intra-abdominal infection

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intra-abdominal infection
2013-10-04 00:31:17
intra abdominal infection

Exam 2 Bayat (Intra-abdominal Infection)
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  1. who is considered high risk pt
    • health care assoc. intra-abdominal infection
    • delay in intervention > 24 hrs
    • advanced age
    • co morbidity/ organ dysfunction
    • low albumin (< 3.2)
    • poor nutritional status
    • diffuse peritonitis
    • presence of malignancy
    • high severity of illness
    • APACHE II score >= 15
  2. what are the single agent antibiotics used for high risk pts
    • carbapenems (primaxin, meropenem, doripenem)
    • Zosyn
  3. what are the combination antibiotics used for high risk pts with appendicitis
    • ceftazidime (Fortaz)
    • Cipro
    • Levofloxacin
    • Cefepime
    • + Flagyl
  4. single therapy antibiotics used to treat low/moderate risk appendicitis
    • cefoxitin
    • ertapenem
    • moxifloxacin
    • tigecycline
    • ticarcillin-clavulanic acid (Timentin)
  5. combination therapy used to treat pts with low to moderate risk appendicitis
    • cefazolin/flagyl
    • ceftriaxone/flagyl
    • cipro/flagyl
  6. how long is the duration of treatment for pts who are low/moderate risk for appendicitis
    3 days
  7. what is cholangitis
    acute inflammation of the common bile duct
  8. what is the most common cause of cholangitis
    cholelithiasis (kidney stones)
  9. what is the treatment for cholangitis
    source control - drainage of the biliary duct system
  10. what drugs are used to treat pts with acute community acquired cholangitis
    • Cefepime/flagyl
    • cipro/flagyl
    • levo/flagyl
    • Primaxin (imipenem/ciastatin)
    • zosyn (piperacillin-tazobactam)
  11. how to treat pts with health-care associated cholangitis
    same regimen as the acute community acquired just add vancomycin
  12. what is cholecystitis
    acute inflammation of the gallbladder
  13. source control treatment for cholecystitis
  14. how do you treat pts with mild/moderate cholecystitis
    • cefazolin
    • cefuroxime
    • ceftriaxone
  15. how do you treat pts with high risk cholectystitis
    • carbapenem
    • zosyn
    • cipro/metronidazole
    • levo/metronidazole
  16. what is cholangitis
    acute inflammation of the common bile duct
  17. what is the most common cause of cholecystitis
  18. what is source control for cholangitis
    drainage of the biliary ductal system
  19. how do you treat a pt with acute community acquired cholangitis
    • cefepime, cipro, levo + metronidazole
    • primaxin (imipenem/cilastatin)
    • zosyn
  20. how do you treat health care associated cholangitis
    same as acute community but add vancomycin
  21. treatment for mild - moderate cholecystitis
    • cefazolin
    • cefuroxime
    • ceftriaxone
  22. treatment for high risk pts with cholecystitis
    • carbapenem
    • zosyn
    • cipro or┬álevo + metronidazole
  23. what is spontaneous bacterial peritonitis
    infection in the peritoneal cavity in the absence of intra abdominal abnormalities
  24. antibiotics used to treat SBP
    • cefotaxime
    • ceftriaxone
  25. duration of therapy for SBP
    5 days
  26. which pts qualify for primary prophylaxis of SBP
    all cirrhotic pts presented with GI bleed or

    low ascetic protein concentration with abdominal risk factors
  27. what is the prophylactic treatment for SBP
    7 day course of norfloxacin or ceftriaxone
  28. which pts qualify for secondary SBP prophylactic therapy
    pts with at least one prior episode of SBP
  29. what is the tx for secondary prophylactic SBP
    life long treatment of oral norfloxacin or Bactrim
  30. sx of peritoneal dialysis associated peritonitis
    • abdominal pain
    • tenderness
    • nausea
    • diarrhea
    • fever
  31. dx of PD
    presence of > 100 cells/mm3 with neutrophilic predominance in dialysate fluid
  32. common pathogens of peritoneal dialysis - associated peritonitis
    coag - staph, s. aureus, E. coli
  33. antibiotics used to treat peritonitis
    ceftazidime, cefepime, or carbopenem + vancomycin
  34. duration of treatment for peritonitis
    14 days
  35. where do you obtain cultures from in PD infection
    • urine
    • peritoneal fluid
  36. what are the empiric antibiotics used for intra-abdominal infections - Health care
    • cefepime, cipro/levo, ceftazidime + flagyl
    • or
    • carbapenem
    • or
    • zosyn
    • all plus AG and vancomycin
  37. which bacteria is part of the normal GI flora
  38. when is emeric therapy used for intra-abdominal infections and enterococci
    • health care associated infections
    • immunocompromised pts
    • valvular heart disease
    • prosthetic intra-vascular materials
  39. what are the appropriate antibiotics used to treat enterococci
    • vancomycin
    • zosyn
    • ampicillin
  40. when is empiric therapy required for intra-abdominal infections for candida spp
    if cultured out of blood or intra-abdominal space
  41. antifungal of choice for intra-abdominal infections caused by candida
    echinocandin (caspofungin, micafungin, anidulafungin)
  42. which antifungal is used to treat isolated candida albicans
  43. drug of choice to treat MRSA
  44. what is the duration for antibiotics in complicated intra-abdominal infection
    4 - 7 days