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causative organism of sinusitis
- S. pneumoniae
- H. influenza
- M. catarrhalis
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7 S & S of sinusitus
- mucopurulent discharge
- congestion
- periorbital swelling
- facial pain
- maxillary toothache
- fever
- nonproductive cough
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4 goals of Tx of sinusitis
- symptomatic relief
- restore & improve sinus function
- prevent complications
- eradiate pathogens
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sinusitis first line therapy in peds w/no PCN allergy
amox 80-90 mg/kg/day in 2-3 doses
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sinusitis first line therapy in peds w/ PCN allergy non-type 1
cefdinir 14 mg/kg/day in 1-2 doses
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sinusitis first line therapy in peds w/ PC allergy type 1
azithromycin 10 mg/kg day 1 then 5 mg/kg/day on days 2-5
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sinusitis first line therapy in adults w/no PCN allergy
amox 1 g PO TID
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sinusitis first line therapy in adults w/ PCN allergy non-type 1
cefdinir 600 mg PO QD 1-2 doses
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sinusitis first line therapy in adults w/ PCN allergy type 1
azithromycin 500 mg on day 1 then 250 mg on days 2-5
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Tx of acute sinusitis > 7 days or > 101 and no previous Tx in past month
- high dose amoxicillin
- or
- macrolide for 10-14 days
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Tx of acute sinusits > 7 days or > 101 and previous Tx in past month
- augmentin
- or
- oral cephalosporin for 10 - 14 days
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causative organisms of otitis media
- up to 75% of cases are viral
- S. pneumonia 49%
- H. influenzae 29%
- M. catarrhalis 28%
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6 S&S of otitis media
- rapid onset
- otalgia
- fever
- irritability
- ear tugging
- hearing loss
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5 goals of Tx of otitis media
- control pain
- eradicate infection
- prevent complications
- avoid unnecessary antibiotics
- minimize adverse effects of Tx
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symptomatic Tx of otitis media
- analgesics
- antipyretics
- local heat
- tympanostomy tubes for recurrent episodes
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Tx of otitis media in peds w/no PCN allergy
amox 80-90 mg/kg/day in 2-3 doses
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Tx of otitis media in peds w/ PCN allergy non-type 1
cefdinir 14 mg/kg/day in 1-2 doses
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Tx of otitis media in peds w/ PCN allergy type 1
azithromycin 10 mg/kg day 1 then 5 mg/kg/day on days 2-5
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Tx of otitis media in peds w/no PCN allergy and a severe illness
augment 90 mg/kg/day in 2 doses
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Tx of otitis media in peds w/ PCN allergy non-type 1 and a severe illness
clindamycin 30-40 mg/kg/day in 3 doses
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Tx of otitis media in adults w/no PCN allergy
amox 1 g PO TID
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Tx of otitis media in adults w/ PCN allergy non-type 1
cefdinir 600 mg PO QD 1-2 doses
-
Tx of otitis media in adults w/ PCN allergy type 1
azithromycin 500 mg on day 1 then 250 mg on days 2-5
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Tx of acute otitis media in kids w/no antibiotic in past month
amoxicillin 80-90 mg/kg/day
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Tx of acute otitis media in adults w/no antibiotics in past month
amoxicillin 1000mg TID
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Tx of acute otitis media 3 days later and responding vs no response
- continue
- stop amoxicillin and start augmentin
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causative organisms of pharyngitis
- group A strepotoccus - most common
- viruses
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5 S&S of pharyngitis
- sore throat
- fever
- dysphagia
- red,swollen tonsil
- malaise, HA, abdominal pain, vomiting
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3 goals of Tx of pharyngitis
- resolve symptoms
- limit spread
- prevent complications
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Tx of symptomatic pharyngitis
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Tx of pharyngitis Group A strep
- PCN is drug of choice, tx for 10 days (can use amoxicillin)
- alternates
- macrolides
- 1st gen cephalosporins
- clindamycin
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acute otitis media < 6 mo with a certain diagnosis
antibacterial therapy
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acute otitis media < 6 mo w/ an uncertain diagnosis
antibacterial therapy
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acute otitis media 6 mo - 2 yo w/ certain diagnosis
antibacterial therapy
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acute otitis media 6 mo - 2 yo w/ an uncertain diagnosis
- antibacterial therapy if severe illness
- observation if non-severe illness, 48-72 hours prior to starting antibiotics
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acute otitis media > 2 yo w/ certain diagnosis
- antibacterial therapy if severe illness
- observation if non-severe illness, 48-72 hours prior to starting antibiotics
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acute otitis media > 2 yo w/ uncertain diagnosis
observation option, 48-72 hours prior to starting antibiotics
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