Infections Causes & Treatment

Infections Causes & Treatment

Infections Causes & Treatment

Pneumonia (OPD)

Causes– Streptococcus pneumoniae, Legionella, mycoplasma pneumonia, chlamydia.

Treatment choice- Cap. Doxycycline 100 mg BD.

Pharyngitis (OPD)

Causes- Group A Streptococcus.

Treatment choice- Cap. Amoxicillin 500mg- 1g TID 10 days.

Pelvic inflammatory disease (OPD)

Causes- Neisseria gonorrhoeae, Chlamydia trachomatis, gram-negative rods, anaerobes,

Treatment choice- Ceftriaxone 250 mg IV STAT plus doxycycline 100 mg orally twice daily for 14 day +/-Tab. metronidazole 500 mg BD 14 days.

Pyelonephritis with flank pain and fever (recurrent urinary tract infection) (sick patient)

Causes- E coil, klebsiella, Enterobacter, pseudomonas.

Treatment choice- Ceftriaxone, 1g IV OD; or if culture result confirm susceptibility, or IV levofloxacin, 500 mg OD.

Pneumonia, postoperative or nosocomial (sick patient)

Causes- S aureus, mixed anaerobes, gram- negative bacilli.

Treatment choice-

Cefepime 2g IV Q8H; or ceftazidime, 2g IV  Q8H; or piperacillin- tazobactam, 4.5 g IV Q6-8 H; or meropenem 1g IV Q8H

PLUS

tobramycin 5-7 mg/kg IV OD; or levofloxacin 500 mg IV OD 

plus

vancomycin 15 mg/kg/dose IV Q12H.

Pneumonia, acute, community-acquired, non-ICU hospital admission (sick patient)

Causes– Pneumococci, M pneumoniae, legionella, C pneumoniae.

Treatment choice– Ceftriaxone 1g IV OD; or ampicillin 2g IV Q6H, plus azithromycin 500 mg IV OD; or Levofloxacin 750 mg IV OD.

Pyelonephritis (OPD)

Causes

E coli, K pneumoniae, proteus species, S saprophyticus.

Treatment choice- Tab. Ciprofloxacin 500 mg bd for 7 days.

Urethritis/ epididymitis

Causes- N. gonorrhoeae, C. trachomatis.

Treatment choice

Ceftriaxone 250 mg IV STAT plus T. azithromycin (or C. doxycycline) for N gonorrhoeae;

Tab. azithromycin 1g OD, or Cap. doxycycline 100 mg BD 7 days, for C. trachomatis.

Gastroenteritis

Causes- Salmonella, shigella, Compylobacter, Entamoeba histolytica.

Treatment choice- Salmonella, shigella Tab. Ciprofloxacin 500 mg BD 5 days,

Compylobacter- Tab. Azithromycin 1gm stat or Tab. Ciprofloxacin 500 mg BD 5 days,

 Entamoeba histolytica- Tab. Metronidazole 800 mg TID for 10 days & Tab. Quinidochlor 250 mg QID 14 days..

Diarrhea

Causes– Vibrio cholera.

Treatment– Cap. Doxycycline 300 mg stat.

Acute sinusitis

Causes- Streptococcus pneumonia, haemophilus influenzae, Moraxella catarrhalis.

Treatment choice- T. Amoxicillin+clavulanic acid 875 mg BD 10 days.

Cystitis

Causes- Escherichia coil, Klebsiella pneumonia, Proteus species, Staphylococcus saprophyticus, other gram-negative rode or enterococci.

Treatment choice- Granules Fosfomycin 3g Stat, Tab. Cephalexin 500 mg QID 7 days.

Brin abscess(SICK PATIENTS)

Causes- Mixed anaerobes, pneumococci, streptococci.

Treatment choice

Ceftriaxone 2g IV Q12H plus metronidazole, 500mg IV Q 8 H plus vancomycin 15 mg/kg IV Q 8 H.

Osteomyelitis (SICK PATIENTS)

Causes- S aureus, secondarilly gram-negative aerobes.

Treatment choice- Vancomycin 15mg/ kg IV Q 8H plus ceftriaxone 2g IV OD .

Intra-abdominal sepsis (eg postoperative, peritonitis, cholecystitis) (SICK PATIENTS)

Causes- Gram-negative bacteria, Bacteroides, anaerobic bacteria, enterococcus.

Treatment choice- Piperacillin-tazobactam 4.5g IV Q6 H; or ertapenem 1g IV OD.

Septic Arthritis(SICK PATIENTS)

Causes- S aureus, N gonorrhoeae.

Treatment choice- Ceftriaxone 2 IV OD.

Endocarditis, acute (including injection drug user) (SICK PATIENTS)

Causes- S aureus, E faecalis, viridans streptococci.

Treatment choice- Vancomycin 15mg/kg/dose IV Q 12H.

Meningitis, bacterial, age >50years, community acquired(SICK PATIENT) 

Causes- Listeria monocytogenes, Pneumococcus, meningococcus,  gram-negative bacilli group B streptococcus.

Treatment choice- Ampicillin 2g IV Q4H; plus ceftriaxone 2g IV12H; vancomycin 15mg/kg IV 8H.

Aspiration pneumonia

Causes- Mixed oropharyngeal flora, including anaerobes.

Treatment choice- Tab. Clindamycin 300 mg Q 6 H 10-14 days.

Furuncle with surrounding cellulitis

Causes- Staphylococcus aureus.

Treatment choice- T. Dicloxacillin 500 mg Q6H 7-10 days for MSSA.

For CA-MRSA:Tab. clindamycin 300 mg TID 7-10 days.

Erysipelas, impetigo, cellulitis, ascendung lymphangitis

Causes- Group A Streptococcus.

Treatment choice-T. Penicilin V 500 mg QID OR Tab. Cephalexin 500 mg QID for 7-10 days.

Otitis media

Causes- S pneumoniae, H influenzae, M catarrhalis.

Treatment choice- Cap. Amoxicillin 500 mg-1g TID 10 days.

Septic thrombophlebitis (eg IV tubing, IV shunts) (SICK PATIENT) 

Causes- S aureus, gram-negative aerobic bacteria.

Treatment choice- Vancomycin 15mg/kg/dose IVQ  12 H plus ceftriaxone 1g IV OD.

Meningitis, postoperative (or posttraumatic)

Causes- S aureus, gram-negative bacilli, coagulase-nigative staphyloccoi, diphtheroids (eg propionibacterium acnes) (uncommon) neumococcus (in posttraumatic).

Treatment choice- Vancomycin, 15mg/kg IV Q8H, plus cefepime 3g IV Q 8 H.

Fever in neutropenic patient reciving cancer chemotherapy(SICK PATIENT) 

Causes- S aureus, pseudomonas, klebsiella, E coli.

Treatment choice- Cefepime 2gIV Q 8H.

Meningitis, bacterial, community-acquired(SICK PATIENT) 

Causes- Streptococcus pneumoniae ( pneumococcus), Neisseria meningitidis (meningococcus).

Treatment choice- Ceftriaxone 2g IV Q 12H, plus vancomycin 15mg/kgIV Q8H.

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