Abx Pharmacotherapeutics PDF

Antibiotics Cell wall inhibitors (e.g., PNCs, cephalosporins, carbapenems) Protein synthesis inhibitors (e.g., AGs, tetracyclines, macrolides, linezolid, mupirocin) Antifolate drugs Fluoroquinolones Common bacterial infections ○ Bacterial conjunctivitis ○ Trachoma...

Antibiotics Cell wall inhibitors (e.g., PNCs, cephalosporins, carbapenems) Protein synthesis inhibitors (e.g., AGs, tetracyclines, macrolides, linezolid, mupirocin) Antifolate drugs Fluoroquinolones Common bacterial infections ○ Bacterial conjunctivitis ○ Trachoma ○ Otitis media/externa ○ Streptococcal pharyngitis ○ Peritonsillar abscess ○ Pneumonia ○ Cellulitis ○ Impetigo ○ RMSF/Lyme disease ○ Diverticulitis ○ H. pylori infection ○ C. difficle infection ○ STDs (e.g., GC, syphilis) ○ UTIs Bacterial conjunctivitis ○ Inflammation of conjunctiva from infection ○ Self-limited, will usually resolve in 5-7 days ○ Presentation: conjunctival erythema, eyelid edema, mucopurulent d/c, crusting ○ Treatments: Tobramycin ophthalmic sol Neomycin/polymixin/gramicidin ophthalmic sol aka Neosporin® ophthalmic Moxifloxacin ophthalmic sol aka Vigamox® Trachoma ○ Highly contagious ocular infection caused by Chlamydia ○ trachomatis ○ Presentation: roughening of inner surface of eye, corneal breakdown, eye d/c, light ○ sensitivity ○ Treatments: Azithromycin single dose Sulfacetamide ophthalmic sol Tetracycline ophthalmic sol/oint Otitis Media ○ Typically follows viral URI which can directly cause viral OM or predispose to baterial 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 aka Amoxil® or Cefdinir aka Omnicef®  Azithromycin aka Z-Pak® if allergic to PCN/ cephalosporins 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 d/c, pain with palpation of tragus/pinna, ear canal edema and discomfort ○ Treatment: topical otic abx ± topical steroids Neomycin/polymyxin/hydrocortisone otic susp aka Cortisporin® Ciprofloxacin/dexamethasone otic susp aka Ciprodex® Strep throat ○ 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 macrocodes 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 aka Bactroban® 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/clavulante aka Augmentin® for animal bites Dicloxacillin or oxacillin for MSSA Clindamycin, vancomycin, or linezolid aka Zyvox® 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, near deficits (stage 2), arthritis (stage 3) ○ Treatment: Doxycycline Amoxicillin, cefuroxime, or erythromycin are alternative agents CAP pneumonia ○ 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 aka Biaxin®, azithromycin aka Zithromax®, or doxycycline if previously healthy and no abx in past 3 mo Respiratory fluoroquinolone (e.g., moxifloxacin aka Avelox or levofloxacin aka Levaquin®) 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 aka Cipro® plus metronidazole aka Flagyl® Alternative agents include TMP/SMX aka Bactrim®, amoxicillin/clavulanate aka Augmentin H. Pylori infection ○ Colonizes 100% of people with DU, 80% of GU ○ Etiology: H. pylori (obviously) ○ 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 (obviously) ○ 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 d/c ○ 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 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) ○ ○