Podcast
Questions and Answers
What is the purpose of hospitalization for patients with rare severe infections?
What is the purpose of hospitalization for patients with rare severe infections?
- To perform surgical procedures
- To monitor dietary habits
- To ensure consistent administration of specific therapies (correct)
- To provide psychological support
Which therapy is mentioned as a possible treatment for severe infections?
Which therapy is mentioned as a possible treatment for severe infections?
- Oral penicillin
- Subcutaneous amoxicillin
- Topical clindamycin
- Intravenous aminoglycoside-cephalosporin combination (correct)
How frequently should fortified topical vancomycin be administered?
How frequently should fortified topical vancomycin be administered?
- Once a day
- Every 30 minutes
- Every hour to every two hours
- Every 15 minutes to hourly (correct)
Which condition does NOT indicate the need to empirically treat for MRSA?
Which condition does NOT indicate the need to empirically treat for MRSA?
What is one of the treatment options for managing severe infections aside from the aminoglycoside-cephalosporin combination?
What is one of the treatment options for managing severe infections aside from the aminoglycoside-cephalosporin combination?
What factor is associated with a higher likelihood of MRSA infection that would warrant empirical treatment?
What factor is associated with a higher likelihood of MRSA infection that would warrant empirical treatment?
Which of the following best describes the administration method for therapies mentioned for severe infections?
Which of the following best describes the administration method for therapies mentioned for severe infections?
Which of the following is a reason to consider MRSA treatment alongside systemic inflammatory response syndrome (SIRS)?
Which of the following is a reason to consider MRSA treatment alongside systemic inflammatory response syndrome (SIRS)?
Which condition would most likely necessitate empirically treating for MRSA?
Which condition would most likely necessitate empirically treating for MRSA?
What is a significant indicator of MRSA infection risk in patients who use injectable drugs?
What is a significant indicator of MRSA infection risk in patients who use injectable drugs?
What is the most common area for erysipelas to occur?
What is the most common area for erysipelas to occur?
Which symptom is commonly associated with erysipelas?
Which symptom is commonly associated with erysipelas?
What characterizes the edge of an erysipelas infection?
What characterizes the edge of an erysipelas infection?
How common is facial erysipelas compared to other locations?
How common is facial erysipelas compared to other locations?
Which of the following symptoms would NOT be indicative of erysipelas?
Which of the following symptoms would NOT be indicative of erysipelas?
What characterizes acute, necrotizing cellulitis in terms of tissue infection?
What characterizes acute, necrotizing cellulitis in terms of tissue infection?
Which of the following symptoms may arise from acute, necrotizing cellulitis?
Which of the following symptoms may arise from acute, necrotizing cellulitis?
What is the primary tissue affected by acute, necrotizing cellulitis?
What is the primary tissue affected by acute, necrotizing cellulitis?
What alteration may occur in the skin due to necrotizing cellulitis?
What alteration may occur in the skin due to necrotizing cellulitis?
Which of the following conditions is associated with the infection altering surrounding tissue in acute, necrotizing cellulitis?
Which of the following conditions is associated with the infection altering surrounding tissue in acute, necrotizing cellulitis?
What is the primary basis for making a diagnosis?
What is the primary basis for making a diagnosis?
In which scenario is bacterial culture and sensitivity testing recommended?
In which scenario is bacterial culture and sensitivity testing recommended?
Which of the following is NOT a common method for diagnosis?
Which of the following is NOT a common method for diagnosis?
Why is bacterial culture and sensitivity important in certain cases?
Why is bacterial culture and sensitivity important in certain cases?
Which condition would inherently require bacterial cultures due to higher risk?
Which condition would inherently require bacterial cultures due to higher risk?
What does the term 'acute infection of the pulmonary parenchyma' refer to?
What does the term 'acute infection of the pulmonary parenchyma' refer to?
Which factor is NOT mentioned as a characteristic of the infection described?
Which factor is NOT mentioned as a characteristic of the infection described?
Which diagnostic method is indicated to confirm the presence of pneumonia in this definition?
Which diagnostic method is indicated to confirm the presence of pneumonia in this definition?
What type of pneumonia is described in this definition?
What type of pneumonia is described in this definition?
Which symptom is most closely associated with the defined pulmonary infection?
Which symptom is most closely associated with the defined pulmonary infection?
Flashcards
Erysipelas location
Erysipelas location
Erysipelas usually appears on the legs and feet, though facial cases are possible.
Erysipelas Symptoms
Erysipelas Symptoms
Erysipelas presents with warmth, redness (erythema), and pain.
Infection edge
Infection edge
The edge of an erysipelas infection is raised and distinctly separated from healthy skin.
Rare severe infections
Rare severe infections
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Hospitalization
Hospitalization
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Aminoglycoside-cephalosporin combination therapy
Aminoglycoside-cephalosporin combination therapy
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Fortified aminoglycoside-cephalosporin therapy
Fortified aminoglycoside-cephalosporin therapy
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Fortified topical vancomycin treatment
Fortified topical vancomycin treatment
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Topical fluoroquinolone monotherapy
Topical fluoroquinolone monotherapy
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Treatment every 15 minutes to hourly
Treatment every 15 minutes to hourly
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MRSA Treatment
MRSA Treatment
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Penetrating trauma
Penetrating trauma
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Injection drug use
Injection drug use
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Purulent drainage
Purulent drainage
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Nasal MRSA colonization
Nasal MRSA colonization
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Concurrent MRSA infection
Concurrent MRSA infection
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Systemic Inflammatory Response Syndrome (SIRS)
Systemic Inflammatory Response Syndrome (SIRS)
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Severe nonpurulent inflammation
Severe nonpurulent inflammation
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Diagnosis Method
Diagnosis Method
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Bacterial Culture Use
Bacterial Culture Use
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Acute Necrotizing Cellulitis
Acute Necrotizing Cellulitis
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Tissue Involvement
Tissue Involvement
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Tissue Destruction
Tissue Destruction
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Gangrene Risk
Gangrene Risk
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Cutaneous Anesthesia
Cutaneous Anesthesia
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Community-acquired pneumonia
Community-acquired pneumonia
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Acute pulmonary parenchyma infection
Acute pulmonary parenchyma infection
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Chest X-ray findings
Chest X-ray findings
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Auscultatory findings
Auscultatory findings
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Infiltrate
Infiltrate
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Study Notes
Student Book of Pharmacology-IV
- Fourth Year Pharm D Students
- By Prof. Salah Gharieb, Prof. Mona Fouad, Ass. Prof. Islam Ahmed Elazizy
- Course covers Infectious Diseases, Surgical Prophylaxis, Respiratory Tract Infections, Skin and Skin Structure Infections, Urinary Tract Infections, Diabetic Foot Infections, Impetigo, Osteomyelitis, Necrotizing Fasciitis, Brain Abscess, Peritonitis, and Intra-abdominal Infections, and Clostridium Difficile Infection.
Course Contents
- Week 1: Endocarditis, lectured by Prof. Salah Ghareib
- Week 2: Surgical prophylaxis, lectured by Prof. Salah Ghareib
- Week 3: Pneumonia, lectured by Prof. Mona Fouad
- Week 4: Pneumonia, lectured by Prof. Mona Fouad
- Week 5: Influenza, Sinusitis, RSV infection, lectured by Prof. Mona Fouad
- Week 6: Urinary tract infections, lectured by Prof. Mona Fouad
- Week 7: Midterm exam
- Week 8: Acute otitis media, Eye infection, lectured by Prof. Mona Fouad
- Week 9: Skin and skin structure infections, lectured by Ass. Prof. Islam Ahmed
- Week 10: Osteomyelitis, lectured by Ass. Prof. Islam Ahmed
- Week 11: Meningitis, Brain abscess, lectured by Ass. Prof. Islam Ahmed
- Week 12: Peritonitis, lectured by Ass. Prof. Islam Ahmed
- Week 13: Clostridium difficile infection, lectured by Ass. Prof. Islam Ahmed
Part I
- By Prof. Salah Gharieb
Infectious Disease: Infective Endocarditis
- Introduction:
- Infection of heart valves or endocardial tissue.
- Vegetation (platelet-fibrin complex) infected with microorganisms.
- Presentation and Clinical Findings:
- Fever (low-grade, remittent)
- Cutaneous manifestations (petechiae, Janeway lesions, splinter hemorrhages)
- Cardiac murmur
- Arthralgias, myalgias, low back pain, arthritis
- Fatigue, anorexia, weight loss, night sweats
- Laboratory Findings:
- Anemia, normochromic, normocytic
- Leukocytosis
- Elevated erythrocyte sedimentation rate
- Positive blood culture (78%-95% of patients)
- Complications:
- Congestive heart failure (38%-60% of patients)
- Emboli (22%-43% of patients)
- Mycotic aneurysm (5%-10% of patients)
- Microbiology:
- Three to five blood cultures (10 mL each), obtained within 24-48 hours.
- Empiric therapy should be initiated only in acutely ill patients, before cultures come back. -Table showing incidence of microorganisms in endocarditis.
Surgical Prophylaxis
- Introduction: Giving antibiotic before bacterial contamination
- Classification of Surgical Procedures: Clean, Clean-Contaminated, Contaminated, and Dirty Procedures, and their infection rates
- Recommended Prophylaxis for Dental or Respiratory Tract Procedures (list of procedures and dosages/regimens)
Respiratory Tract Infections: Pneumonia
- Definition: Acute infection of pulmonary parenchyma.
- Hospital-Acquired Pneumonia (HAP):
- Second most common nosocomial infection.
- Ventilator-Associated Pneumonia (VAP): Higher incidence in ICU, surgery patients
- Community-Acquired Pneumonia (CAP): less than 1% mortality without hospitalization.
- About 14% mortality with hospitalization.
- Mortality Rates:
- HAP: 38%-60%
- Emboli: 22%-43%
- Mycotic aneurysm: 5%-10%
Skin and Skin Structure Infections
- Cellulitis: Acute spreading skin infection.
- Erysipelas: Acute spreading skin infection, usually in extremities. Poorly defined margins.
- Necrotizing Fasciitis: Acute, necrotizing cellulitis involving subcutaneous fat and superficial fascia
- Microorganisms: Streptococcus pyogenes
- Treatment: Penicillin G, Cefazolin, or Ceftriaxone (if severe, MRSA associated).
Urinary Tract Infections
- Lower UTI: Cystitis, frequent urination, pain, dysuria
- Upper UTI: Pyelonephritis, costovertebral angle tenderness, fever, chills.
- Microorganisms: Escherichia coli most common.
- Predisposing factors: Age, female sex, diabetes, pregnancy, immunodeficiency, urinary tract instrumentation, obstruction, renal disease
- Treatment: Trimethoprim/sulfamethoxazole, Levofloxacin, or Ciprofloxacin (outpatient) depending on severity
- Recurrent Cystitis: Relapse vs. Reinfection.
Diabetic Foot Infections
- Epidemiology: 25% of people with diabetes develop foot infections.
- Etiology: Neuropathy, vasculopathy, immunologic defects
- Microorganisms: Polymicrobial, including S. aureus, Group A Streptococcus.
- Therapy: Mild infections: Dicloxacillin; Moderate/severe infections: vancomycin and clindamycin
Impetigo
- Definition: Acute skin infection affecting superficial layers of epidermis.
- Types: Bullous and nonbullous
- Causes: S. pyogenes or S. aureus
- Treatment: Topical antibiotics (mupirocin, retapamulin, or other topical antibiotics) or Systemic antibiotics (cephalexin).
Osteomyelitis
- Definition: Infection of the bone.
- Causes: Direct extension, hematogenous spread.
- Signs/Symptoms: Fever, localized pain, tenderness, swelling
- Treatment: Intravenous antibiotics tailored to the suspected pathogen.
Brain Abscess
- Pathophysiology: Direct extension, retrograde septic phlebitis, or hematogenous spread.
- Signs/Symptoms: Expanding intracranial mass lesion, seizures, fever, headache
- Microorganisms: Usually polymicrobial (Streptococcus spp., anaerobes)
- Treatment: Surgical debridement and drainage, often with antibiotics.
Peritonitis
- Definition: Inflammation of the peritoneum lining the abdominal cavity.
- Types: Primary (spontaneous) and secondary (due to another abdominal process).
- Causes of Secondary Peritonitis: Perforation, GI organ perforation, operative contamination.
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