jmnies's version from 2017-05-07 06:46


DiseaseDrug2nd line
If penicillin allergy:Doxy, levo or moxi (adults) Levo (children)
clinda + 3rd gen ceph (Cefpodoxime) for children, doxy, levo or moxi for adults
AOMAmox, abx within 30 days: augmentin
Pen allergy then ceph, min 10 d treatment <2>2 7 day/>6 is 5 day
augmentin (if amox unsuccessful) or cefpodoxime, cefuroxime, or cefdinir or ceftriaxone IM shot/3 day IV
Recurrent OM3 episodes in 6 months or 4 within one year
AOEFQ drops (cipro, ofloxacin)neomycin/polymyxinB/hydrocortisone drops or azole if fungal
Simple chronic bronchitisAmox, Doxy, Macrolide or BactrimAug; Ceph 2/3
Complicated chronic bronchitis (FEV<50), abx use in the past 3 monthsAugmentin or Ceph 2/3 or DoxyMacrolide; FQ
Severe Complicated bronchitis (FEV<35), pseudomonasLevofloxacin or Cipro (for pseudomonas)
H flu (Acute Bronchitis)Amoxicillin
M. Cat, H flu (beta lactamase producing)(Acute Bronchitis)Augmentin
M. Pneumo, chlamydophila pneumo (Acute Bronchitis)Macrolide (erythromycin, clarithromycin, azithromycin) or doxycycline
B. Pertussis (Acute Bronchitis)Macrolide
Influenza A & B (Acute Bronchitis)Oseltamivir or Zanamivir
Previously healthy, no recent antibiotic use (Outpatient CAP)Macrolide or Doxy
Comorbidities or Abx use within past 3 months or >60 y/o (Outpatient CAP)Aug plus Macrolide
FQ alone
Geographic region with high rate or macrolide-resistant S.pneumoniaeHigh dose Amox or AUG plus macro (atypical) or FQ
MRSAvancomycin, SMP-TMX, linezolid, clinadmycin
Aspiration (Outpatient CAP)Aug or Clinda
Influenza pneumoniaOstelamivir or zanamivir
Children <5 y (Outpatient CAP)AmoxAug or Zpak (atypical)
Children >5 y (CAP)Amox or AugAug or Zpak (atypical) or Doxy (>7)
General IP ward or ICU (inpatient CAP)Parenteral beta-lactam (ceph 2/3, amp/subbactam, etc) + macrolide
ICU w/ risk for pseudomonasAntipseudomonal beta-lactam (PIP-TZ, cefepine, etc) +FQ or AG + Zpak
Influenza pneumoniaOseltamivir
Influenza + bacterial superinfectionCeph 2/3 or FQ + Vanco or Linezolid
All ages fully immunized (children in hospital)Ampicillin or Pen G + zpak Ceph 2/3 (instead of amp) or Doxy (>7) (instead of macro) or other macro
All ages not immunized (children in hospital)Ceph 2/3 + Zpak and add clinda or vanco if MRSA Doxy (>7) (instead of macro) or other macro
Active Tb (<4% INH resistance)INH, RIF, ETB and PZA; if organisms susceptible D/C ETB and PZA after 2 mo continue for 4 mo w/ 2 INH/RIF
Active Tb (>4% INH resistance)add SM +/- FQ to the standard regimen
Standard (LTBI)INH daily (+/- B6)RIF if not compliant
Pregnancy, alcoholics or poor dietINH + pyridoxine daily
INH resistance (LTBI)Rifampin +/- pyrazinamide or rifabutin (HIV)


Question Answer
Sulfonamidessteven johnson syndrome
Tachyphylaxisrapid loss of responsiveness
Ayptical CAP organismlegionella, M. pneumoniae, C. pneumoniae
MC causative pathogen of acute pharyngitisrhinovirus
Inhaled ICS SEoral candidiasis, dysphonia
OTC medication to help with sinus drainagepseudo ephedrine
Otitis externaofloxacin otic
Necrotizing otitis externaDM
Otitis externapseduomonas a
Gold standard for otits externa and SEcontact dermatitis and ototoxicity, neomycin, polymyxin B, hydrocortisone
Zafirlukastluekotriene receptor agonist
Serious SE of inhaled GChyperglycemia
Allergy induced asthma that cannot be controlledomalizumab
Mild perisistent asthma in a childlow dose inhaled CS
Spacer, rinse mouthBudesonide (ICS)
Previously healthy and no use of antimicrobials within the previous 3 monthsMacrolide (azithromycin, clarithromycin, or erythromycin) OR Doxycyline
Presence of comorbidities, immunosuppressing conditions, use of antimicrobials within the previous 3 months (in which case an alternative from a different class should be selected)levofloxacin OR beta-lactam plus macrolide
Mycoplasma pnemo infectionmacrolide
Anti-myobacterium drugs for minimum of6 months
INHstandard for LT TB, peripheral neuropathy & hepatitis greater risk in elderly, ethanol abuse, monitor LFTs
RIF1st for AIDs TB, flu like syndrome, red orange urine
ETHoptic neuritics, monitor vision
Streptomycinnephrotoxic; ototoxic
PyrazinamidePolyarthralgias, hepatotoxicity & hyperuricemia leading to gout

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