none.
So just Fluid/electrolytes
UNLESS: high risk bacteremia, bone/joint infx, < 3 months old, cirrhosis, iron overload
GIVE: FQ +/- 3rd ceph or AG |
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Term
| which type of bacterial diarrhea do you not normally treat unless pt is < 3 months old? |
|
Definition
Yersinia
GIVE:FQ +/- 3rd gen ceph or AG |
|
|
Term
| which type of bacterial diarrhea do you not normally treat unless pt has cirrhosis? |
|
Definition
Yersinia
GIVE:FQ +/- 3rd gen ceph or AG |
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Term
| which type of bacterial diarrhea do you not normally treat, and if you do then you give: ciprofloxacin, norfloxacin, ofloxacin (when lasts >48hrs) |
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Definition
|
|
Term
| which type of bacterial diarrhea do you not normally treat unless the person is a healthcare worker? |
|
Definition
|
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Term
| which type of bacterial diarrhea do you not normally treat unless it's a baby that's <6 months old? |
|
Definition
Salmonella.
GIVE: 3rd gen ceph or FQ |
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Term
| which type of bacterial diarrhea do you not normally treat unless they have bone/joint infection? |
|
Definition
Yersinia
GIVE:FQ +/- 3rd gen ceph or AG |
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Term
| what are the four types of Salmonella diarrhea? |
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Definition
| Enterocolitis, Bacteremia, Localized infx, and Enteric fever (aka typhoid) |
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Term
| Travelers' Diarrhea: Causes and Treatment? |
|
Definition
Caused by: ETEC, Campylobacteria, Shigella, Salmonella
Treatment:
-Fluid electrolytes
-Bismuth q30min (up to 8 doses)
-Loperamide (ONLY if no bloody diarrhea, no high fever, and d/c if diarrhea lasts >48hrs)
-Fluoroquinolones: 3 days worth (if you have 3 or more loose stools in 8hrs or N/V, cramps, fever, blood) |
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