Antibiotics and Bacterial Infections
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Questions and Answers

Which antibiotic is commonly used to treat bacterial conjunctivitis?

  • Azithromycin
  • Linezolid
  • Moxifloxacin (correct)
  • Cephalosporin

    • What is the primary bacterium that causes trachoma?

  • Chlamydia trachomatis (correct)
  • Escherichia coli
  • Haemophilus influenzae
  • Streptococcus pneumoniae

    • Which of the following is NOT a common bacterial infection?

  • Pneumonia
  • Meningitis (correct)
  • Otitis media
  • Strep throat

    • What is the usual duration of bacterial conjunctivitis before it resolves on its own?

    <p>5-7 days</p> Signup and view all the answers

    Which antibiotic is used to treat H.pylori infection?

    <p>Macrolide</p> Signup and view all the answers

    What is the primary presentation of trachoma?

    <p>Roughening of inner surface of eye</p> Signup and view all the answers

    Which of the following is NOT a treatment for trachoma?

    <p>Moxifloxacin ophthalmic solution</p> Signup and view all the answers

    What is the primary cause of otitis media?

    <p>Viral URI</p> Signup and view all the answers

    What is the common pathogen causing otitis externa?

    <p>S. pneumoniae</p> Signup and view all the answers

    What is the first line of treatment for strep throat in a patient allergic to penicillin?

    <p>1G cephalosporin</p> Signup and view all the answers

    What is the treatment of choice for peritonsillar abscess?

    <p>Surgical I&amp;D + Clindamycin</p> Signup and view all the answers

    What is the etiology of catarrhalis?

    <p>Virus</p> Signup and view all the answers

    What is the common symptom of otitis externa?

    <p>All of the above</p> Signup and view all the answers

    What is the treatment of choice for impetigo?

    <p>Oral antibiotics</p> Signup and view all the answers

    What is the complication of tonsillitis?

    <p>Peritonsillar abscess</p> Signup and view all the answers

    What is the antibiotic of choice for otitis media in a patient allergic to penicillin and cephalosporins?

    <p>Azithromycin</p> Signup and view all the answers

    What is the primary bacterium responsible for causing Rocky Mountain Spotted fever?

    <p>Rickettsia rickettsii</p> Signup and view all the answers

    What is the treatment of choice for Lyme disease in non-pregnant individuals?

    <p>Doxycycline</p> Signup and view all the answers

    What is the mode of transmission of Cellulitis?

    <p>Through cuts, scratches, burns, incisions, catheters, etc.</p> Signup and view all the answers

    What is the treatment of choice for MRSA infections?

    <p>Vancomycin</p> Signup and view all the answers

    What is the etiology of Pyogenes?

    <p>Streptococcus pyogenes</p> Signup and view all the answers

    What is the primary site of infection for Rocky Mountain Spotted fever?

    <p>Skin</p> Signup and view all the answers

    What is the treatment of choice for animal bites?

    <p>Amoxicillin/clavulanate</p> Signup and view all the answers

    What is the etiology of CAP pneumonia?

    <p>Multiple bacteria including S.pneumo, H.influenzae, S.aureus, and others</p> Signup and view all the answers

    What is the primary treatment for gonorrhea?

    <p>Single dose of ceftriaxone IM + azithromycin single dose PO</p> Signup and view all the answers

    What is the presentation of syphilis in the secondary stage?

    <p>Skin/mucous membrane rash</p> Signup and view all the answers

    What is the most common cause of UTIs?

    <p>E. coli</p> Signup and view all the answers

    What is the treatment for chlamydia?

    <p>Azithromycin single dose PO</p> Signup and view all the answers

    What is the term for asymptomatic bacteriuria?

    <p>Asymptomatic bacteriuria</p> Signup and view all the answers

    What is the treatment for syphilis in penicillin-allergic patients?

    <p>Tetracycline PO x 2 weeks</p> Signup and view all the answers

    What is a characteristic symptom of prostatitis?

    <p>Prostatic/perineal pain</p> Signup and view all the answers

    What is the term for UTIs that occur in non-pregnant outpatient women without abnormalities or instrumentation?

    <p>Uncomplicated UTI</p> Signup and view all the answers

    What is the treatment for a previously healthy individual with community-acquired pneumonia who has not taken antibiotics in the past three months?

    <p>Clarithromycin or azithromycin or doxycycline</p> Signup and view all the answers

    What is the primary cause of urethritis?

    <p>N. gonorrhea or C. trachomatis</p> Signup and view all the answers

    What is the treatment for severe C. difficile infection?

    <p>Vancomycin</p> Signup and view all the answers

    What is the typical presentation of diverticulitis?

    <p>LLQ pain and tenderness, fever, elevated WBC count</p> Signup and view all the answers

    What is the primary cause of community-acquired pneumonia?

    <p>Enterobacteriaceae, P. aeruginosa, Bacteroides spp., and enterococci</p> Signup and view all the answers

    What is the treatment for H. pylori infection?

    <p>Quadruple therapy</p> Signup and view all the answers

    What is the risk factor for developing C. difficile infection?

    <p>Previous use of antibiotics</p> Signup and view all the answers

    What is the bacterium that colonizes 100% of people with duodenal ulcers and 80% of gastric ulcers?

    <p>H. pylori</p> Signup and view all the answers

    Study Notes

    Antibiotics

    • Cell wall inhibitors: PNCs, cephalosporins, carbapenems
    • Protein synthesis inhibitors: AGs, tetracyclines, macrolides, linezolid, mupirocin
    • Antifolate drugs
    • Fluoroquinolones

    Common Bacterial Infections

    Bacterial Conjunctivitis

    • Inflammation of conjunctiva from infection
    • Self-limited, resolves in 5-7 days
    • Presentation: conjunctival erythema, eyelid edema, mucopurulent discharge, crusting
    • Treatments: Tobramycin ophthalmic solution, Neomycin/Polymixin/Gramicidin ophthalmic solution, Moxifloxacin ophthalmic solution

    Trachoma

    • Highly contagious ocular infection caused by Chlamydia trachomatis
    • Presentation: roughening of inner surface of eye, corneal breakdown, eye discharge, light sensitivity
    • Treatments: Azithromycin single dose, Sulfacetamide ophthalmic solution, Tetracycline ophthalmic solution/ointment

    Otitis Media

    • Typically follows viral URI which can directly cause viral OM or predispose to bacterial OM
    • Etiology: S.pneumo (35%), H.influenzae, M.catarrhalis, viruses
    • Presentation: Immobile, erythematous TM; otalgia, otorrhea, fever
    • Treatment: mild-to-moderate resolves within 1 week without tx; NSAIDs, Amoxicillin, Cefdinir, Azithromycin

    Otitis Externa

    • Results from combo of heat and retained moisture with desquamation and maceration of epithelium of canal
    • Etiology: P.aeruginosa, S.pneumo
    • Presentation: Ear discharge, pain with palpation of tragus/pinna, ear canal edema and discomfort
    • Treatment: Topical otic abx ± topical steroids, Neomycin/Polymyxin/Hydrocortisone otic suspension, Ciprofloxacin/Dexamethasone otic suspension

    Streptococcal Pharyngitis

    • Pharyngeal infection caused by GAS aka S.pyogenes
    • Presentation: Sore throat, fever, chills, purulent tonsillar exudate, cervical LAD
    • Treatments: Penicillin V, 1G cephalosporin (Cephalexin) if PCN allergic, Clindamycin if allergic to PCN + cephalosporins due to resistance to macrolides

    Peritonsillar Abscess

    • Also called quinsy, complication of tonsillitis
    • Consists of collection of pus in peritonsillar space; considered an ENT emergency
    • Etiology: Oral flora including anaerobes, GAS
    • Presentation: Severe U/L sore throat, dysphagia, dysphonia, referred otalgia, “hot potato voice”, LAD, trismus
    • Treatment: Surgical I&D + abx, Clindamycin or Metronidazole + Benzathine Penicillin G

    Impetigo

    • Superficial skin infection seen in young children
    • Etiology: S.aureus, S.pyogenes
    • Presentation: Red papular lesions that evolve to pustules, honeycomb-like crusting affecting facial areas
    • Treatment: Mupirocin topical, Dicloxacillin or Cephalexin if extensive

    Cellulitis

    • Bacterial infection of skin; bacteria enter through cuts, scratches, burns, incisions, catheters, etc.
    • Etiology: MRSA, MSSA, P.multocida (cat/dog bites), Eikenella cordoned (human bite), P.aeuginosa (penetrating injury)
    • Presentation: Localized pain, erythema, swelling, heat
    • Treatment: Depends on the cause, Amoxicillin/Clavulanate for animal bites, Dicloxacillin or Oxacillin for MSSA, Clindamycin, Vancomycin, or Linezolid for MRSA

    Rocky Mountain Spotted Fever

    • Tick/mite-born illness
    • Transmitted by American dog tick (Dermacentor variabilis) and Rocky Mountain wood tick (D.andersoni)
    • Etiology: R.rickettsii
    • Presentation: Evolving macular rash; rarely CNS involvement, hypovolemia, HoTN, renal failure
    • Treatment: Doxycycline, Chloramphenicol if pregnant or allergic

    Lyme Disease

    • Spirochetal infection transmitted by ticks (Ixodes scapularis)
    • Etiology: Borrelia burgdorferi
    • Presentation: ECM (stage 1), nonspecific sx like HA, muscoskeletal pain, neurologic deficits (stage 2), arthritis (stage 3)
    • Treatment: Doxycycline, Amoxicillin, Cefuroxime, or Erythromycin are alternative agents

    Community-Acquired Pneumonia (CAP)

    • Infection of lung parenchyma
    • Etiology: S.pneumo, H.influenzae, S.aureus, K.pneumoniae, P.aeruginosa; atypicals like M.pneumoniae, C.pnuemoniae, Legionella spp.
    • Presentation: Fever, chills, cough, sweats, pleuritic CP, and dyspnea
    • Treatment: Clarithromycin, Azithromycin, or Doxycycline if previously healthy and no abx in past 3 mo, Respiratory fluoroquinolone (e.g., Moxifloxacin or Levofloxacin) if co-morbidities or previous abx use (alt: high-dose Amoxicillin/Clavulanate plus Macrolide)

    Diverticulitis

    • Digestive disease in which pouches form within the bowel wall
    • Etiology: Enterobacteriaceae, P.aeruginosa, Bacteroides spp., and enterococci
    • Presentation: LLQ pain + tenderness, fever, elevated WBC count
    • Treatment: Ciprofloxacin plus Metronidazole, Alternative agents include TMP/SMX, Amoxicillin/Clavulanate

    H.Pylori Infection

    • Colonizes 100% of people with DU, 80% of GU
    • Etiology: H.pylori
    • Presentation: Burning epigastric pain 90min to 3hr after eating (DU) or worse with eating/ unrelated (GU)
    • Treatment: Quadruple therapy first-line

    C.Difficile Colitis

    • Diarrheal illness
    • Most commonly acquired in hospital
    • All abx has risk of CDI
    • Etiology: C.difficile
    • Presentation: Malodorous diarrhea, up to 20 BMs/day
    • Treatment: Metronidazole for mild-moderate disease, Vancomycin for severe disease

    Urethritis

    • Commonly caused by N.gonorrhea or C.trachomatis
    • Presentation: Mucopurulent urethral discharge
    • Treat while symptoms are present
    • Treatment: Gonorrhea: single dose of Ceftriaxone IM + Azithromycin single dose PO, Cefpodoxime PO, or Cefixime PO, Chlamydia: Azithromycin single dose PO, Doxycycline PO x 7 days

    Syphilis

    • Spirochetal infection caused by T.pallidum
    • Presentation: Painless chancre (1º), skin/mucous membrane rash (2º), symptomless (latent), neurologic/ cardiovascular sx (3º)
    • Treatment: Benzathine Penicillin G single dose, Tetracycline or Doxycycline x 2 weeks if allergic

    Urinary Tract Infections (UTIs)

    • Term encompasses cystitis, pyelonephritis, prostatitis, and asymptomatic bacteriuria
    • Uncomplicated UTI refers to acute disease in non-pregnant outpatient women without abnormalities or instrumentation; complicated UTIs refers to all other UTIs
    • Etiology: E.coli (75-90%), S.saprophyticus, Klebsiella spp., Proteus spp., Citrobacter spp.
    • Presentation: Dysuria, freq/urgency (cystitis); fever, LBP, CVAT, N/V (pyelo); dysuria, freq, chills, prostatic/perineal pain (prostatitis)

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    Description

    This quiz covers types of antibiotics, including cell wall inhibitors and protein synthesis inhibitors, as well as common bacterial infections such as conjunctivitis, pneumonia, and cellulitis.

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