CPJE(treatment options for most common diseases and other "high-yield" stuff)

MRSA PO

Bactrim

Doxycycline

Clindamycin

Linezolid/Zyvox

Tidezolid/Sivextro

Delafloxacin/Baxdela

omadacycline/Nuzyra

​

MRSA IV

Vancomycin.  [mrsa Pneumonia]

Clindamycin

Linezolid.       [mrsa Pneumonia]

Tedizolid

Delafloxacin/Baxdela

Daptomycin/cubicin

ceftaroline/teflaro

quinipristin/Dalfopristin

tigecycline/Tygacil

omadacycline/nuzyra

dalbavancin/Dalvance

oritavancin/Orbactiv

telavancin/Vibativ. [mrsa Pneumonia]

​

Enterococci (urine, sepsis,endocarditis)

1.Ampicillin+Gentamycin

2.Ampicillin+Ceftriaxone

if ampicillin allergy

Vanco+Genta

​

VRE

Daptomycin

Linezolid

tigecicline

telavancin

oritavancin

synercid

Diphtheria treatment

pcn or Erythromycin ×14days

close contact prophylaxis:vaccine&Abx(erythromycin ×7d or PCN G IM×1)

Listeria

Amp+Gent

if pen allergy: Bactrim+/- Genta

N.meningitidis

Ceftriaxone +Vanco

if neonates or elderly give Ampicillin to cover Listeria

for neonates Cefotaxime or Gentamycin+ Ampicillin

Dexamethazone as add on

close contacts: vaccine &Abx:

Rifampin 600mg po bid×2d or

Cipro 500 mg po ×1 or

Ceftriaxone 250mg ×1 IM

N. gonorrheae

Ceftriaxone 500 mg IM×1

if chlamydia is not excluded,add

Doxycycline 100mg po BID×7 days

if cephalosporin allergy

Azitromycin 2g +Gentamycin 240mg IM

or

Azithromycin+ Gemifloxacin 320mg po

for all newborns apply Erythromycin ophthalmic for prophylaxis

alternative:(Suprax)Cefixime PO

TRI to FIX my gonorrhea

Moraxella catarrhalis

causes PHM

Pneumococcus

Haemophillus

Moraxella

Abx for Pseudomonas

Piperacillin/Tazobsctam-Zosyn

Ceftazidime-Fortaz ,Tazicef

Cefepime- Maxipime

Cefidericol- Fetroja

Ceftazidime-avibactam-Avycaz

Ceftolozane-tazobactam-Zerbaxa

carbapenems:Doripenem

meropenem: imipenem

Recarbio- imipenem-cilastatin-relebactam)

fluoroquinolones: cipro(po), levo,Dela

aminoglycosides: as adjunct

monobactam: Aztreonam (Azactam)

​

H. pylori

Triple therapy: PREVPAC

Clarythromycin 500mg bid+Amox 1g bid (or metronidazole) +PPI bid×14days

if PCN allergy: Metronidazole 500ng bid

Bismuth Quadruple therapy: PYLERA

Metronidazole +Bismuth+ Tetracycline 3 caps qid after meals &at bedtime ×10 days

​

Clostridium perfringens(gas gangrene)

zosyn+Clindamycin

(penicillin+Clindamycin)

amputation

Clostridium difficile

ORAL VANCOMYCIN 125mg QID ×10days

OR

ORAL Fidaxomycin (Dificid) 200mg BID×10 days

for fulminant cases: Vanco 500mg QID+IV Metronidazole

for recurrence:po vanco for 2-8 weeks od Dificid if vanco was used in 1st episode

Bezlotoxumab(Zinplava): for recurrence of CDI(watch for HF)

​

Syphilis

Bicillin-LA

alt: tetracycline, doxy, ceftriaxone

early syphilis: PCN G 2.4 million IM×1

late syphilis: pcn G 2.4 million IM weekly for 3 weeks

neurosyphyllis: Aqueous PCN G 3-4 million IV q4h for 10-14 days

Lyme disease( borrelia burgdorfery)

​

Doxy 10-14 days

or

Amoxy 14 days

or

cefuroxime(ceftin) 14 days

Lyme carditis and Lyme neurologic ×14-21 days

Lyme arthritis: 28 days

in severe cases IV ceftriaxone 14-21 days (in lyme arthritis IV ceftriaxone 28days!)

infective endocarditis

Vanco IV +/- gram (-) coverage

alt: oxacillin/nafcillin +Gentamycin

IE dental prophylaxis

pts with prosthetic heart valve, history of IE, cardiac transplants

Amox 2g PO 30-60 min prior the procedure

if PCN allergy:

cephalexin 2g po,

azithromycin or clarythromycin 500mg PO ,

Doxy 100mg PO

if NPO-> cefazoline or Ceftriaxone 1g IM/IV

​

cellulitis/ Erysipelas/ Abscess

cellulitis-Cephalexin

abcess-drainage and Bactrim ,doxy or Clindamycin

diabetic skin infxns: superficial staph+strep

deep: gram negative+anaerob

Intra-abdominal infxns

​

1. Ertapenem(Invanz) or zosyn

2.Levaquin/cipro+metronidazole

prophylaxis: cefazolin+/- metronidazole

alternative: cefOtetan or cefOroxime

(O for anaerObes)

​

UTI

causes PEKEPS

TX:

acute cystatis: bactrim, nitrofurantoin×3 days,

fosfomycin 3g ×1 dose

for complicated UTI-quinolones(except Moxi)

pyelonephritis: bactrim, urinary fluoroquinolones(cipro/levo) 10-14 days

acute cystatis in pregnancy

beta lactams

fosfomycin

macrobid- if not at term

piperacillin/tazobactam( Zosyn)

higher dosages are for HAP(4.5g IV q6hrs

if crcl 20-40 give 4.5 GRAM q8h or 3.375g q6h

crcl<20 give 4.5 GRAM q12h or 2.25g q6h

​

PCN allergy

avoid: penicillins, cephalosporins, carbapenems

photosensitivity

Bactrim

fluoroquinolones

tetracycline

Ceftriaxone (Rocephin)

NO renal adjustment !!!

Do not mix with CA

Do not give to neonates

meningitis & endocarditis-2g IV q12h

gonorrhea -500 mg IM ×1

​

VancOmycin

​

OtOtOxicity, nephrOtOxicity& red man syndrome

15-20 mg/kg IV infusion over at least an hour!!!!

the Longer is the Duration the more bacteria it kills

trough levels- 10-20mcg/ml. check before the 4th dose

for pts with BPOEM-levels have to be 15-20mcg/ml. in case of low levels increase THE DOSE

bacteremia, endocarditis, osteomyelitis, meningitis, HAP)

if the renal fnxn goes down

increase the INTERVAL

Vancomycin (Vancocin)

oral solution Firvanq

refrigerate before and after reconstitution

seizure causing meds

Tramadol

tapentadol(nucenta)

meperedine(demrol)

bupropion

​

Aminoglycosides

OtOtoxicity &nephrOtOxicity

pseudomonas & gram(-)

be sure kids don't have tubes in the ears while on this drugs. may lead to possible hearing loss.

[ex:neosporin has neomycin].

PEAK is important! dose dependant

Gentamycin 5-10, trough <2

check the peak AFTER the 3rd dose

if peak is not met- INCREASE THE DOSE

Gentamycin

usually given 3-5 mg/kg/day q8h IM/IV

can be given DAILY! 4-7MG/KG/DOSE IV Q24H

​

Daptomycin (CubiciN) IV ONLY

NS only!

do not use in Pneumonia!

causes myopathy. d/c statin while on cubicin

single-use vials ONLY!

alternatives for Cubicin: zyvox& synercid

Fluoroquinolones -floxacines

CAP(never cipro)

UTI(never Moxi)

STDs

avoid in kids<18y.o!!!

increases warfarin

photosensitive

QT prolongation

C-Cns effects ,Crystal formations in kidneys(drink a lots of H2O))

I-insulin( hypo,hyper)

P-peripheral neuropathy

R-rupture of tendon

O-phOtosesitivity, QT prolongation

stop tube feeding for 2 hours before and 4 hours after

cipro IV to Po 80%

Moxi-no renal adjustment

Levo-QD

Macrolies

QT prolongation

Inhibitors except Zpak

zpak -on empty stomach

otitis media

DOC: AMOX 90mg/kg/day ÷2 doses

ALT: AZITHROMYCIN (in pcn allergy)

Doxycycline(Vibramycin, Acticlact, Doryx MPC, Oracea)

with FOOD

stay up for 30min

ok in renal impairment

​

Minocycline

Minocin

Solodyn

Ximino

Amzeeq

​

Tetracycline

Sumycin

Tetracyclines

​

separate from antacids

give with food

photosensitive

avoid kids<8y.o and pregnant

Metronidazole-Flagyl

avoid alcohol for 3 days

metallic taste

GI upset

Seizures

furry tongue

cyp2c9 inhibitor=⬆️warfarin

DOC: bacterial vaginosis( fishy odor)

alt: solosec(secnidazole) 2g packet

​

Linezolid (Zyvox)

thrombocytopenia(check cbc), neutropenia, anemia, serotonin syndrome[ avoid MAOIs, -triptans, Celexa, bupropion, Ritalin(⬆️NE,DA) ]

check vision

600mg q12h

no renal adjustment

Tidezolid(Sivextro)

200mg QD

similar to zyvox

Synersyd(Quinipristin/Dalfopristin) only IV

D5W only

gram (+), VRE [E. vaceum], MRSA

Tygacil (tigecycline)

100mg IV first, then 50mg IV q12h

Telavancin (Vibativ)

gram (+)

nephro/ototoxicity

IV only

give over an hour

​

Dalbavancin (Dalvance)

single dose regimen 1500 mg ×1

or

two-dose regimen: 1000mg IV ,then 500mg one week later

Oritavancin (Orbactiv, Kymyrsa 4 hrs in RT)

single dose is given over 3 hours

good for 6 hours at RT

refrigerate up to 12 hrs

using heparin 120hrs after oritavancin falsely ⬆️aPTT

Bactrim, Septra

PCP

treatment:Bactrim 15-20 mg/kg q6-8h for 14-21 days

prophylaxis: Bactrim 1DS QD

if sulfa allergy:Atovaquon(mepron)

treatment: 750mg po bid ×21 days with meal

prophylaxis: 1500mg QD

UTI

Bactrim 800/160mg PO q12h

uncomplicated uti: 3-5days

complicated: 7-10days

pyelonephritis: 10-14 days

prostatitis:up to 28 days

MRSA: 1DS po bid or 2DS po bid

bone marrow, hyperK, nausea,cbc

crcl: 15-30➡️50% dose

crcl<15➡️not recommended

D5W only! keep RT 6 hours

do not refrigerate

​

Rifaximin (Xifaxan)

traveler's diarrhea: 200mg po TID ×3DAYS

hepatic encephalopathy: 550mg po BID

Irritable bowel syndrome with diarrhea (IBS-d): 550mg TID×14 days

Abx safe in pregnancy

penicillins and cephalosporins

Erythromycin and Azitromycin (not clarythromycin)

Clindamycin

Nitrofurantoin (not after 38 weeks)

Daptomycin

metronidazole avoid in 1st trimester

bactrim avoid in 1st trimester abd at term

​

Do not refrigerate(suspension forms)

Azithromycin

clarythromycin

Clindamycin

fluoroquinolones

voriconazole