Bugs and drugs

MCO of Cellulitis

MCO of Cellulitis

Strep, staph

Treatments of cellulitis

Primary: keflex Alt.: azithromycin

MCO of Abscess

MRSA

Treatment of abscess

I&D, then bactrim or clindamycin

MCO of impetigo

streptococcus pyogenes

treatment of impetigo

local: mupirocin topical diffuse: bactrim or Pen VK oral

MCO of dog bites

pasturella canis

treatment of dog bites

update tdap primary: augmentin alt.: clindamycin and ciprofloxacin

MCO of cat bites

pasturella multicida

treatment of cat bites

update tdap primary: augmentin alt.: cefuroxime or doxycycline

MCO of human bites

strep viridans, staph epidermidis, corynebacterium

treatment of human bites

update tdap no ssx infxn: augmentin alt.: clindamycin and ciprofloxacin

MCO acute otitis media

S. pneumoniae, H flu, M. catarrhalis

treatment of otitis media

primary: amoxicillin, if rx abx in the prior month give augmentin Alt.: augmentin or cefdinir

MCO of acute otitis externa

s. aureus, pseudomonas

treatment of acute otitis externa

primary: ciprofloxacin + hydrocortisone (cipro HC otic) Alt.: ofloxacin otic (floxin)

MCO of suppurative conjunctivitis

s. aureus, S. pneumoniae, H. flu

treatment of suppurative conjunctivitis

primary: ciprofloxacin opthalamic ( ciloxan) Alt.: polymyxin B + triethoprim (polytrim)

MCO of pharyngitis/tonsilitis

Group A, C, G strep

treatment of pharyngitis/tonsilitis

cefdinir or penicillin VK or penicillin G Alt.: azithromycin or clindamycin

MCO of acute sinusitis

S. pneumoniae, H flu, M. catarrhalis

treatment of acute sinusitis

primary: augmentin 10-14d Alt: cefpododime or levofloxacin

MCO community acquired pneumonia >18 yo

S. pneumonia, atypicals and mycoplasma, H. flu, M. catarrhalis

treatment of community acquired pneumonia

Primary

• No comorbidity: doxycycline or amoxicillin

• Comorbidity: augmentin + azithromycin

Alt:

• No comorbidity: azithromycin

• comorbidity: levofloxacin

treatment of culture proven strep pneumoniae CAP

Primary:

• PCN susceptible: PCN G or amoxicillin +/- azithromycin

• Alt: doxycycline

• PCN resistant: levofloxacin

MCO tuberculosis, active

mycobacterium tuberculosis

treatment of active tuberculosis

not resisitant: rifapentine + isonaizid + pyrazinamide +ethambutol x2 months then rifampin + isonaizid + pyrazinamide x4 months with pyridoxine (vit B6)

alt: multiple combinations

MCO of whooping cough

bortatella pertussis

treatment of whooping cough

Primary: azithromycin Alt: bactrim

MCO of acute bronchitis

90% viral 5% mycoplasma pneumoniae 5% C. pneumoniae

treatment of acute bronchitis

primary: doxycycline alt: azithroymcin or augmentin

MCO of acute bacteria exacerbation of chronic bronchitis

20-50% viral C. pneumoniae mycoplamsa pneumoniae

treatment of acute bacterial exacerbation of chronic bronchitis

primary: doxycycline or bactrim and prednisone alt: azithromycin or levofloxacin

MCO of nosicomial or abx associated enterocolitis

C. diff

treatment of nosicomial or abx assoc. enterocolitis

oral vacnomycin or fidaxomycin

MCO of mild diverticulitis

enterobacteriaciae like bacteriodies fragilis and E. coli

treatment of mild diverticulitis

Primary: ciprofloxacin and metronidazole or bactrim and metronidazole alt: augmentin and metronidazole

MCO of travelers diarrhea

E. coli, shigella, salmonella or camphylobacter

treatment of travelers diarrhea

primary: ciprofloxacin alt: azithromycin

MCO of urethritis/cervicitis

Nisseria gonorrhea chlamydia trachomatis

treatment of urethritis/cervicitis- N. gonorrhea

ceftriaxone 1g IM x1

alt: azithromycin

treatment of urethritis/cervicitis- chlamydia

doxycycline 100 BID

alt: azithromycin or levofloxacin

MCO UTI uncomplicated in women

e. coli, P mirabilis, K. pneumoniae, S. saprophyticus

treatment of UTI uncomplicated in women

bactrim x3d or nitrofurantoin x5d

alt: rocephin

MCO of UTI complicated in either sex

e. coli, P. aeurginosa, enterococci, S. aureus, candida species

treatment of UTI complicated in either sex

levofloxacin

alt: ceftriaxone (rocephin)

MCO of UTI pregnant

E. coli, group B strep, enterobacter, proteus, klebsiella

treatment of UTI pregnant

nitrofurantoin x5-7d or augmentin

alt: cephalexin

MCO pyelonephritis in women

e. coli, p. aeurginosa, enterococci, s. aureus

treatment of pyelonephritis in women

ciprofloxacin 500 BID x5-7d

MCO of acute bacterial prostatitis, uncomplicated

treatment of acute bacterial prostatitis, uncomplicated

MCO of chancroid

Haemophilus ducreyi

treatment of chancroid

ceftriaxone IM or azithromycin

alt: ciprofloxacin

MCO of syphilis

treponema palidum

treatment of syphilis

PCN G

alt: doxycycline

MCO of acute noninvasive gastroenteritis- non-invasive

norovirus, rotavirus, bacillus cereus, staph aureus, clostridium perfringens