Term
| Signs and Symptoms of Lower UTIs |
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Definition
| dysuria, urgency, frequent urination, nocturia, suprapubic heaviness, blood in the urine; |
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Term
| Signs and Symptoms of Upper UTIs |
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Definition
| flank pain, abdominal pain, fever, shaking, chills, N/V, malaise; |
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Term
| Causative Microorganisms of UTIs |
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Definition
| aerobic gram (-) bacilli from intestinal tract: E. coli, Staph. saprophyticus, P. mirabilis, K. pneumoniae |
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Term
| Empirical Therapy for Acute Lower UTI |
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Definition
Ampicillin;
Amoxicillin;
Trimetophrim + Sulfamethoxazole (Bactrim DS);
Single-dose therapy (concerns about recurrences): TMP-SMX 2 DS tabs, amoxicillin, ampicillin; |
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Term
| Chronic Prophylaxis of UTIs (>3 UTIs in 1 yr) - more cost effective, take for 6 months |
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Definition
nitrofurantoin 50-100 mg daily;
TMP 100 mg;
TMP (80 mg) - SMX (400 mg) 1/2 tab nightly or 3 times weekly;
ciprofloxacin 250 mg daily; |
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Term
| Pt is allergic to penicillins or TMP-SMX when treating Lower UTIs |
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Definition
switch to:
cipro 250 mg q12 hrs for 3 days;
nitrofurantoin 100 mg q6 hrs for 3 days;
cephalexin 500 mg q6 hrs for 7-14 days; |
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Term
| Therapies for Pts w/ UTIs that have a resistant Microorgansim to TMP-SMX or Aminopenicillins |
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Definition
Switch to:
- amoxicillin + potassium clavulanate;
- fluoroquinolones (esp. for MDR E.coli);
- nitrofurantoin; |
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Term
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Definition
can cause prematurity, low birth weight, and still birth;
routine screening at first prenatal visit & at 28 wks gestation;
Tx (7-day therapy):
- sulfonamide, amoxicillin, amoxicillin-clavulanate, cephalexin, or nitrofurantoin;
AVOID tetracyclines & fluoroquinolones; |
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Term
| Causative Microorganisms of Pharyngitis |
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Definition
Viral:
- rhinovirus, coronavirus, adenovirus, influenza virus, parainfluenza virus, Epstein-Barr virus;
Bacterial:
- Group A Strep. (Strept. pyogenes) |
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Term
| Signs & Symptoms of Pharyngitis |
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Definition
sore throat from inflammation;
dysphagia (difficulty swallowing);
fever;
tonsillar exudates;
swollen & tender anterior cervical lymph nodes;
lack of a cough;
fever > 38 degrees C (101 degrees F); |
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Term
| Empirical Therapy of Pharyngitis for Children and Adults |
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Definition
Penicillin V;
Penicillin G benzathine;
Amoxicillin; |
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Term
| Pt Allergic to Amoxicillin/Penicillins with Pharyngitis |
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Definition
Switch to:
- 1st gen. cephalosporin (cephalexin);
- macrolide (erythromycin, azithromycin, clarithromycin) OR
- clindamycin; |
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Term
| Signs & Symptoms of Rheumatic Fever |
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Definition
1-5 wks after GABHS pharyngitis;
fever; polyarthritis; erythema marginatum; chorea; subcutaneous nodules; heart palpitations; |
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Term
| Therapy for Acute Rheumatic Fever |
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Definition
- antimicrobial therapy will not modify course of an acute attack;
- 10-day course of oral penicillin to eradicate GABHS; |
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Term
| Therapy for Long-term Prophylaxis of Rheumatic Fever |
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Definition
- penicillin G benzathine;
- penicillin V;
- erythromycin; |
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Term
| Pt that has had Rheumatic Fever, previous endocarditis & going to the dentist - Prophylaxis from Endocarditis |
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Definition
- give amoxicillin 1 hr before the procedure;
If allergic to penicillin:
- clindamycin;
- cephalexin;
- azithromycin or clarithromycin; |
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Term
| Causative Microorganism for Gonorrhea |
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Definition
| Neisseria gonorrhoeae (gram (-) diplococcus) |
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Term
|
Definition
May be asymptomatic or minimally symptomatic;
Men - symptoms w/i 2-8 days of exposure, urethritis, dysuria, urinary frequency, & after several days, profuse, purulent urethral discharge;
Women - symptoms w/i 10 days of exposure, dysuria, urinary frequency vaginal dishcharge as a result of mucopurulent cervicitis |
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Term
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Definition
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Term
| Tx of Gonorrhea in pt allergic to cephalosporins |
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Definition
ciprofloxacin (no longer recommended);
ofloxacin (no longer recommended);
spectinomycin |
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Term
| Pt has gonorrhea, may also have Chlamydia trachomatis (60% co-infection) --> Treatment of Chlamydia |
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Definition
azithromycin (1 gram PO once for 1 dx OR 2 gram PO once to eradicate both dxs);
- doxycycline;
- a fluoroquinolone (ofloxacin or levofloxacin); |
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Term
|
Definition
| a Spirochete - Treponema pallidum |
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Term
|
Definition
Primary - painless lesion occurs (chancre);
Secondary - mucocutaneous eruptions from hematogenous & lymphatic spread of T. pallidum;
Latent - positive serology test but no other evidence of dx;
Tertiary & Neuro- - inflammatory rxn in every organ of body; |
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Term
| Tx of Syphilis <1 yr duration |
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Definition
| penicillin G benzathine once or once a week for 2 wks |
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Term
| Tx of Syphilis >1 yr duration & normal CSF examination |
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Definition
| penicillin G benzathine once a wk for 3 wks |
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Term
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Definition
| parenteral penicillin G - 3-4 million units q4 hrs for 10-14 days |
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Term
| Tx of Syphilis if allergic to penicillin |
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Definition
Tx:
- doxycycline 100 mg orally BID;
- tetracycline 500 mg QID for 2-4 wks;
- ceftriaxone IM or IV for 8-10 days; |
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Term
|
Definition
Micro:
- Trichomonas vaginalis;
Symptoms (women >>> men):
- 50% are asymptomatic;
- malodorous yellow-green vaginal dishcarge, vulvar pruritis, dyspaurenia, dysuria, strawberry vagina & cervix |
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Term
|
Definition
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Term
| Signs & Symptoms of Sinusitis |
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Definition
more freq. in children;
mucopurulent nasal discharge; nasal congestion; malodorous breath; facial pain; morning periorbital swelling; fever; HAs; erythematous throat; persistence of nasal discharge & cough >7 days --> bacterial sinusitis; |
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Term
| Microorganisms that cause Sinusitis |
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Definition
| S. pneumoniae; H. influenzae; M. catarrhalis; |
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Term
| Empirical Therapy for Sinusitis |
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Definition
Many cases resolve spontaneously;
Tx for symptomatic relief & preventing intracranial complications;
Amoxicillin; |
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Term
| Tx of Sinusitis in pts allergic to Penicillins |
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Definition
- TMP/SMX;
- cephalosporins (cefuroxime, cefaclor, cefprozil, cefpodoxime, cefixime);
- macrolide (azithromycin);
- clarithromycin;
- fluoroquinolones (levofloxacin) |
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Term
| Causative Microorgansisms of Community Acquired Pneumonia (CAP) |
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Definition
S. pnuemoniae;
H. influenzae;
S. aureus;
Gram (-) bacilli;
C. pneumoniae; |
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Term
|
Definition
fever;
cough (with or without sputum);
Chest radiograph revealing consolidation in 1 or more areas of lung; |
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Term
| Therapy for CAP in Outpatients previously healthy & no antibiotics in last 3 months |
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Definition
| Tx wi/ macrolide (erythromycin, clarithromycin, azithromycin) or Doxycycline |
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Term
| Therapy for CAP in Outpatients that have had antibiotics in last 3 months or have Co-morbidities |
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Definition
| Tx w/ respiratory fluoroquinolone or Advanced macrolide (high dose amoxicillin +/- clavulanate; cefprozil; cefuroxime; cefpodoxime;) |
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Term
| Therapy of CAP in non-ICU Inpatients |
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Definition
- a respiratory fluoroquinolone;
- advanced macrolide + beta-lactam (cefotaxime, ceftriaxone, ampicillin-sulbactam, or ertapenem); |
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Term
| Therapy for CAP for Inpatients in ICU |
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Definition
- a beta-lactam (cefotaxime, ceftriaxone, ampicillin + sulbactam) AND azithromycin;
- a beta-lactam (cefotaxime, ceftriaxone, or ampicillin + sulbactam) AND respiratory fluoroquinolone;
- aztreonam + respiratory fluoroquinolone; |
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Term
| Acute Treatment of Pneumocystosis (Pneumocystis jiroveci) |
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Definition
S/Sx: fever, SOB, non-productive cough, most common life-threatening opportunistic infection in pts w/ AIDS;
Tx (+ corticosteroids):
- TMP/SMX (major);
- pentamidine (minor);
- trimetheoprim + Dapsone (minor); |
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Term
| Prophylaxis of Pneumocystosis (if CD4 count is <200) |
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Definition
Tx w/:
- TMP/SMX (major);
- pentamidine;
- dapsone;
-dapsone + pyrimethamine; |
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Term
| Causative Microorganisms for Nosocomial (hospital-acquired) Pneumonia |
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Definition
Gram (-):
- K. pneumoniae;
- Enterobacter;
- P. aeruginosa;
Gram (+):
- Staph. aureus (MRSA) |
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Term
| Tx of Early Onset (<5 days) Nosocomial Pneumonia |
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Definition
| - ceftriaxone OR antipneumococcal fluoroquinolone OR ampicillin/sulbactam OR ertapenem |
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Term
| Tx of Late Onset (>5 days - multi-drug resistant) Nosocomial Pneumonia |
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Definition
- antipseudomonal cephalosporin OR a carbapenem OR piperacillin/tazobactam + antipseudomonal fluoroquinolone or aminoglycoside;
+ linezolid OR vancomycin if MRSA is suspected |
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Term
|
Definition
caused by:
- Strept. pyogenes;
- Staph. aureus;
S/Sx:
- inflammation of skin & subcutaneous fat;
- local tenderness, pain, swelling, & erythema;
- fever, chills, lymphadenopathy; |
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Term
|
Definition
Staph or unknown gram (+):
- mild - dicloxacillin;
- more severe - nafcillinor oxacillin;
Strept infection:
- mild - penicillin VK;
- more severe - penicillin G;
If Allergic to Beta-Lactams:
- clindamycin;
- 1st gen. cephalosporin (cephalexin, cefazolin);
- vancomycin;
- oral fluoroquinolones; |
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Term
|
Definition
Caused by E.coli;
S/Sx:
- 50% of males develop at sometime in life;
- Acute: sudden onset of fever, chills, tenderness, pain, urinary symptoms (frequency, urgency, nocturia, retention);
- Chronic: difficulty urinating, recurrent UTIs w/ same pathogen, low back pain, perineal pressure, prostatic enlargement; |
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Term
|
Definition
Acute (4-6 wks), Chronic (6-12 wks):
- ciprofloxacin;
- TMP-SMX; |
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