Midterm Exam Study Guide
Common CAP pathogens
S. Pneumoniae (most common)
H. Influenzae (smokers/COPD)
P. Aeruginosa (CF)
CAP first line treatment
Macrolides, Doxycyline, Amoxicillin
what to give if 1st CAP treatment doesn't work?
Respiratory Fluoroquinolone if not received abx in the past 3 months
Mycoplasma pneumoniae
atypical pneumonia; commonly seen in children
pediatric atypical pneumonia treatment
Macrolides (Erythromycin), if failed then Respiratory fluoroquinolone
CAP treatment during pregnancy
Amoxicillin, cephalosporins, or Erythromycin
Treatment of chlamydial pneumonia in infant
Macrolide (Azithromycin): 500mg orally on day 1 followed by 250 mg once daily on days 2-5
When to use broad/empiric spectrum antibiotics?
Before cultures are resulted/ critically ill patient after first culture obtained, based on NP knowledge of
patient history, local susceptibility/geographic location
When to use narrow spectrum antibiotics?
Used when the culture and sensitivity is resulted, and pathogen is known.
how to treat C.diff
Stop the antibiotic that may have caused it
1st: Vancomycin 125 mg PO QID x 10 days.
2nd: Metronidazole 500mg PO TID x 10 days
address hydration
Drug class known for ALL drugs in class to promote development of C. Diff
, 2nd and 3rd generation Cephalosporins
Penicillin: Cross-sensitivity reactions with which drug classes
Cephalosporins & Carbapenems
(Allergy may be mild or severe)
Safe penicillin during pregancy
Amoxicillin
patient education for Cephalosporins
Report to provider any loose stools, complete full course of antibiotics, s/s of allergy
Cephalosporins in pregnancy
All appear safe for use
patient education for Tetracyclines
photosensitivity (wear sunscreen!), complete full course, s/s of allergy
Tetracyclines in pregnancy
Can lead to fetal death; avoided for use
Patient education for macrolides
Take with meals to avoid GI upset, contraindicated w/ warfarin
Aminoglycoside patient teaching
Patients should report tinnitus, high-frequency hearing loss, persistent headache, nausea, dizziness or
vertigo
sulfonamides patient teaching
Finish full course
Increase fluid intake to 8-10 cups/day
Take on empty stomach
Avoid sun exposure/wear sunscreen
Sulfonamides during pregnancy
not to be used during 1st trimester, can cause kernicterus in infants
Gentamicin renal dose adjustments
decreased dosage for renal impaired
tinea capitis treatment
oral griseofulvin