What pathogen is highly associated with CAP in general population? -
streptococcus pneumoniae
Other common pathogens with CAP - atypical bacteria
... [Show More] (mycoplasma pneumonia)
viruses (influenza, respiratory syncytial virus)
First line treatment CAP in previous healthy adults - Amoxicillin, doxycycline,
macrolides (DAM)
Treatment of CAP in pregnancy - amoxicillin, cephalosporins, erythromycin
(ACE)
Treatment for mycoplasma pneumonia in the pediatric patient - Macrolides
(erythromycin, clarithromycin, azithromycin)
treatment of chlamydial pneumonia in infant - Erythromycin base/ethylsuccinate
Broad spectrum antibiotics - when to use? - empiric therapy
When you don't know which bacteria it is
more likely to facilitate emergence of drug-resistant organisms and superinfections
prescribe these before culture results back
suspects patient has UTI
Narrow spectrum antibiotics - when to use? - When the pathogen is known
Preferred
What are empiric antibiotics? - Broad Spectrum antibiotics that are given BEFORE
the results are in for certain circumstances.
Also can be prescribed when the NP believes it is a certain disease.
A)Prescription for an antibiotic for severe infection based on knowledge
B)Prescription of an antibiotic for severe infection based on clinical evaluation
C)Prescription of antibiotic for severe infection based on most likely causative
agent
When to prescribe empiric antibiotics? - E for Emergency
E for enticpation
Embulatory patientsPt has severe infxn, initiate treatment before test results available
How to treat C Diff - Stop taking the abx that caused it
flagyl and vancomycin
Drug class known for all drugs in class to promote development of C diff -
cephalosporins (especially second or third generations)
Penicillin's have cross-sensitivity with which drug class? - cephalosporins
Can you take penicillin's if pregnant? - Yes
Can you prescribe cephalosporins if pregnant? - yes
Patient education needed for cephalosporins - Can promote C diff, instruct patients
to report increase in stool frequency
Can you prescribe tetracyclines in pregnant patients - No - can cause tooth staining
Patient education for tetracyclines - Photosensitivity. Advise patients to avoid
prolonged exposure to sunlight, to wear protective clothing, and to apply sunscreen
to exposed skin/avoid tanning beds.
Instruct patients not to take this medication together with calcium supplements,
milk products, iron supplements, magnesium-containing laxatives, and most
antacids.
Advise patients to notify the provider if diarrhea occurs, as this is an indication of
potentially life-threatening superinfection of the bowel.
Macrolides patient education - increased risk of Torsades due to prolonged QT
Which macrolide is ok for pregnancy? - erythromycin
Aminoglycosides patient education (ex. gentamicin, tobramycin, amikacin) - use is
associated with ototoxicity and nephrotoxicity [Show Less]