Infectious Diseases

-H.influenza
-Neisseira meningitidis
-strep pneumonia
Tx:cefotaxime or ceftriaxone plus vancomycin

-strep + staph species
Tx strep: Pen G(may add gent),ceftriaxone,or vanc(if pcn allergy)
-staph MSSA:Nafcil./oxacil.
-staph MSSA all.to PCN:vanc
-staph MRSA:vancomycin

-mycoplasma pneumoniae, strep pneumoniae,chlamydia pneum., H. influenza, moraxella
Tx: macrolides, amox, augmentin, doxy, bactrim cefuroxime, cefprozil

-M.pneumoniae,s.pneumoniae, klebsiella, h. influenza
Tx: macrolide or fluoroquinolone

-AG + cefotaxime or ceftriaxone, or cefepime, or ticarcillin/clav, meropenem, piperacillin, if MRSA: add vanc

-Mouth anaerobes
-uncomplicated: pen G, clinda
-complicated: ticarcillin/clav or piperacillin/tazo

-Mycobacterium tuberculosis
Tx: if latent with isoniazide for 9 months
Latent/iso resistant:rifampin + pyrizinamide 2 months
Active disease: pyrizinamide + rifampin + isoniazide

-supportive measures
-if febrile/hospitalized: FQ or Bactrim

-strep or staph
-keflex, dicloxicillin, erythromycin

-e-coli, proteus,S aureus, pseudomonas(decubitus only)
Tx: if MRSA use vanc
Otherwise: keflex, clinda, if severe:ticarcillin/clav

-e-coli mostly, in hospital also p.aeroginosa and staph
Tx: bactrim or cipro(any quinolone).3 days for UTI, 14 days for pyelonephritis,4-6 weeks for prostatitis

-spirochete:treponema pallidum
-Pen G 2.4 mill units IM x1
50000-75000 U/kg q12 for infant born to infected, untreated mom
-21 days after exposure:painless lesion

-neisseria gonorrhea (gram -)
-Pen and FQ resistant
-only 3rd gen cephalosporins: ceftraixone 125 IM x1
Spectinomycin 2g IM q12hx2days

-always tx when pt. diagnosed with gonorrhea
-azithromycin 1g x1
-doxy 100 mg bid x 7days

at least 2 of these criteria:
-temp >38 or <36
-WBC>12000 or <4000
-RR>20
-HR>90
>10% immature neutrophil(band)
-PaCo2 <32 Torr

-ceftriaxone, cefotaxime, cefepime, ticarcillin,piperaccillin, meropenem,imipenem + AG
If gram + suspected: vanco

-lyme disease
-rocky mountain spotted fever
-Ehrlichiosis
-Tularemia
Rickettsia species

-DOC: doxy
-alternative:cefuroxime

-DOC: doxy
-alternative: chloramphenicol

-DOC for ehrlichio: doxy
-alternative:tetracycline
-DOC for Tularemia:gent/tobra
-alternative: cipro,chloramphe

-chicken pox/shingles
-CMV in immunocompromised as retinitis, colitis, esophagitis
-genital infectionsh

-inhibit bacterial protein synthesis
-bactericidal
-gram + and gram - aerobes
-no anaerobes
-desired trough<2mcg/mL

-nephrotoxicity:reversible
-ototoxicity
-neuromuscular blockade

-inhibit cell wall synthesis
-bactericidal

-Cell wall synthesis inhibition
-bacteriocidal

-Disruption of bacterial DNA synthesis
-bacteriocidal

-linezolid (zyvox)
-quinapristin/dalfopristin (synercid) only IV
-vancomycin

-inhibits bacterial translation
-static against enterococci and staph,
-cidal against strep
-active against e.faecium, but not faecalis

-Quinapristin inhibits late phase protein synthesis,dalfopristin inhibits early phase protein synthesis
cidal against staph and strep
static against e.faecium, but not e. faecalis
Common SE:thrombophlebitis, hyperbilirubinemia(25%),arthralgia, myalgia

-inhibits peptoglycan synthesis (no wall)
-glycopeptide antibiotic
-cidal for all except entero(static)

Nephrotoxicity (small)
ototoxicity
thrombophlebitis (IV)
histamine release or red man syndrome (reduce infusion rate to no more than 500 mg/30 min)

-cidal
-disruption of bacterial DNA
-concentration dependent activity
-large Vd, high tissue concentrations

-static
-inhibit RNA synthesis
-only biaxin is renally eliminatedg

-static
-interfere with folic acid
-

bacteriostatic
inhibit RNA synthesis

-static
-inhibit bacterial protein synthesis

-atypical pneumonia: mycoplasma pneumonia+ chlamydia pneumonia
-clamydia (STD)
-MRSA if vanc not appropriateg
-NOT pseudomonas

-polyene antifungal
-nephrotoxicity is dose-limiting
-electrolyte imbalances: hypo- magnesemia, kalemia, calcemia
-normocytic,normochromic anemia
-dose not to exceed 1.5mg/kg/day

-Sporanox
-esophageal and oropharyngeal candidiasis
-aspergillosis
-onychomycosis