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cat bite
augmentin (PO) / unasyn (IV)
CAP
azithromycin and ceftriaxone
HAP
vanc and zosyn
HCAP
worry about pseudomonas: zosyn; cefepime; meropenem; aztreonam; quinolones; aminoglycosides
C diff
PO metronidazole. If fail x 2 then give PO vanco
SBP
ceftriaxone
Febrile neutropenia
zosyn or cefepime (+/- vanco)
cholangitis
flagyl and cipro (or unasyn) - covers anaerobes and gram negatives
diverticulitis
flagyl and cipro (or unasyn) - covers anaerobes and gram negatives
meningitis (college age)
ceftriaxone + vanco (for resistant S pneumo) + dexamethasone
meningitis (old person)
ceftriaxone + vanco (S pneumo) + ampicillin (listeria)
aspiration pna
unasyn or clinda
cellulitis
keflex or unasyn or bactrim (CA-MRSA) or vanco (MRSA)
community acquired MRSA cellulitis
bactrim or clinda
necrotizing fasciitis
surgery + zosyn (+ clinda + vanco)
asymptomatic bacteriuria
no tx unless pt is pregnant.
UTI
bactrim or keflex or macrobid or ciprofloxacin
What bugs does zosyn cover?
GP (including pneumococcus and enterococcus). GN (including pseudomonas). Anaerobes
What bugs does cefepime (4th gen ceph) cover?
GP (but not enterococcus). GN (including pseudomonas).
What bugs does augmentin/unasyn cover?
GP (including pneumococcus and enterococcus). GN (but not pseudomonas). Anaerobes.
What drugs cover anaerobes?
Unasyn. Zosyn. Metronidazole (below diaphragm). Clinda (above diaphragm)
What drugs cover GNs?
3rd and 4th gen cephalosporins. Zosyn. Aminoglycosides. Ciprofloxacin.
What drugs cover atypicals?
Azithromycin. Levaquin.
What drugs cover enterococcus?
Ampicillin. Vancomycin. Zosyn. Unasyn.
When should you worry about enterococcus?
UTI with GPCs. Intra-abdominal infections.
What drugs cover pseudomonas?
Zosyn. Cefepime. Quinolones. Carbapenems. Aztreonam.
When should you worry about pseudomonas?
VAP. UTI or Intraabdominal infx in hospitalized pt. Cystic fibrosis. Osteomyelitis of foot with tennis shoe.
When should you worry about anaerobes?
Oral infx. Abscesses. Aspiration PNA. Loss of bowel integrity. Diabetic ulcers. Infx of skin below waist.
What bugs do carbapenems cover?
Gram positive (including enterococcus); Gram negative (including pseudomonas); anaerobes
High imipenem levels may cause?
Seizures
What bugs does aztreonam cover?
ONLY gram negative aerobes (pseudomonas; N gonorrhea; N meningitidis; enterobacter; H influenzae. Does NOT work on gram positives!
What bugs do 4th gen cephalosporins NOT cover?
Anaerobes and atypicals
What bugs do quinolones cover?
Gram negative (including pseudomonas)
What drugs does bactrim cover?
Gram positive; Gram negative; community acquired MRSA; PCP prophy in HIV
What bugs does daptomycin cover?
Gram positives only. (including MRSA and enterococcus)
What bugs does linezolid cover?
Gram positives; MRSA; VRE
What do you treat Extended Spectrum Beta-Lactamase (esbl) bugs with?
carbapenems or tigecycline
What drugs cover MRSA?
Vancomycin; Linezolid; Daptomycin; for CA-MRSA: Bactrim; Clindamycin; Doxycycline
What drugs cover pseudomonas?
What bugs does unasyn cover?
Gram positives (includes pneumococcus and enterococcus); Gram negatives (but not pseudomonas); Anaerobes
What bugs does tigecycline cover?
Gram positives (includes MRSA); VRE; Gram negatives (but NOT pseudomonas or proteus); Anaerobes
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