what are the primary organisms on the surface of the skin?
staph and strep
What is given prior to surgery to reduce risk of infection
IV antibiotics
When should cefazolin or cefuroxime be infused before the start of surgery?
60 minutes before
If a quinolone or vanc is used for surgery, when should the infusion be started
120 minutes before
When should additional abx be given during surgery?
if the surgery is >3-4 hours or with major blood loss
When should antibiotics be stopped after surgery?
within 24 hours
what abx is preferred for most surgeries to prevent MSSA and strep infections
cefazolin
What is the abx preferred for surgery if the patient has a beta lactam allergy
clindamycin
What is the coverage needed for colorectal surgeries?
broad coverage of staph and strep along with broad gram negative and anaerobic coverage
What are the recomended abx for colorectal surgeries?
cefotetan, cefoxitin (only cephalosporins that cover anaerobes)ampicillin/sulbactam (acts the same as 2nd gen cephalosporins)ertapenem (also act the same as 2nd gen cephalosporins)ORmetronidazole + (cafazolin or ceftriaxone). Metronidazole provides the anaerobic coverage while the third gen cephalosporin provides some gram positive and gram negative coverage
What are recommended abx for colorectal surgery if the patient is allergic to beta lactams?
clindamycin (gram + cvg) + (aminoglycoside, quinolone, or aztreonam) (gram - coverage)- will not cover anaerobes unless moxi is chosen.ORmetronidazole (anaerobic cvg) + aminoglycoside or quinolone (quinolone gives more gram + coverage than aminoglycoside)
If there is mrsa risk for a surgical patient, what abx should be used?
vancomycin
Recommended abx for patients with cardiac or vascular surgery?
cafazolin or cefuroxime
recommended abx for patients with hip repair/join replacement surgery?
cefazolin
what are the classic symptoms of meningitis
feverheadachestiff neckaltered mental status
How is meningitis diagnosed?
lumbar puncture
What are possible bacterial causes of meningitis?
strep pneumoneisseria meningitisH. influenzaeListeria (among older adults)
What should Listeria be treated with for meningitis?
ADDITIONAL treatment with ampicillin
How long should a patient with meningitis ( N. meningitis and H influenzae) be treated?
7 days
How long should a patient with meningitis (s. pneumo) be treated?
10-14 days
How long should a patient with meningitis (listeria) be treated?
21 days
What can be given 15-20 minutes prior or with the first antibiotic dose to prevent neurological complications in meningitis treatment?
dexamethasone (continue for 4 days)
who is more susceptible to listeria meningitis?
neonates, age over 50, immunocompromised patients
what is preferred meningitis treatment for neonates?
ampicillin (cover listeria) + cefotaxime OR gentamicin
why cant ceftriaxone be used in neonates with meningitis?
biliary sludging and brain damage could result
What is the preferred meningitis treatment in ages 1 month to 50 years?
ceftriaxone or cefotaxime + vancomycin
What is the preferred meningitis treatment in ages over 50 or immunocompromised patients?
ampicillin+cetriaxone or cefotaxime+vancomycin
What is preferred meningitis treatment in patients with a penicillin allergy?
quinolone (moxi or levo) + vanc +/- bactrim (listeria cvg)
What are some signs of otitis media?
bulging eardrum (tympanic)otorrhea (middle ear fluid)otalgia (ear pain)tugging or rubbing ears
What is preferred for pain with otitis media?
systemic drugs like tylenol or ibuprofen rather than topical drops
how long should a patient be observed without abx with non severe otitis media
48-72 hours
What is antibiotic treatment for otitis media?
high dose amoxicillin or augmentin is first line for around a week
how much clavulanate should be with amoxicillin for otitis media
as low as possible (ratio of 14:1)- augmentin ES 600 is a good choice
otitis media patients with a nonsevere penicillin allergy should get
an oral cephalosporin (cefdinir, cefpodoxime)
nonsevere otitis media temperature
<102.2F
patients under 23 months old are automatically considered to have severe otitis media if
they have symptoms in both ears
What is the treatment dose of amoxicillin for otitis media?
80-90 mg/kg/day in 2 divided doses
What is the dose of augmentin for otitis media?
90 mg/kg/day in 2 divided doses with 6.4 mg/kg/day of clavulanate
What should be given to patients unable to tolerate oral medication with otitis media?
ceftriaxone IM or IV
What are the cephalosporin alternatives to penicillins for otitis media?
cefdinir tabscefuroxime tabscefpodoxime tabsceftriaxone IM/IV
If the first treatment of otitis media fails use
augmentin oral or ceftriaxone IM/IV
When is it considered that otitis media treatment failed? (what length of time)
48-72 hours of treatment and unimproved sx
Common cold symptoms
sneezing, runny nose, cough
common influenza sx
sudden onset feverchillsfatiguebody aches
common strep throat sx
sore throatswollen lymph nodeswhite patches on tonsils
sinusitis sx
nasal congestionfacial/ear/dental painheadache
influenza patients should only be treated is they have had sx for
under 48 hours
when should strep be treated
positive antigen diagnostic test (tonsil swab)
when should sinusitis be treated
>10 days of sx OR>3 days of severe sx (fever, face pain)ORsymptoms worsen after initial improvement
What is first line for common cold
otc products
what is first line for the flu
oseltamavir for 5 daysbaloxavir 1 dosezanamivir inhalation for five days
What is first line for strep
penicillin, amoxicillin for 10 days
what is first line for sinusitis
augmentin
when to use abx for 5-7 days for a copd exacerbation
if they have increased dyspnea, sputum volume and sputum purulenceORif they have increased sputum purulence plus increased volume or dyspneaOR if they are mechanically ventilatedwithout purulent sputum all three symptoms are needed
What is the preferred abx for a copd exacerbation
1. augmentin2. azithromycin3. doxycycline
symptoms of bronchitis
cough lasting more than 5 days
What causes acute bronchitis
viruses
What is a bacterial cause of bronchitis
bordatella pertussis
diagnosis of bronchitis is done through
ruling out other causes. chest xrays are usually not done
What is treatment for bronchitis
supportive therapy, antibiotics not recommended unless there is pneumonia. however, if it is bordatella pertussis, treat with a macrolide (azithromycin/clarithromycin) or bactrim
what are sx of pneumonia
coughpurulent sputumralestachypnea
What is the gold standard for diagnosis of CAP
chest x-ray- infiltrates- consolidations
When cap is mild it is called
walking pneumonia
what are the bacterial causes of cap
s. pneumoh. influenzaem. pneumo
what is the duration of treatment for CAP
5-7 days
what patients require broader coverage of possible drug resistant strep pneumo with cap
patients with comorbidites or are immune suppressed
What comorbidities determine cap treatment
chronic heart, lung, renal, liver diseasediabetesalcoholismmalignancyasplenia (no spleen)
when should a cap patient be treated as if they have Hap
if they received parenteral abx in the last 90 days or if they had a respiratory isolation of Mrsa or PA before
What is cap treatment for patients with no comorbidities
1. high dose amoxicillin (1gram TID) OR2. doxycyclineOR3. macrolide (azithromycin or clarithromycin if local pneumonia resistance is <25%)
What is cap treatment for patients with comorbidities
1. beta lactam + macrolide or doxy -augmentin/cefpodoxime/cefdinir/cefuroxime2. respiratory quinolone monotherapy (moxi, gemi, levo)
What is cap treatment inpatients
Antibiotics IVbeta lactam + macro lide or doxyOR respiratory quinolone monotherapy
What are the preferred beta lactams for inpatient cap treatment
Ceftriaxone, cefotaxime, ceftaroline, or unasyn
What is severe cap treatment (ICU)
Beta lactam + macrolideORbeta lactam + respiratory quinolone
If a cap patient should take if they have risk factors for MRSA
Vancomycin or linezolid
If a cap patient is at risk for PA they should take
Zoysia, cefepime, ceftazidime, imipenem/cilastatin, mereopenem or aztreonam
Onset of hospital acquired pneuomnia
Greater than 48 hours after hospital admission
Onset of ventilator associated pneuomnia
>48 hours after the start of mechanical ventilation
What are the common pathogens in hap and vap
Nasocomial pathogens. Risk for mrsa, mdr gram negative rods including PA
What is the treatment of hap and vap if the patient has a low risk for mrsa or mdr pathogens
CefepimeZosyn
What is the treatment of hap and vap if the risk for mrsa is high or postive but there is a low risk for MDR pathogens
Cefepime + vanc OR meropenem + linezolid
What is the treatment of hap and vap if the patient is at risk for both mrsa and mdr pathogens (eg iv abx in the past 90 days)
Zosyn + cipro + vancORCefepime + gentamicin + linezolid
What increases the risk for mrsa or mdr
Positive mrsa nasal swabHigh prevalence of pathogen noted in hospital unitIv abx use within the past 90 days
What are some antibiotics for PA
ZosynCefepime/ceftazidime or ceftolozane/tazobactamLevofloxacin or ciproImipenem/cilastatin or meropenemTobramycin, gentamicin, or amikacinColistimethate or polymixin b
What are the two best abx for mrsa
Vanc or linezolid
Difference between latent and active tb
Latent lacks sx but active has sx of cough/hemoptysis, fever, and night sweats that can be transmitted by respiratory droplets.
Hospitalized patients with active tb require
Isolation in a single negative pressure room with contact precautions
How is latent tb diagnosed?
Tuberculin skin test (TST) also called a purified protein derivative test (PPD)
How is a tst or ppd test administered
Intradermally and the area is inspected for induration 48-72 hours later
Who may receive a false positive TB test?
Those who have recieve the bacille calmette guerin (BCG) vaccine (used in parts of the world with high tb rates). Use an IGRA test in these patients.
What is a positive diagnosis of tb for patients in close contact of recent tb cases or patients that are immunosuppressed.
>5 mm induration
What is a postive diagnosis of tb for patients that are recent immigrants, IV drug users, moderate immunosuppression, residents/employees of high risk congregate settings like prison inmates or healthcare workers
>10 mm induration
What is a positive diagnosis of tb for patients with no risk factors
>15 mm induration
How long are patients on latent tb therapy to increase completion rates
3-4 months
Shorter latent tb therapy duration lowers a patients risk for
Hepatotoxicity
What latent tb therapy should not be used in pregnant women
Inh and rifapentine
What latent tb therapy should patients get if they adults, children over 2, and HIV positive patients? (If art does not interact)
Inh and rifapentine
How long should a patient be on inh and rifapentine for latent tb
12 weeks via directly observed therapy (DOT)
What is the preferred latent tb regimen for children of all ages and hiv negative adults?
Rifampin
How long should a patient be on rifampin for latent tb
4 months
What is a latent tb therapy that can be used in adults, children of all ages, and HIV positive patients?
Isoniazid with rifampin
How long should a patient with latent tb be on isoniazid with rifampin therapy
3 months
What is the latent tb treatment of choice for pregnant women?
INH
How long is inh (isoniazid) treatment for latent tb?
6 - 9 months
How must a positive tb test be confirmed
With a sputum culture
How is M. Tuberculosis detected
Using acid fast bacilli stain (it is slow growing and this may take up to 6 weeks)
What is "RIPE" therapy for active tb?
RifampinIsoniazidPyrazinamideEthambutol
How long should a patient with active tb be on ripe therapy
2 months
How long is the second "continuous" phase of tb treatment?
Typically it is 4 months
What are the two drugs given during the continuous phase of active tb treatment
Rifampin and isoniazid
What is used to increase medication adherence in tb infections
DOT; preferred in the homeless, drug resistant disease, adherence issues, positive sputum smears and delayed culture posivity). Patients on this can take their meds 2-3 times a week instead of daily
What are 4 side effects of rifampin
Increased lftsHemolytic anemiaPositive coombs testFlu like syndrome
What is a very important counseling point with rifampin
It can stain contact lenses and clothing orange/red (body secretions turn this color)
What can replace rifampin in patients that have major drug interactions to it
Rifabutin
What is a boxed warning for INH
Hepatitis
What decreases the risk of INH associated peripheral neuropathy?
Pyridoxine 25-50 mg po
What are 3 side effects of inh therapy
Increased lftsDrug induced lupusPositive coombs test (hemolytic anemia)
What is a contraindication to pyrazinamide
Acute gout
What are two side effects of pyrazinamide
Gout and increased lfts
What are four side effects of ethambutol
Increased lftsOptic neuritis that is dose relatedConfusionHallucinations
Rifampin will decrease concentrations of what 3 drugs
Protease inhibitorsWarfarinOral contraception
What 4 drugs should rifampin never be used with??
ApixabanRivaroxabanEdoxabanDabigatran
What is required with ethambutol treatment
Monthly vision exams
Infective endocarditis usually affects the
Heart valves
How is infective endocarditis diagnosed
Echocardiogram and a positive blood culture.
What are the three most common organisms that cause infective endocarditis
StaphylococciStreptococciEnterococci
What is empiric treatment for infective endocarditis
Vanc and ceftriaxone
What is added to the infective endocarditis regimen for synergy
Gentamicin (used when infection is difficult to eradicate, such as prosthetic valve infections or when treating resistant organisms)
Adding gentamicin to an infective endocarditis regimen puts the patient at risk for
Additive nephrotoxicity
How long should a patient be treated for infective endocarditis
4-6 weeks of IV treatment
When gentamicin is used for infective endocarditis, what is the goal peak and trough?
Because it is a gram positive infection, the peak goal is 3-4 mcg/mL and the trough goal is <1
Preferred infective endocarditis treatment when the pathogen is viridians group streptococci
Penicillin or ceftriaxone +/- gentamicin
Preferred infective endocarditis treatement when the pathogen is staphylococci (MSSA)
Nafcillin or cefazolin (+ gentamicin and rifampin if prosthetic valve)
What can be used in place of penicillins in infective endocarditis if the patient has an allergy
Vancomycin
What is the preferred treatment for infective endocarditis when the pathogen is MRSA
Vancomycin (+gentamicin and rifampin if prosthetic valve)
What is an alternative to vancomycin for mssa and mrsa infective endocarditis when the patient has a beta lactam allergy and no prosthetic valve
Daptomycin monotherapy
What patients are at high risk for infective endocarditis?
Artificial prosthetic heart valve or heart valve repaired with artificial materialHistory of endocarditisHeart transplant with abnormal valve functionCertain congenital heart defects including heart/heart valve disease
What is infective endocarditis prophylaxis for high risk patients undergoing a dental procedure
Amoxicillin 2 grams 30-60 minutes before the procedure
What is the alternative medication for endocarditis prophylaxis in patients that are allergic to penicillin
Clindamycin 600 mg ORAzithromycin or clarithromycin 500mg
What patients are often at risk for spontaneous bacterial peritonitis
Patients with cirrhosis of the liver
What is another name for spontaneous bacterial peritonitis?
Primary peritonitis
What is the first line DOC for SBP (spontaneous bacterial peritonitis)
Ceftriaxone for 5-7 days
What can be used for primary or secondary prophylaxis of SBP
Bactrim or cipro
What are the most likely pathogens for secondary peritonitis?
Strep, enteric gram negatives and anaerobes (bacteroides fragilis)
What is cholecystitis
Inflammation of the gallbladder due to a gallstone
What is cholangitis
Infection of the common bile duct
What is important to cover with intra-abdominal infections (excluding primary peritonitis)
Anaerobes
What is an antibiotic that can be added to a regimen for intraabdominal infections for anaerobic coverage?
Metronidazole
Mild to moderate 2ndary peritonitis and cholangitis treatment options
All cover PEK, anaerobes, strep +/- enterococci1. Cefoxitin2. Ertapenem3. Moxifloxacin4. (Cefazolin, cefuroxime, ceftriaxone) + metronidazole5. (Cipro or levofloxacin) + metronidazole
What are the treatment regimens for high severity 2ndary peritonitis and cholangitis?
Cover PEK, CAPES, PA, anaerobes, strep, +/- enterococciCarbapenem (not ertapenem)Pipercillin/tazobactam(Cefepime or ceftazidime) + metronidazole(Ciprofloxacin or levofloxacin) + metronidazoleCefazolin + (aztreonam or aminoglycoside) + metronidazole
What are 3 systemic signs of a skin and soft tissue infections (SSTI)
Temp > 100.4HR > 90 BPMWBC >12,000 or <4,000 cells/mm3
What are the superficial SSTIs?
ImpetigoFurunclesCarbuncles
What is an example of a nonpurulent infection?
Cellulitis
What is an example of a purulent infection?
Abscesses
What is a sign of impetigo?
Honey colored crusts on nose, mouth, hands or arms
What is preferred treatment for impetigo
Warm wet compress and a topical abx like mupirocin (bactroban)
If a patient has numerous impetigo lesions
Cephalexin (keflex) 250 mg PO QID
Folliculitis/furuncles/carbuncles treatment if there are systemic signs
Cephalexin (keflex) 500mg PO QID
Carbuncles require
Incision and drainage before abx treatment
What nonpharm treatment can help folliculitis and furuncles?
Warm compresses
If a patient with folliculitis/furuncles/carbuncles is nonresponsive to keflex, change to what drug? (2 options)
MRSA coverageBactrim Doxycycline
Mild cellulitis should be treated wiht
Abx active against strep +/- MSSACephalexin
What is mild to moderate purulent abscess caused by usually
CA MRSA
What is the treatment of mild to moderate abscess if there is systemic signs or multiple sites?
1. I & D2. Bactrim or doxyMRSA coverage
Severe purulent SSTI treatments
Antibiotics with MRSA coverage1. Vancomycin2. Daptomycin3. Linezolid
Necrotizing fascitis treatment
Vancomycin + beta lactam (piptazo, imipenem cilastatin, meropenem)
Diabetic foot infections are usually
Polymicrobial so broad spectrum coverage
What can a diabetic foot infection lead to ?
Osteomyelitis
When no mrsa coverage is needed how should a diabetic foot infection be treated?
UnasynZosynCarbapenemTigecycline (last line)Moxifloxacin
When mrsa or Pa coverage is needed, what diabetic foot infection treatment should be chosen?
Vanc plusCeftazidim/cefepime/zosyn/aztreonam/carbapenem (not ertapenem)Consider adding metronidazole if ceftazidime/cefepime/aztreonam is selectiveAlternatives to vanc are dapto or linezolid
What is the duration of treatment for nonsevere diabetic foot infection
7-14 days
What is the duration of treatemnt for severe deep tissue diabetic infection
2-4 weeks
What is duration of treatment for severe limb threatening or bone/joint infection
4-6 weeks
What are the signs of a lower uti (cystitis)
Urgency/frequencyNocturiaDysuria (painful urination)Suprapubic heavinessHematuria
What are the signs of an upper uti (pyelonephritis)
Flank/painAbdominal pain, nausea, and vomitingFever/malaise
What are the signs of vaginal candida infections
Extremely itchy with white thick discharge
When is a uti considered noncomplicated
NonpregnantPremenopausal women with no urologic abnormalities or comorbities
When is a uti considered complicated
MaleIndwelling catheterNeurogenic bladdder
How is a uti diagnosed
With a urinalysisPyuria (wbc over 10)And bacteruria (>10^5 bacteria/mL in asymptomatic pts, >10^3 bacteria in symptomatic males and >10^2 in symptomatic females and cathetarized patients
What is the most common pathogen for acute uncomplicated cystitis?
E.coli
What is the drug of choice for acute uncomplicated cystitis? there are 2
Macrobid (nitrofurantoin) 100mg po bid with food for 5 daysORBactrim DS tablet for 3 days
Who should not have macrobid
Crcl <60
Who should not have bactrim
Sulfa allergy or high e.coli resistance
What are the best abx for pregnancy uncomplicated cystitis
Cephalexin or amoxacillin
What can be added to uti treatment to relieve dysuria
Phenazopyridine (pyridium)
What is treatment for acute uncomplicated pyelonephritis moderately ill outpatient (PO) if local quinolone resistance is <10%
Ciprofloxacin 500mg po BID for 7 daysLevofloxacin 750 mg po daily for 5 days
For acute uncomplicated pyelonephritis treatment if local quinolone resistance is >10%
CeftriaxoneSMX/TMPBeta-lactam
Treatment for acute uncomplicated pyelonephritis for severely ill hospitalized patient (IV)
Initial: cipro or levofloxacin OR gentamicin +/- ampicillin/zosyn/ceftriaxone OR a carbapenem. Treat for 14 days
What is the treatment for a complicated uti
Carbapenem if esbl producing bacteria are present. Treat similar to pyelonephritis
What is the brand name of phenazopyridine?
Pyridium, azo
How long can phenazopyridine be used
2 days max
What is a side effect of phenazopyridine?
Red orange urine coloring and other body fluids like contact lenses/clothes can be stained
How should phenazopyridine be taken?
With food to minimize stomach upset and 8oz of water
What is the preferred treatment of bacteruria in pregnancy
Augmentin or an oral cephalosporin
What uti treatment should be avoided in pregnancy
Quinolones due to toxicity
What causes 80-90% of travelers diarrhea cases
E.coli
What are less common causes of travelers diarrhea
Campylobacter jejuni, shigella spl and salmonella
What is a sx of travelers diarrhea
Dysentery (bloody diarrhea)
What is the preferred abx for dysentary
Azithromycin
What is the preferred abx if blood diarrhea is not present
Quinolones, rifaximin
Preferred travelers diarrhea treatment if fever, blood in stoools, pregnant, or pediatric
Azithromycin 1000mg PO x1 or 500 mg PO daily x1-3
Preferred travelers diarrhea treatment if no fever, no blood in stools, not pregnant, or not pediatric
Cipro, levofloxacin, oflaxacin, rifaximin
What does cdiff release
Toxin A and B that attack the intestinal lining
What are the sx of cdiff
Abdominal cramps, profuse diarrhea, fever
What can cdiff lead to
Pseudomembranous colitis which can lead to toxic megacolon
What should not be used for cdiff
Antidiarrheal medication
If a patient is having multiple loose stool on an antibiotic
Discontinue abx as soon as possible
How is cdiff diagnosed
Positive cdiff stool toxin test or positive c diff culture
What is considered non severe for cdiff
Wbc <15000 and scr <1.5
What is considered severe for cdiff
Wbc >15000 scr >1.5
What is considered fulminant/complicated cdiff
Signifiant systemic toxic effects present (hypotension, shock, ileus or toxic megacolon)
What is the treatment for the 1st episode of a nonsevere or severe cdiff
VAN 125 my PO QID for 10 days ORFDX (fidaxomycin, dificid) 200mg PO BID for 10 days
What is a treatment for nonsevere cdiff if vanc and fidaxomycin are not available
Metronidazole 500 mg PO TID x 10 days
What is cdiff treatment for the 1st epidode of fulminant/complicated disease
Vanc 500 mg PO/NG/PR QID + metronidazole 500mg IV q8h
What is the treatment for the 1st recurrence of cdiff if the patient was given metronidazole for the first episode
Vanc 125 mg PO QID x 10 days
What is the treatment for the 1st recurrence of cdiff if the patient was given vanc for the initial episode
Fidaxomicin 200 mg po BID x 10 days
If vanc or fdx are used for the initial episode for cdiff, what should be given if it reoccurs?
Vanc tapered and pulsed regimen. Ex: 125mg po QID 10 days, BID 1 week, daily x1 week, then 125 mg every 2-3 days for 2-8 weeks
Sx of chalmydia
Discharge, no sx
Sx of gonorrhea
Discharge, no sx
Sx of syphilis
Painless, smooth genital sores
Sx of hpv
Genitval warts or no sx
Bacterial vaginosis sx
Discharge clear/white/grey; fishy odor; ph >4.5; little or no pain
Trichomoniasis sx
Discharge yellow/green; soreness, pain with ix
What is the doc for syphillis
Bicillin LA
What is the dose used for syphillis
Bicillin LA 2.4 million units IM x 1
What is an alternative syphillis treatment in patients allergic to beta lactams
Doxycycline
What patients allergic to beta lactams with syphillis should still receive bicillin la?
Pregnant patients and HIV positive patients with poor compliance/follow up
How is syphilis diagnosed?
Rapid plasma reagin (RPR), venereal disease research lab (VDRL) blood test
What is the dosing for syphillis that has been going on for a year or unknown duration?
Bicillin La 2.4 million units IM weekly for 3 weeks
What is the treatment for neurosyphilis and congenital syphilis
Penicillin G aqueous crystalline
What is the doc for gonorrhea
Ceftriaxone + azithromycin (preferred) or doxy
What is the dosing of ceftriaxone for gonorrhea
250 mg IM x 1
What is the dosing of azithromycin for gonorrhea
1 g po x 1
What is the doc for chlamydia?
Azithromycin
What is the dose of azithromycin for chlamydia
1g po x1
What is the doc for bacteria vaginosis
Metronidazole or metronidazole 0.75% gel
What is a counseling point for bacterial vaginosis
Females with bacterial vaginosis should not douche
What is the doc for trichomoniasis
Metronidazole
What is the dose of metronidazole for trichomoniasis
2 g PO x1
What should a pregnant woman take for trichmoniasis
Metronidazole
What is the doc for genital warts (HPV)
Imiquimod cream
What is Aldara (imiquimod cream) also approved for besides hpv?
For superficial basal cell carcinoma
How can hpv be prevented
Gardasil vaccine
Gardasil reduces risk of
Cervical and other cancers
Gonorrhea treatment with also treat what?
Chlamydia. They both use azithromycin 1g x1
How should a pencillin allergy be confirmed in a pregnant woman with syphillis
Confirm with skin prick test
What are rickettsial diseases
Diseases carried by ticks, fleas, and lice
What is the most fatal illness caused by ticks/fleas/lice
Rocky mountain spotted fever
What is the treatment of rocky mountain spotted fever
Doxycyline (also the doc for pediatric pts)
What is the doc for lyme disease
Doxy
How can you get typhus or ehrlichiosis?
From ticks/fleas/lice
How is tularemia treated?
Gentamicin or tobramicin
How is lyme disease diagnosed
Enzyme immunoassay (EIA)